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Repro module - 4th year > 2011 module exam > Flashcards

2011 module exam Flashcards

1
Q

The pelvic diaphragm provides support for the pelvic viscera. It is composed of the levator ani and one more muscle. Which muscle is that?

A

Coccygeus

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2
Q

What can be injured during multiple deliveries leading to urinary incontinence?

A

Tendinous arch of the pelvic fascia

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3
Q

Which structure can be found in the deep perineal pouch?

A

Bulbourethral glands

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4
Q

Which folds form the penile (spongy) urethra?

A

Urogenital

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5
Q

What defect results from inadequate androgen production?

A

Hypospadias

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6
Q

What is the origin of the testicular artery?

A

Abdominal aorta

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7
Q

Which structure provides most of the nourishment for sperm?

  • Seminal vesicle
  • Prostate gland
A

• Seminal vesicle

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8
Q

Enlargement of which lobe of the prostate can obstruct the urethra?

A

Median lobe

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9
Q

Which lymph nodes would be first infiltrated by a testicular tumor?

A

Lumbar lymph nodes

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10
Q

What provides parasympathetic innervation for the uterus?

A

Pelvic splanchnic nerves

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11
Q

Which anatomical landmark is used in the staging of metastatic breast cancer?

  • Pectoralis minor
  • Pectoralis major
  • Axillary vein
A

• Pectoralis minor

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12
Q

What is enlargement of one or both breasts in a female before puberty called?

A

Macromastia

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13
Q

What condition is characterized by abnormal enlargement of the breast in a male?

A

Gynecomastia

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14
Q

A 34 year old woman presents with hirsutism, cystic ovaries, and amenorrhea after which she experiences heavy bleeding. The endometrium shows increased proliferation. What is this endometrium called?

  • Anovulatory
  • Proliferative
  • Secretory
A

• Anovulatory

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15
Q

A woman with a BIRAD 5 lesion on mammogram presented with eczematous changes of her breast. A biopsy was taken; what is expected to show in the biopsy?

A

Pleomorphic cells in the basal layer of skin

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16
Q

A woman presents to the clinic with a sense of lumpiness and pain in her breast. Biopsy of the breast showed cysts, glandular proliferation, and apocrine metaplasia. What is the most likely diagnosis?

A

Fibrocystic disease

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17
Q

A woman complains of a fixed mass in her breast. On examination of the biopsy, the ducts were extremely proliferative with atypical nuclei but no evidence of invasion. What is the likely diagnosis?

A

Carcinoma in situ

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18
Q

<p>An ovarian mass was detected and biopsied. The cells had signet ring morphology. What would this ovarian mass be?</p>

A

Krukenberg tumor

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19
Q

Which gene is most likely mutated in hereditary serous cystadenoma?

A

BRCA-1

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20
Q

Which tumor would be composed of cytotrophoblast and surrounding syncytiotrophoblast?

A

Chriocarcinoma

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21
Q

What is the most common site for developing cervical carcinoma?

A

Transformation zone

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22
Q

How would a lesion with dysplastic cells occupying two thirds of the cervical epithelium be classified?

A

High grade squamous intraepithelial lesion

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23
Q

The cervical mucosa shows pleomorphic cells lining glandular spaces. What is the likely lesion?

A

Adenocarcinoma of the cervix

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24
Q

Which of the following confers a high risk for developing endometrial carcinoma?

  • Cousins with endometrial cancer
  • PCOS for many years
A

• PCOS for many years

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25
Q

Which of the following is true regarding leiomyoma?

A

It is composed of whorls of smooth muscles with spindle cells

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26
Q

After a young female experienced an abortion, the products of conception showed a karyotype of 69 XXY. What is the most likely pathology?

A

Partial hydatidiform mole

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27
Q

A tumor was found in a pregnant woman on delivery. It was hemorrhagic in appearance. What is it most likely to be?

A

Chriocarcinoma

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28
Q

Which type of neoplasia is associated with elevated human placental lactogen?

A

Placental site trophoblastic tumor

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29
Q

A Kuwaiti family has a history of breast cancer. How would they be genetically investigated?

A

By performing gene-linkage analysis

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30
Q

A family reports history of breast, thyroid and prostate cancer. Which gene should be investigated?

A

BRCA-2

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31
Q

A woman has a history of breast and colon cancer. Which gene is of concern?

A

MSH-2

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32
Q

A man was stabbed in his chest, after which he was taken by the ambulance but died on their way to the hospital. What is the cause of his death?

  • Hypovolemic shock
  • Internal bleeding
  • Stab wound to the chest
  • Cardiac failure
A

• Stab wound to the chest

Note: the cause of death is the lesion that could be appreciated and identified; the mechanism of death is usually speculated.

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33
Q

A maid was found lying dead in her house with rope marks on her neck. On examination of the body, a faint discoloration of skin was noticed in the hips, and was more intense in the back. Which of the following is most likely to have taken place?

  • The body was hanged for half an hour then laid down on the floor
  • The body was hanged for eight hours then laid down on the floor
  • The body was hanged for three hours then laid down on the floor
A

• The body was hanged for three hours then laid down on the floor

34
Q

A woman with history of vaginal bleeding was diagnosed with endometrial carcinoma. Which imaging modality would be ordered to assist the staging of endometrial carcinoma?

  • MRI of the pelvis
  • CT of the pelvis
A

• MRI of the pelvis

35
Q

Which of the following describes the effect of progesterone on breathing during pregnancy?

A

Increases the tidal volume

36
Q

Which of the following metabolic changes takes place during the second half of pregnancy?

A

Increased postprandial amino acid levels

37
Q

Which of the following facilitates oxygen diffusion through the placenta from the mother to the fetus despite a gradient of 30 mmHg?

A

Fetal hemoglobin shifts oxygen dissociation curve to the left

38
Q

Movement of CO2 from the fetus to the mother through the placenta increases PaCO2 on the maternal side and decreases it on the fetal side facilitating diffusion of oxygen; what is this effect called?

  • Bohr effect
  • Double bohr effect
A

• Double bohr effect

39
Q

What is the mechanism of action of northindrone?

A

Thickens the cervical mucus

40
Q

Which drug can be used to induce abortion before 20 weeks of pregnancy?

A

Mifepristone

41
Q

Which of the following is a contraindication for the usage of oral contraceptives?

A

Cerebrovascular disease

42
Q

Which drug is a partial estrogen agonist that is used to induce ovulation?

A

Clomiphene

43
Q

What is the mechanism of action of clomiphene?

A

It antagonizes the effect of negative feedback of estrogen on the pituitary and hypothalamus

44
Q

Which of the following is true regarding hormone replacement therapy?

  • It is most effective if used early enough
  • It induces bone deposition by osteoblasts
A

• It is most effective if used early enough

45
Q

A pregnant woman was on phenytoin to control her epileptic seizures. However, she developed seizures during pregnancy. What would explain that?

A

The total concentration of phenytoin has deceased during pregnancy

46
Q

Which of the following are identified as a definite cause of recurrent miscarriages?

A

Anti-phospholipid antibodies

47
Q

How do anti-sperm antibodies result in infertility?

A

Prevent cervical mucus penetration by sperm

48
Q

A concerned mother brought her daughter to the physician. The daughter had signs of breast development, axillary and pubic hair growth, as well as acne. The physician diagnosed her with precocious puberty. What would the age of the daughter probably be?

  • 7
  • 10
  • 13
  • 14
A

•7

49
Q

A 14 year old girl was brought to the clinic with history of primary amenorrhea although she does report experiencing pain at the same time every month. On examination, the obstetrician diagnosed her with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. How is this condition managed?

  • Creation of breast
  • Administration of medroxy progesterone acetate
  • Hormone replacement therapy
  • Creation of neovagina
A

• Creation of neovagina

Note: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome (also referred to as Mayer-Rokitansky syndrome or Rokitansky-Küster-Hauser syndrome) consists of vaginal aplasia with other müllerian (ie, paramesonephric) duct abnormalities. [1] Type I MRKH syndrome is characterized by variable underdevelopment of the vagina and uterus. Type II MRKH also incorporates extragenital/extramüllerian malformations, including vertebral, cardiac, urologic (upper tract), and otologic anomalies. [2] Surgical correction of the vaginal anomaly permits normal sexual function and, possibly, reproduction with assisted techniques.

50
Q

What is the normal range of menstrual cycle length?

  • 21 to 35 days
  • 28 to 38 days
A

• 21 to 35 days

51
Q

A woman has her periods with normal amount every 45 days. What is this menstrual bleeding pattern called?

A

Oligomenorrhea

52
Q

A 45 year old woman with 3 children presents with vaginal bleeding. A pipelle was used to get an endometrial biopsy that showed complex hyperplasia with atypia. How would this patient be managed?

  • Endometrial ablation
  • Hysterectomy
A

• Hysterectomy

53
Q

Which of the following is true regarding lactogenesis?

A

Lactose, proteins and water are transported via exocytosis

54
Q

Which of the following is one benefit of lactation for the mother?

A

Prolongs lactational anovulation

55
Q

What is the source of nutrients for the embryo before four weeks of gestation?

A

Trophoblast

56
Q

Which of the following is true regarding implantation?

A

Reduced endometrial receptivity is the main cause of most cases of failure of implantation

57
Q

Which of the following represents hormone levels during menopause?

A

FSH is high, Estradiol is low, inhibin is low, AMH is low

58
Q

Which of the following women is more likely to have an early menopause?

A

A woman who smokes 2 packets of cigarettes per day for 10 years

59
Q

A 35 year old woman presents with amenorrhea for the last 14 months accompanied with hot flushes and dry vagina. What is she most likely to have?

A

Primary ovarian failure

60
Q

Which phase of sexual response cycle is characterized by increased muscle tension, increased heart rate and breathing, increased blood flow to the genitals, as well as skin flushes?

A

Excitement

61
Q

A pregnant woman gave birth to a baby with cleft palate. She recalls using amoxicillin five times daily for seven days during the 20th week of gestation; she is convinced that the congenital abnormality in her baby is because of that drug. What would confer strong evidence against that?

A

It is not related to the drug because the palate closes in the first trimester

62
Q

During which phase of myometrial activity are progesterone, prostacyclin, nitric oxide and relaxin active?

A

Active inhibition

63
Q

A pregnant woman is brought to the maternity hospital in preterm labor at 32 weeks of gestation. What can be administered to decrease the myometrial contractions?

A

Beta 2 agonists

64
Q

A woman’s last menstrual period was on 10/1/2015. What is the expected date of delivery?

  • 10-10-2016
  • 17-10-2016
  • 13-10-2016
  • 7-10-2016
A

• 17-10-2016

65
Q

A pregnant woman was examined; the fetal head was in the right flank and his buttocks were in the left flank. What is this lie called?

  • Horizontal lie
  • Longitudinal lie
  • Transverse lie
A

• Transverse lie

Note: the pic wasn’t provided.

66
Q

A pregnant woman was examined, the fetal head was in the suprapubic region, and the fetal back was palpated in the left flank. Where would the fetal heart be auscultated?

  • In the left lower quadrant
  • In the left upper quadrant
  • Just above the maternal umbilicus
  • Just below the maternal umbilicus
A

• In the left lower quadrant

Note: the position of the fetus described in the scenario is called left occipitoanterior (LOA).

67
Q

A woman who is pregnant for the fifth time had two previous miscarriages and two preterm deliveries. The two babies survived. Which of the following truly represents her parity code?

  • G5 P0 + 2 + 2 + 2
  • G5 P2 + 2 + 2 + 2
A

• G5 P0 + 2 + 2 + 2

Note: G (gravida): number of pregnancies regardless the outcome including the current one. P (para); 1st number: term deliveries; 2nd number: preterm deliveries; 3rd number: number of miscarriages, 4th number: number of living births.

68
Q

When does implantation take place?

A

One week after fertilization

69
Q

Which of the following events takes place just before implantation?

A

Hatching of the zona pellucida

70
Q

A pregnant woman presents with severe hypertension, proteinuria and seizures. What is she having?

A

Eclampsia

71
Q

A pregnant woman came to the obstetric clinic where an ultrasound was performed. It revealed a big baby and a large amount of amniotic fluid. What could the mother have?

A

Gestational diabetes

72
Q

A 39 year old woman presented with hirsutism, chronic amenorrhea and obesity. What is the likely diagnosis?

A

Polycystic ovarian syndrome

73
Q

A tall female presents with normal breast development, amenorrhea and no pubic or axillary hair. What is the likely diagnosis?

A

Androgen insensitivity syndrome

74
Q

A young man presents to the clinic with grouped superficial painful ulcers on his penis and lymphadenopathy. What is the likely diagnosis?

A

Herpes genitalis

75
Q

A 31 year old man presented with a soft tender yellow penile lesion that has a necrotic base. What is the likely condition?

A

Chancroid

76
Q

A woman in active labor is having an obstructed labor. Her pelvis was found to have converging walls, straight sacrum, prominent ischial spines and a narrow subpubic arch. What type of pelvis is this?

  • Platypoid
  • Gynecoid
  • Android
  • Anthropoid
  • Mixed
A

• Android

77
Q

EBM: A study was performed to assess the association between ovarian cancer and smoking. The cases were picked from the oncology clinic in a hospital while the controls were picked from the cardiology clinic in the same hospital. What could have gone wrong during the selection procedure?

A

The smokers will be overrepresented among the controls

78
Q

EBM: Why is cox multivariate regression used in analysis of the association of an exposure with an outcome?

A

It eliminates the effect of potential confounders

79
Q

EBM: Which measure of association can be retrieved from a case-control study?

A

Odds ratio

80
Q

EBM: What measure of disease occurrence can be retrieved from a cohort study?

A

Cumulative incidence

Repro module - 4th year (18 decks)

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