Wall Quiz #7 Flashcards by Marcella Rodriguez

Which ethical principal is demonstrated by the patient choosing treatment or non-treatment after being informed of risks and benefits of both?
A. Justice
B. Beneficence
C. Autonomy
D. Paternalism
E. Nonmaleficence

C. Autonomy

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All of the following antigens related to hemolytic disease require fetal assessment, EXCEPT:
A. Kidd Jka
B. Rh (non-D) C 
C. Kell K
D. Kidd Jkb
E. Duffy Fya

D. Kidd Jkb

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Which part of the cell does ionization radiation affect?
A. Endoplasmic reticulum 
B. Mitochondria
C. Cytoplasm
D. Nucleus
E. Ribosomes

D. Nucleus

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Which of the following cancers is most diagnosed during pregnancy?
A. Cervical cancer 
B. Breast Cancer 
C. Ovarian Cancer 
D. Melanoma
E. Lymphoma

A. Cervical cancer

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What is the first step in management in a post menopausal female who presents with a bartholin gland duct cyst?
A. Drainage of cyst and biopsy of cyst wall
B. Excision
C. Warm compresses
D. Antibiotics

A. Drainage of cyst and biopsy of cyst wall

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Which of the following is the least likely laboratory test you would order on a patient who is suspected to have a bleeding disorder?
A. Von-Willebrand-Ristocetin cofactor activity
B. Von-Willebrand factor antigen
C. Factor VIII
D. Bleeding time
E. PT/PTT

D. Bleeding time

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All of the following muscles contribute to the urogenital sphincter complex EXCEPT:
A. Sphincter urethrae
B. Compressor urethrae
C. Urethrovaginal sphincter
D. Detrusor muscle fibers of the bladder base

D. Detrusor muscle fibers of the bladder base

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Which of the following would be an appropriate next step for a 19-year-old with suspected endometriosis who has failed initial medical treatment?
A. Referral for psychiatric evaluation
B. Levonorgestrel IUD
C. Uterosacral nerve ablation
D. Laparoscopy to confirm presence of endometriosis
E. Repeat the dose of GnRH agonist

D. Laparoscopy to confirm presence of endometriosis

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A patient presents with the following (picture of urethral prolapse) with complaint of a light bleeding. This lesion is most commonly found in which patient population?
A. Infant
B. Neonate
C. Postmenopausal 
D. Adolescence
E. Perimenopausal

C. Postmenopausal

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A 20-year-old G1P0 at 20 weeks gestation presents with cough, fever, and chest pain for 3 days. Chest radiograph shows left lower lobe infiltrate. What is the best management?
A. Vancomycin 
B. Moxifloxacin 
C. Azithromycin 
D. Levofloxacin 
E. Rifampin

C. Azithromycin

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Placental-site trophoblastic tumors most commonly develop following:
A. Missed abortion
B. Ectopic pregnancy
C. Molar pregnancy
D. Term gestation
E. Partial molar pregnancy

D. Term gestation

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The risk of fetal death before 32 weeks is increased in patients with elevated resistance in uterine artery doppler studies and is seen in all of the following conditions EXCEPT:
A. Incompetent cervix with cerclage 
B. Placental abruption
C. Pre-eclampsia
D. Fetal growth restriction
E. Acute fatty liver of pregnancy

A. Incompetent cervix with cerclage

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What days of the menstrual cycle constitutes the window of implantation for the human embryo?
A. Day 14 to 16 
B. Day 16 to 20 
C. Day 20 to 24 
D. Day 24 to 28

C. Day 20 to 24

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Which of the following medications is approved by the FDA and is likely to be associated with an increase sexual desire in premenopausal women?
A. Histamine receptor blockers
B. Estrogen and testosterone (Estratest)
C. Methyltestosterone
D. Flibanserin(Addyi)
E. GnRH releasing agonist

D. Flibanserin(Addyi)

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During a term CD an 3cm ovarian mass is encountered, suspicious for a mature cystic teratoma, what is the next best step?
A. Expectant Management
B. Cystectomy
C. TAH/BSO
D. Unilateral salpingo-oophorectomy 
E. Resect postpartum

B. Cystectomy

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Which of the following is the most sensitive and consistent test for ovarian reserve?
A. Estradiol level
B. Luteinizing hormone level 
C. Progesterone level
D. Antimullerian hormone level 
E. FSH

D. Antimullerian hormone level

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A patient presents POD#5 from TAH, she is 45-year- old with DM. Temp is 100.4 F. On exam the skin around the wound is red/purple with bullae and crepitus. The most effective first line treatment is:
A. Penicillin G
B. Daptomycin
C. Penicillin G and clindamycin
D. Imipenem
E. Vacuum-assisted wound closure

C. Penicillin G and clindamycin

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A 20-year-old G1P0 presents with vaginal bleeding. Her serum B-Hcg is 80,000 mIU/mL. Pelvic U/S shows diffuse mixed echogenic pattern. All of the following diagnostic tests are recommended EXCEPT:
A. PT/PTT
B. BUN/Creatinine 
C. AST/ALT
D. LDH
E. Chest X-Ray

D. LDH

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When using Ifosfamide (Ifex) in the salvage treatment of recurrent epithelial ovarian cancer, what is Mesna used to prevent?
A. Hypersensitivity
B. Pulmonary fibrosis 
C. Cardiotoxicity
D. Hemorrhagic cystitis 
E. Neurotoxicity

D. Hemorrhagic cystitis

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All of the following are side effects of spironolactone EXCEPT?
A. Vomiting
B. Post menopausal bleeding 
C. Excessive salivation
D. Dizziness
E. Mastalgia

C. Excessive salivation

All of the following are components in Enhanced Recovery After Surgery pathways except:
A. Carbohydrate loading drink 2 hours before procedure start time
B. Transdermal scopolamine patch
C. Increased crystalloid administration
D. Resume regular diet 4 hours after procedure
E. Scheduled NSAIDs

C. Increased crystalloid administration

A 60-year-old woman presents to your office for routine gyn visit. On exam you notice small 0.5 cm area of mesh in the anterior compartment of the vagina. She is symptomatic. What is your next step?
A. Order imaging to rule out invasion into adjacent organs
B. Counsel to refrain from vaginal intercourse
C. Recommend topical estrogen for 6-12 weeks
D. Excise the mesh in the office
E. Excise the mesh in the operating room

C. Recommend topical estrogen for 6-12 weeks

The most common early post-op complication of lymph node dissection in the groin is:
A. Hemorrhage
B. Infection
C. Neuropathy
D. Lymphocyst formation 
E. Deep vein thrombosis

D. Lymphocyst formation

Trichloroacetic Acid is a safe treatment for vaginal warts during pregnancy. What is the agents mechanism of action?
A. Stimulating local cytokine production
B. Anti-metabolism of pyrimidine
C. Interfere with DNA synthesis
D. Breakdown of intercellular junctions
E. Coagulation of tissue proteins

E. Coagulation of tissue proteins

``` What is the reason for the procoagulant effect of tamoxifen? A. Increased protein C B. Inhibition of protein S C. Decreased antithrombin III D. Increased antithrombin III E Increased platelet production ```

C. Decreased antithrombin III

``` What muscle overlies the sacrospinous ligament? A. Puborectalis B. Pubococcygeus C. Iliococcygeus D. Coccygeus E. Piriformis ```

D. Coccygeus

``` Which of the following structures provides the most anatomic support to the vagina? A. Cardinal ligament B. Sacrospinous ligament C. Iliococcygeous fascia D. Uterosacral ligament E. Rectovaginal septum ```

D. Uterosacral ligament

``` When uterine rupture occurs what is the risk for neonatal death? A. 0.1% B. 0.5% C. 5% D. 10% E. 25% ```

C. 5%

``` What is the earliest electrocardiogram finding associated with hyperkalemia? A. Absent P waves B. Peaked T waves C. Widened QRS interval D. Lengthened PR interval E. Pre-ventricular contractions ```

B. Peaked T waves

You have been treating a 4-month-old infant with topical estrogen cream for labial adhesions. The mother points out breast budding, what is your next step in management? A. Evaluate for congenital adrenal hyperplasia B. Surgical repair C. Continue Estrogen cream D. Labial separation E. Betamethasone cream

E. Betamethasone cream

``` What HPV serotype is the most common type present in 55% of vaginal cancer samplings? A. 16 B. 18 C. 31 D. 33 E. 45 ```

A. 16

``` Which of the following ovarian tumors has the unique finding of Call-Exner bodies on histopathology? A. Dysgerminoma B. Gonadoblastoma C. Immature teratoma D. Serous cystadenoma E. Granulosa cell tumor ```

E. Granulosa cell tumor

``` Which of the following is not one of the major criteria for the diagnosis of Toxic shock syndrome? A. Hypotension B. Gastrointestinal symptoms C. Orthostatic syncope D. Macular erythroderma E. Systolic blood pressure < 90 mm Hg ```

B. Gastrointestinal symptoms

``` In a patient with a fetal demise, what serum marker may be elevated? A. Anti-mullerian hormone B. HCG C. Inhibin D. Alpha Fetal Protein E. Estriol ```

D. Alpha Fetal Protein

Your patient has been involved in a series of domestic disputes with her partner. All of the following are correct provider actions EXCEPT: A. Assess the immediate safety of the patient B. Report any abuse or neglect of the children C. Make patient aware of help hotlines D. Assistance offered to develop an escape plan E. Call the State’s Attorney Office to immediately enforce an order of protection

E. Call the State’s Attorney Office to immediately enforce an order of protection

``` A 65-year-old with distal interphalangeal joint pain and swelling, which of the following is the recommended first line therapy? A. Methotrexate B. Acetaminophen C. Opioids D. Steroids E. Tofacitinib (Xeljanz) ```

B. Acetaminophen

``` Most common post-operative complication associated with the trans obturator slings when compared with a TVT is: A. Bladder perforation B. Voiding dysfunction C. Groin pain D. Mesh complications E. Bleeding ```

C. Groin pain

``` A 45-year-old patient presents to your office with a blood pressure 160/104 mmHg, otherwise asymptomatic, what is the next best step? A. Start Thiazide diuretic B. Repeat Blood pressure C. Start Beta blocker D. Electrocardiogram E. Lifestyle modifications ```

B. Repeat Blood pressure

``` A neonate was delivered and was found to have fused labioscrotal folds. What is the inheritance pattern of the most likely inherited pathology? A. Autosomal recessive B. X linked recessive C. Autosomal dominant D. Multifactorial E. Y linked recessive ```

A. Autosomal recessive

``` A patient received a Varicella vaccination when she was 8 weeks pregnant, what is the next best step in management? A. Terminate pregnancy B. Amniotic Fluid PCR C. Reassurance D. Targeted U/S E. Doppler of Middle cerebral artery ```

C. Reassurance

``` At what chronological age does a woman obtain maximum bone density? A. 15-years-old B. 17-years-old C. 19-years-old D. 21-years-old E. 25-years-old ```

C. 19-years-old

``` Women who experience difficulties with breast feeding have a high risk of: A. Postpartum weight gain B. Postpartum depression C. Mastitis D. Weaning Prematurely E. Poor Mother-Infant attachment ```

B. Postpartum depression

``` What percent of patients with chronic hypertension will develop pre-eclampsia? A. 0.1% B. 2.5% C. 10% D. 25% E. 75% ```

D. 25%

``` 24. A 58 year old post-menopausal woman presents with a DEXA score of -1.5 and a 12% risk of a major fracture based on her FRAX score. All the following treatments are acceptable EXCEPT? A. Calcium B. Hormone replacement therapy C. Weight bearing exercises D. Calcitonin E. Vitamin D ```

D. Calcitonin

``` Which measurement on the pelvic organ prolapse quantification system(POP-Q) can be used to assess urethral mobility? A. Point Ap B. Point Aa C. Point c D. Point gh E. Pb ```

B. Point Aa

``` A 52-year-old presents for her annual exam; She had a Total Vaginal Hysterectomy/BSO last year for menorrhagia and fibroids. Which of the following is least likely necessary? A. Fasting glucose B. Lipid panel C. Pap smear D. Mammography E. Influenza vaccination ```

C. Pap smear

``` Which of the following medications when used with protease inhibitors to treat HIV cause an exaggerated vasoconstrictive response? A. Beta mimetics B. Pitocin C. prostaglandins D. Ergotamine E. Calcium channel blockers ```

D. Ergotamine

48-year-old cervical screening cytology results: Cytology and HPV negative, atypical endometrial cells present. What is the next best step? A. Excisional procedure B. Endocervical and Endometrial sampling C. Repeat cytology and HPV testing in 6 months D. Routine screening E. Repeat cytology and HPV testing in 12 months

B. Endocervical and Endometrial sampling

``` A patient presents with difficulty externally rotating and adducting her thigh after a hysterectomy. Which nerve was injured? A. Femoral B. Tibial C. Lateral femoral cutaneous D. Peroneal E. Obturator ```

E. Obturator