2014 Flashcards
(91 cards)
1
Q
Gonadal sex is determined by what week of gestation? A. At fertilization B. 7th C. 9th D. 12th
A
B
2
Q
The testis is expected to reach the scrotal sac by what month of gestation? A. 6th B. 7th C. 8th D. 9th
A
B
3
Q
The equivalent of the female labia majora in males is: A. Scrotal swelling B. Urethral fold C. Urethral groove D. Glans penis
A
A
4
Q
The derivative of the Wolffian duct in females is the: A. Uterus B. Ovary C. Gartner’s duct D. Upper third of the vagina
A
C
5
Q
Mesonephric duct is the: A. Wolffian duct B. Mullerian duct C. Urogenital sinus D. Future ureter
A
A
6
Q
A 3 year old male was brought to the clinic and upon palpation, no testis in the right scrotal sac was found. A permanent testis was palpated at the right internal inguinal ring. This would suggest what condition? A. True undescended testis B. Ectopic testis C. Retractile testis D. Dysgenetic testis
A
A
7
Q
A patient with Mayer-Rokitansky syndrome will have:
A. Normal ovaries
B. 46 XY karyotype
C. Infrequent association with skeletal abnormalities
D. Normal uterus
A
A
8
Q
Principal causes of ambiguous genitalia in a child whose gonads contain testicular tissue include? A. Congenital Adrenal Hyperplasia B. Placental Aromatase Deficiency C. 5-reductase Deficiency D. Gonadal Dysgenesis
A
C
9
Q
Which cells cause the regression of Mullerian ducts? A. Leydig B. Sertoli C. Interstitial D. Genital Ridge
A
B
10
Q
A 15 y/o was brought up as a male. He was recently noted to have a spurt in growth and appearance of pimples on his face. No gonads were palpable but he had an enlarged phallus. Ultrasound revealed the presence of a uterus; karyotyping revealed XX. This individual’s problem is likely:
A. Male pseudohermaphroditism
B. Female pseudohermaphroditism
C. Congenital adrenal hyperplasia
D. Testicular dysgenesis
A
B
11
Q
Which of the following will not have mullerian structures?
A. Dysgenetic males
B. Pseudohermaphrodite male
C. Patients with mixed gonadal dysgenesis
D. Pseudohermaphrodite female
A
B
12
Q
Which structure contains the receptor for SRY antigen?
A. yolk sac
B. dorsal mesentery
C. genital ridge
D. allantois
A
C
13
Q
Feature of Turner’s syndrome:
A. XXY
B. Normal intelligence
C. Tall stature
D. Normal ovary
A
B
14
Q
Which of the following malformations is probably missed at menarche?
A. Imperforate hymen
B. Transverse vaginal septum
C. Longitudinal vaginal septum
D. Vaginal atresia
A
C
15
Q
Structure that forms distal vagina
A. Cloaca
B. Urogenital sinus
C. Mullerian Duct
D. Wolffian Duct
A
B
16
Q
Prenatal exposure to androgens after 12 weeks would cause
A. clitoral hypertrophy
B. retain urogenital sinus
C. labioscrotal fusion
D. penile urethra
A
A
17
Q
A true hermaphrodite:
A. pure XX or XY
B. both XX and XY
C. both ovarian and testicular tissue on both gonads
D. both ovarian and testicular tissue on opposite or both gonads
A
D
18
Q
Which of the following structures need testosterone for its development?
A. testes
B. ovaries
C. prostate glands
D. vas deferens
A
D
19
Q
A 16 year-old with breast and pubic hair Tanner stage III consulted for absence of menses. No palpable uterus upon examination. Serum testosterone is within normal female levels. What is the diagnosis?
a. Androgen Insensitivity Syndrome
b. Congenital Absence of the Uterus
c. Turner’s Syndrome
d. Klinefelter’s Syndrome
A
B
20
Q
Which of the ff is used in oral contraceptives?
a. Estrone
b. Ethinyl estradiol
c. Estriol
d. Equilin
A
B
21
Q
The ff are derivatives of 19-nortestosterone progestin EXCEPT:
a. Medroxyprogesterone acetate
b. Ethynodiol diacetate
c. Levonorgestrel
d. Norethindrone
A
A
22
Q
True for COCs and thromboembolism except:
a. Progestin only increases clotting factors
b. Past users of cocs do not have cardiovascular disease
c. Low dose cocs no effect on venous thromboembolism
d. Hypertension is risk factor for stroke in cocs
A
C
23
Q
Which of the following is NOT a NEW progestin:
a. Norethindrone
b. Gestodene
c. Norgestimate
d. Desogestrel
A
A
24
Q
POP pills
a. Suppresses the secretion of Gnrh
b. Induces Endometrial hypertrophy
c. Thickening of cervical mucus
d. Takes a long time for fertility to resume after withdrawal
A
C
25
What is the mechanism of action of COCs?
a. Progesterone suppresses FSH action, Estrogen suppresses LH action
b. Progesterone suppresses LH action, Estrogen suppresses FSH action
c. Progesterone suppresses FSH action, Estrogen suppresses GnRH action
d. Progesterone suppresses GnRH action, Estrogen suppresses FSH action
B
26
What is the chemical modification done to make estrogen orally active:
a. Addition of ethinyl group at 17 position
b. Addition of ethinyl group at 19 position
c. Removal of carbon at 17 position
d. Removal of carbon at 19 position
A
27
```
Which progestin has the least detrimental effect on lipoproteins?
A. desogestrel
B. levonorgestrel
C. norethindrone
D. mestranol
```
A
28
```
The risk of getting venous thromboembolism with the use of oral contraceptives is _____ as compared to the risk in pregnancy.
A. 5 times greater
B. 3 times greater
C. The same
D. ½ as great
```
D
29
```
Oral contraceptives are currently thought to cause which of the following congenital defects?
A. limb reduction defect
B. sexual ambiguity
C. heart defect
D. no association with any defect
```
D
30
Which is not an absolute contraindication for OCP/COC use?
A. prior thromboembolism
B. liver tumor with previous use of OCP
C. migraine headache
D. breast cancer with positive estrogen receptors
C
31
Which of the following is an advantage of progestin-only pills (POPs) as compared with combined oral contraceptives (COCs)?
A. fewer ovarian cysts
B. less breakthrough bleeding
C. less effect on lactation
D. lower incidence of ectopic pregnancy if method fails
C
32
```
What is a strong contraindication to progestin-only contraceptive use?
A. smoking
B. depression
C. mild hypertension
D. unexplained bleeding
```
D
33
```
What aspect of injectible progestin is worrisome in adolescents and young women?
A. decrease in bone mineral density
B. increased pelvic infection
C. worsening of acne
D. increase of risk of uterine cancer
```
C
34
```
Which of the following is an initial disadvantage of Norplant?
A. Low failure rate
B. Immediately effective
C. High initial expense
D. Prompt return to pregnancy
```
C
35
```
What is the efficacy of post-coital contraception?
A. 25%
B. 50%
C. 75%
D. 100%
```
D
36
```
Based on the two cell-two gonadotropin theory, LH primarily acts on ___ cells to produce androstenedione.
A. granulosa
B. theca
C. arcuate nucleus
D. Leydig cells
```
B
37
Progesterone challenge tests circulatory levels of w/c hormone?
a. estrogen
b. progesterone
c. LH
d. FSH
A
38
severity of dysmenorrhea is primary correlated with:
a. duration of menstrual flow
b. number of days w/ premenstrual spotting
c. delayed menses
d. regularity of menses
A
39
Among the ff what is the cause of secondary amenorrhea
a. 45XO
b. agonadism
c. kallman syndrome
d. asherman syndrome
D
40
What is menstruation of >7days or >80mL at regular intervals.
a. metrorrhagia
b. menorrhagia
c. menometrorrhagia
d. polymenorrhea
B
41
What is the regular but frequent menstruation (<21days)?
a. menomenorrhagia
b. menorrhagia
c. polymenorrhea
d. oligomenorrhea
C
42
Primary amenorrhea is associated with elevated levels of prostaglandin
a. F1 alpha
b. F2 alpha
c. E1 alpha
d. E2 alpha
B
43
```
The mainstay of treatment for anovulatory dysfunctional uterine bleeding.
A. estrogen
B. progestin
C. bromocriptine
D. DMPA
```
B
44
Ovulatory bleeding:
A. is abnormal uterine bleeding unrelated to a demonstrable organic cause.
B. is bleeding at irregular frequent intervals, with variable amount.
C. is erratic and irregular bleeding in the absence of cyclic production of progestin.
D. is excess bleeding associated with progestin withdrawal but with loss of normal hemostasis.
D
45
```
A 30 year old G3P2 in her 32nd week AOG consulted at the OB Admitting Section for profuse vaginal bleeding which she noticed upon waking up. She had no prenatal checkups. Vital signs were within normal with no note of uterine contractions. Fetal heart tones were noted at the left lower quadrant at 140/min. What is the most probable diagnosis?
A. Abruptio Placenta
B. Vasa Placenta
C. Placenta Previa
D. Placenta Accreta
```
C
46
```
Which examination should be requested in the above patient to verify diagnosis?
A. Pelvic Ultrasound
B. CT Scan
C. MRI
D. Abdominal X-ray
```
A
47
```
Which of the following is a risk factor for placenta abruptio?
A. oligohydramnios
B. prematurity
C. hypertension
D. previous placenta previa
```
C
48
```
A 20yo primigravid is delivered by outlet forceps extraction manifested bleeding right after delivery despite well contracted uterus. Diagnose:
A. retained placental fragments
B. cervical laceration
C. vaginal hematoma
D. uterine atony
```
B
49
A 35 yo primigravid is undergoing caesarian section for placenta abruption with hemoglobin level of 85g/dL. Blood was oozing at uterine incision. The platelet count was 150,000 unilts/mL3. How would you manage?
A. fresh whole RBC with crystalloid
B. packed RBC with fresh frozen plasma
C. crystalloid with packed RBC
D. packed RBC, fresh frozen plasma, platelets
C
50
```
Which of the following will most likely have placenta previa?
A. 36 yo G5P4 with transverse lie
B. 35 yo G5P3 with vertex presentation
C. 20 yo G1P0 with vertex presentation
D. 21 yo G2P1 with breech presentation
```
A
51
```
A G5P4, 37 wk AOG came to OBAS cold, pale, and with perspiration. History of fundic pressure by traditional hilot was noted. Uterus was contracted and no appreciated FHT. There was also moderate bleeding. The diagnosis:
A. placenta previa
B. abruption placenta w/DIC
C. uterine rupture
D. placenta accreta
```
C
52
Spontaneous rupture of the pregnant uterus is most frequently associated with:
A. Grandmultiparity
B. Multiple pregnancy
C.Injudicious use of oxytocin during labor
D. Placenta accreta
C
53
You perform Outlet Forceps Extraction (OFE) on a primigravid under epidural anesthesia, delivering a 3.1 kilogram baby. Immediate postpartum course was uneventful as the episiotomy is adequately repaired. At the recovery room, her BP was initially 120/80 mmHg but dropped to 90/50 mmHg after 2 hours, with corresponding tachycardia of 120 bpm. She was noted to be pale. On pelvic exam, there was no vaginal bleeding and the episiotomy site was intact with minimal oozing. The corpus was well contracted. What is your present impression?
a. Uterine rupture
b. Expanding retroperitoneal hematoma
c. Retained Placental secundines
d. Incomplete Uterine Inversion
B
54
While doing an axtraction of a fundally located placenta, you notice an unusual adherence of the placenta on underlying endometrium. What is your diagnosis?
a. abruption placenta
b. impending uterine rupture
c. placenta accreta
d. retained placental secundine
C
55
What is the most common cause of death/morbidity in placenta previa?
A. Hemorrhage
B. Infection
C. Postpartum ___
D. P___
A
56
What is the distance of the placenta from the internal os in a low lying placenta previa?
A. 1 cm
B. 1.5 cm
C. 2 cm
D. 2.5 cm
C
57
Profuse vaginal bleeding upon amniotomy
a. vasa previa
b. placenta previa totalis
c. uterine rupture
d. placenta accrete
A
58
Normal semen analysis value:
a. Volume 0.5 ml
b. Morphology 40%
c. Motility 40%
d. Sperm density 30 million/ml
D
59
To determine the ovarian reserve in women 35 y.o. and above, the baseline levels of which hormone must be measured:
A. LH
B. FSH
C. Progesterone
D. Estrogen
B
60
initial fertility work-up includes the following except:
a. semen analysis
b. laparoscopy
c. documentation of ovulation
d. evaluation of fallopian tubes
B
61
Most common site of tubal occlusion
a. insterstitial
b. isthmus
c. ampullary
d. fimbrial
C
62
in normal fertile couple, the monthly conception rate is
a. 10%
b. 15%
c. 20%
d. 25%
C
63
After ovulation, the oocyte remains fertilizable for a minimum of how many hours?
a. 12 hrs or less
b. Up to 24 hrs
c. more than 48 hrs
d. as much as 72 hrs
B
64
```
What diagnostic technique should be used to assess tubal patency?
A. Internal examination
B. Transvaginal ultrasound
C. Hysteroscopy
D. Hysterosalpingogram
```
D
65
Usual 1st line pharmacological agent for the treatment of oligomenorrhea in infertility.
a. Estrogen
b. Clomiphene citrate
c. Letrozole
d. Pioglitazone
B
66
In vitro fertilization increases chance of
a. multiple gestation
b. fetal malformation
c. pre-eclampsia
d. placenta previa
A
67
part of work-up for infertile couples
a. estradiol
b. testosterone
c. TSH
d. hysterosalpingogram
A
68
```
When a fetus is in breech presentation with both knees flexed and both hips flexed, this is called ______ breech.
A. Incomplete
B. Frank
C. Incomplete
D. Footling
```
C
69
```
A midpelvis contraction is suspected if, on clinical pelvimetry, any of the ff. are noted except:
A. Convergent pelvic sidewalls
B. Prominent ischial tuberosities
C. Narrow sacrosciatic notches
D. Bispinous diameter
```
B
70
```
As a fetal effect during difficult labor/vaginal delivery, the following entity, characterized by scalp edema overlying the fetal occiput may develop:
A. Cephalhematoma
B. Caput Succadeum
C. Molding
D. Contusion
```
B
71
```
Protracted labor during the active phase is defined as a rate of less than ___cm/hr in nulliparas.
A. 1
B. 1.2
C. 1.5
D. 2
```
B
72
```
Measured uterine contractions of ____ Montevideo units is required for diagnosing entry into active phase of labor
A. 200
B. 100
C. 50
D. 10
```
A
73
```
Slower-than-normal decrease in the rate of cervical dilatation or fetal descent during active phase of labor is termed:
A. Prolongation
B. Arrest
C. Protraction
D. Undetermined
```
C
74
```
Possible maternal consequence of labor in cases of contracted pelvises include the following except:
A. intraamniotic infection
B. fistula formation
C. uterine rupture
D. abruptio placenta
```
D
75
```
Uterine dysfunction represents an abnormality in the expulsive forces of labor. This type of uterine dysfunction is characterized by a distorted pressure gradient:
A. Hypotonic uterine dysfunction
B. Hypertonic uterine dysfunction
C. Precipitous labor
D. Tetanic dysfunction
```
B
76
When the fetal head has been in the same station in the entire duration of the deceleration phase of labor for >1 hour, this is labeled as:
A. Arrest of descent
B. Failure of descent
C. Protracted descent
D. Arrest of dilatation
B
77
Syliva, 24 year old G1P0 with amenorrhea for 8 weeks presented with fever generalized muscular/body pain and cough with greenish phlegm. She had hypogastric pain every time she coughed. Her temperature at consult was 38.9 C. The following antibiotics may be used EXCEPT:
A. Cefaroxime
B. Amoxcillin
C. Tetracycline
D. Cephalexin
C
78
Reproductive outcomes that may arise from exposure to pharmacologic agents except?
A. Infection
B. Congenital malformation
C. Developmental delay
D. Normal fetus
A
79
The best time to counsel a patient on the effects of drugs:
A. preconception
B. first trimester
C. first prenatal visit
D. just before labor
A
80
Mechanism of action of most teratogens:
A. Alteration in tissue growth
B. Cell death
C. Errors in cellular differentiation
D. Unknown
D
81
Which stage is associated with structural malformations?
A. Prefertilization
B. Zygote
C. Embryonic
D. Fetal
C
82
The following statements regarding the US FDA is true except:
A. A - Controlled studies show no fetal risk
B. B – human studies done with possible risk to human fetus and possible animal risks
C. C – human studies have not been performed; animal studies may or may not show risks; potential benefits justify potential risks
D. X – contraindicated
B
83
The baseline risk for occurrence of congenital malformations in the general population:
```
A. 1%
B. 3%
C. 5%
D. 7%
E. 10%
```
B
84
The USFDA classifies drugs in class C when:
A. Controlled studies show no fetal risk
B. No good human studies have been done. Animal studies show some risk.
C. Some human studies show risk but potential benefits may outweigh the risks.
D. No good human studies have been done. Animal studies show no risk.
B
85
Isotretinoin is under what F.D.A. classification?
A. A
B. B
C. C
D. X
D
86
The Global Study on Sexual Attitudes and Behavior found that sexual well-being in both males and females is positively correlated with what?
a. Fertility Rate
b. Socioeconomic Status
c. General Well-Being
d. None of the above
C
87
Cock or penile rings cause?
a. chronic incontinence
b. gangrene
c. premature ejaculation
d. infection in the female reproductive tract
B
88
Importance of body image in our lec: 2 years ago, Spanish pedia appealed to their government to set a min BMI for woman fashion models as a way of presenting the ff medical prob in young girls:
a. Early menarche
b. anorexia nervosa
c. Early coital debut
d. NOTA
B
89
Part of the 10 sexual right set by the world health organization except:
a. Satisfying safe and pleasurable sex life
b. Sex education
c. Have as many sexual partners as long as precautions are done
d. Highest attainable standard of health
C
90
Induced hypoxia is done to:
a. Decrease libido
b. Increase erection
c. Increase pleasure during sexual climax
d. None of the above
C
91
ICPD refers to:
a. International conference for Pediatrics
b. International Conference for Psychiatric Disorders
c. International Conference for Population and Development
d. None of the above
C
