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Wall Quizzes > Wall Quiz #9 > Flashcards

Wall Quiz #9 Flashcards

1
Q 
In dividing the rectus abdominis muscle during the Maylard incision, which artery is ligated?
A. Deep circumflex
B. Inferior epigastric
C. External iliac artery 
D. Superior epigastric 
E. Superficial epigastric
A

B. Inferior epigastric

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2
Q 
The granulosa cell aromatase enzyme allows conversion of androstenedione to which of the following:
A. Estrone
B. Progesterone
C. 17-hydroxyprogesterone 
D. Dehydroepiandrosterone 
E. DHEA-S
A

A. Estrone

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3
Q 
All of the following androgens are produced by the ovary EXCEPT:
A. Testosterone
B. Androstenedione
C. Dihydrotestosterone
D. Dehydroepiandrosterone 
E. Estradiol
A

E. Estradiol

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4
Q 
How is water transferred across the placenta?
A. Active transport 
B. Simple diffusion 
C. Bulk flow
D. Endocytosis
E. Exocytosis
A

C. Bulk flow

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5
Q 
All of the following can be assessed or measured using simple cystometrics EXCEPT:
A. Total bladder capacity
B. Stress urinary incontinence
C. Intrinsic sphincter deficiency
D. First sensation of bladder filling 
E. Urge incontinence
A

C. Intrinsic sphincter deficiency

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6
Q 
In which phase of the cell cycle does protein synthesis, RNA synthesis and DNA repair occur?
A. M 
B. S 
C. G2 
D. G1 
E. G0
A

D. G1

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7
Q

A wide local excision is performed on a VIN III lesion. Margins are clear, but squamous cell CA is noted within the specimen, invading to 0.9 mm. The next step should be:
A. Repeat excision, with wider margins
B. Observation
C. Radicalvulvectomy
D. Inguinal node dissection
E. Hemi-vulvectomy with node dissection to superficial inguinal nodes

A

B. Observation

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8
Q 
Which tumor suppressor protein does the viral oncogene HPV E6 bind to and inactivate, leading to immortalization of the cervical cell?
A. Rb
B. P16
C. P53
D. Cyclin D1 
E. P21
A

C. P53

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9
Q 
Which of the following muscles is not commonly found in myofascial pain syndrome?
A. Levator ani
B. Coccygeous
C. Deep transverse perineal 
D. Gluteus minimus
E. Obturator
A

D. Gluteus minimus

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10
Q

In the management of CIN III, endocervical sampling is appropriate in each of the following scenarios EXCEPT:
A. Colposcopy is inadequate
B. In the evaluation of ASC-H
C. At 17 weeks gestation
D. Surveillance for AIS after conization
E. During surveillance of positive margins for HSIL

A

C. At 17 weeks gestation

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11
Q

Which of the following properties of bipolar instruments decreases the concern for burns?
A. Currents are confined between two closely approximated electrodes
B. Thermal spread is lower
C. Currents are higher
D. Current travels to grounding pad

A

A. Currents are confined between two closely approximated electrodes

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12
Q

A 26 y/o nulligravida presents with a 6-month history of secondary amenorrhea. She complains of increased hair growth on her chin and worsening acne. On exam, clitoromegaly is noted. What is the most likely cause?
A. Mullerian agenesis
B. Hypothalamic amenorrhea
C. Non classical Congenital adrenal hyperplasia
D. Androgen secreting tumor
E. Polycystic ovarian syndrome

A

D. Androgen secreting tumor

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13
Q 
All of the following are part of the first tier workup for secondary bone loss EXCEPT?
A. Complete blood count 
B. Serum chemistry
C. TSH
D. Celiac panel
E. 24-hrurine calcium level
A

D. Celiac panel

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14
Q 
All of the following are bone formation markers EXCEPT:
A. C-telopeptide
B. Osteocalcin
C. Bone specific alkaline phosphatase 
D. Procollagen type I
E. N-terminal pro-peptide
A

A. C-telopeptide

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15
Q 
A 67-year-old Caucasian woman presents for her annual exam. Her DEXA scan shows a T-score: -1.7 FRAX score shows a 10% risk of a major osteoporotic fracture. After counseling the patient you recommend to repeat her DEXA scan in:
A. 1 year 
B. 2 years 
C. 3 years 
D. 5 years 
E. 10 years
A

D. 5 years

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16
Q 
A 7-year-old girl presents with a 6 cm adnexal complex mass and tanner stage 3 breasts development. The tumor marker most likely to assist in your preoperative evaluation is:
A. AFP
B. CEA
C. LDH
D. Human epididymis protein 4
E. Inhibin B
A

E. Inhibin B

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17
Q 
All of the following are features of medical abortion EXCEPT:
A. Available in early pregnancy 
B. Avoids invasive procedure 
C. Light bleeding
D. Success rate is about 95%
E. Avoids anesthesia
A

C. Light bleeding

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18
Q 
A 21-year-old presents with temp 100.8, decreased hearing, pressure and pain in her right ear. She admits to having a “cold” recently. On examination tympanic membrane is erythematous. The most likely organism is:
A. Coxsackie A virus
B. Parainfluenzavirus
C. Hemophilus influenza
D. Staphylococcus aureus 
E. Ureaplasma urealyticum
A

C. Hemophilus influenza

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19
Q 
Which of the following is increased with use of extended cycle (continuous) oral contraception compared with that of traditional cyclic oral hormonal contraception with a pill free week?
A. Headaches
B. Escape ovulation
C. Endometrial cancer
D. Unpredictable bleeding 
E. Less patient satisfaction
A

D. Unpredictable bleeding

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20
Q

A patient in labor gives a history of mitral stenosis. She is asymptomatic and currently taking a beta blocker. What complication is the prophylactic beta blocker trying to prevent in these patients?
A. Irregular heart rhythm
B. Mural thrombus formation
C. Tachycardia leading to pulmonary edema
D. Left ventricular hypertrophy and dilation

A

C. Tachycardia leading to pulmonary edema

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21
Q

A 67-year-old is having a hysterectomy/BSO for endometrial cancer. The report from the frozen section of the uterus shows: “invasive uterine papillary serous carcinoma” The most appropriate next step in management:
A. No additional management needed
B. Pelvic lymph node dissection
C. Pelvic washings, omentectomy, pelvic & para-aortic lymph node dissection
D. Pelvic & para-aortic lymph node dissection
E. Omentectomy, appendectomy, pelvic & para-aortic lymph node dissection

A

C. Pelvic washings, omentectomy, pelvic & para-aortic lymph node dissection

22
Q 
After an exposure and infection with Hepatitis B, what is the first detectable serological marker?
A. Anti-HB core antibody
B. Hbe antigen
C. HBs antigen
D. Anti-HBs IgG Antibody
E. Anti-HB Core antibody IgM
A

C. HBs antigen

23
Q 
A 32-year-old G2P2 reports “absence of sexual desire”. She admits experiencing marked distress in her relationship with her fiancé because of not wanting intercourse. Which of the following is most likely?
A. Anhedonia
B. Hypoactive sexual desire disorder 
C. Orgasmic dysfunction disorder
D. Post- traumatic stress disorder
E. Vaginismus
A

B. Hypoactive sexual desire disorder

24
Q 
In cases of endometrial cancer, levels of which tumor associated antigen are most elevated?
A. AFP
B. CA 19-9
C. CA 125
D. CEA
E. Her2-/Neu
A

C. CA 125

25
Q

28-year-old G1P0 with a T5 spinal cord injury is admitted to L&D. She is 39 weeks with palpable contractions. What is the most important step in her management of her labor?
A. IV magnesium sulfate
B. Avoidance of narcotic
C. Augment labor
D. Early initiation of regional anesthesia
E. Frequent cervical examination

A

D. Early initiation of regional anesthesia

26
Q

A G2P1 at 30 weeks has an NST due to chronic hypertension. After 30 minutes, the NST shows two accelerations each with a peak of 10 beats per minute above the base line and a duration of 10 seconds. MVP is 4. The most appropriate next step is:
A. Continue NST for an additional 30 minutes
B. Obtain a biophysical profile
C. Perform an oxytocin challenge test
D. Repeat NST in 3-4 days
E. Deliver

A

D. Repeat NST in 3-4 days

27
Q 
A 30-year-old G0P0, BMI 40, with biopsy proven EIN, desires future fertility. Which of the following is NOT an acceptable form of treatment?
A. Medroxyprogesterone acetate 
B. Micronized vaginal progesterone 
C. Etonorgesterol
D. Megestrol acetate
E. Depo-medroxyprogesterone
A

C. Etonorgesterol

28
Q 
The fetus of a mother with Lupus is at greatest risk for a complete heart block if the mother has a positive test result for:
A. Anticardiolipin
B. Anti-double stranded DNA 
C. Anti smith
D. Anti-SSA (Ro)
E. Lupus anticoagulant
A

D. Anti-SSA (Ro)

29
Q

Which of the following places a patient at greatest risk for Ovarian Hyperstimulation Syndrome when conducting ovulation induction via menopausal gonadotropins?
A. Congenital adrenal hyperplasia
B. Hypothalamic amenorrhea
C. Polycystic ovary syndrome
D. Prolactin secreting pituitary adenoma
E. Unexplained infertility

A

C. Polycystic ovary syndrome

30
Q

You have completed colposcopy for your 26-year-old G0P0 for LSIL. The biopsy report reads: “AIS”. You counsel the patient and she strongly desires childbearing potential. Your best management is:
A. Close observation with pap tests every 3 months
B. Cervical cone biopsy
C. Laser ablation
D. Simple Hysterectomy
E. A type II radical hysterectomy with node dissection

A

B. Cervical cone biopsy

31
Q

28 yo G1P0 with a h/o IDDM presents for preconceptional counseling. The result of her fasting glucose is 150 mg/dL. You advise her that her risk for fetal anomalies in her pregnancy correlates best with her:
A. 100-g glucose challenge test
B. 75-g glucose challenge test
C. Fasting glucose level
D. Glycosylated hemoglobinlevel (HgbA1C)
E. Random glucose level

A

D. Glycosylated hemoglobinlevel (HgbA1C)

32
Q 
A female fetus has 6-7 million oocytes present during the 20th week of gestation. Approximately how many oocytes are present at birth?
A. 70,000
B. 250,000 
C. 700,000 
D. 1,500,000
A

D. 1,500,000

33
Q

Genetic testing should be performed in response to which of the following semen analysis results?
A. Semen volume of 2.0 mL
B. Sperm concentration of 2 million
C. Presence of fructose in the semen sample
D. 8-percent normal sperm morphology by Kruger criteria
E. Motility Less than 50%

A

B. Sperm concentration of 2 million

34
Q 
The only antibiotic that should be used to treat syphilis during pregnancy is:
A. Ceftriaxone sodium
B. Doxycycline
C. Erythromycin
D. Penicillin G Benzathine 
E. Tetracycline
A

D. Penicillin G Benzathine

35
Q 
Which of the following hormones “rescues” the corpus luteum from luteolysis?
A. Luteinizing hormone
B. Human placental lactogen
C. FSH
D. Human chorionic gonadotropin 
E. Estrogen
A

D. Human chorionic gonadotropin

36
Q 
A 19-year-old presents for HPV vaccine. Shortly after receiving her first vaccination, the patients has shortness of breath, flushing, itching, and nausea. On examination, her blood pressure is 70/30, pulse 110, and wheezing in both lung fields. The most likely diagnosis?
A. Anaphylaxis
B. Panic attack
C. Pulmonary embolus 
D. Septic shock
E. Vasovagal response
A

A. Anaphylaxis

37
Q 
Serum levels of which hormone can be used to support a clinical impression of ectopic pregnancy but cannot reliably distinguish an ectopic from an intrauterine pregnancy?
A. Estradiol
B. Progesterone
C. LH
D. Follicle stimulating hormone 
E. CA 125
A

B. Progesterone

38
Q 
Which POP-Q point represents the level of uterosacral ligament attachment to the proximal posterior cervix?
A. Point GH 
B. Point D 
C. Point Ap 
D. Point TVL 
E. Point Bp
A

B. Point D

39
Q

A woman is concerned that her 8 yo daughter is beginning puberty. What is the most important step in your evaluation?
A. A serum estradiol level
B. LH level
C. GnRH releasing hormone challenge test
D. Pelvic ultrasound
E. A physical exam

A

E. A physical exam

40
Q

A 15-year-old adolescent is seen for contraceptive counseling. She has no symptoms, and her examination results are normal. She asks you about the benefits of being screened for chlamydia. The best response is that an adolescent should be screened:
A. Only if she is sexually active
B. Only if she is sexually active and has more than one partner
C. Only if she has had a previous sexually transmitted disease
D. At least annually if she is sexually active

A

D. At least annually if she is sexually active

41
Q 
During a diagnostic evaluation for pelvic pain in a 15 yo adolescent who is not sexually active, you find endometrial implants. Which other pelvic pathology may be found at the time of surgery?
A. Cervical dysplasia
B. Dysgenic gonads
C. Interstitial cystitis
D. Meckel’s diverticulum 
E. Unicornuate uterus
A

E. Unicornuate uterus

42
Q 
A 48 yo woman is seen for decreased libido. She wants to start Viagra for sexual desire. You tell her that according to current data, the most likely effect of Viagra on sexual function would be:
A. Extended plateau phase
B. Increased frequency of orgasm 
C. Increased sexual desire
D. Improved vaginal lubrication
E. No change
A

E. No change

43
Q

You have hospitalized a 25-week gravida for a fetal arrhythmia. You order digoxin for the mother, but she refuses treatment. You counsel her on risks, benefits and alternatives. However, she continues to refuse. The most appropriate next step in management is to:
A. Obtain a court order
B. Administer a less effective medication
C. Continue to provide education and counseling of the benefits of digoxin
D. Decline further care
E. Refer to psychological counseling

A

C. Continue to provide education and counseling of the benefits of digoxin

44
Q 
A 15-year-old presents with primary amenorrhea. She has Tanner 4 stage breast development. On pelvic exam, you find a short blind vagina, no uterus and sparse pubic hair. The most appropriate next diagnostic test is:
A. Barium enema
B. Estradiol level
C. Intravenous pyelogram 
D. Karyotype
E. Pelvic U/S
A

D. Karyotype

45
Q

A 49 yo G2P2 who recently underwent a hysterectomy and BSO, is seen in your office to discuss the risks and benefits of hormone therapy. According to the most current data, estrogen therapy alone will most significantly:
A. Decrease of colon cancer
B. Increase risk of death
C. Increase risk of breast cancer
D. Increase risk of coronary heart disease
E. Increase risk of stroke

A

E. Increase risk of stroke

46
Q 
A 22 yo G1P0 presents in active labor. During the second stage, you diagnose occiput posterior presentation. This scenario is consistent with which anatomic pelvic shape?
A. Android
B. Gynecoid
C. Anthropoid
D. Platypelloid
E. Narrow Pubic Arch
A

C. Anthropoid

47
Q

72-year-old presents with chronic itching of the
vulva. She states there is some bleeding when scratching the area. On examination, you find a red brown plaque on the posterior fourchette. What is the next step?
A. A biopsy of the lesion
B. Empiric topical antifungal therapy
C. Intralesional application of Imiquimod
D. A skinning vulvectomy
E. Topical application of podophyllum resin

A

A. A biopsy of the lesion

48
Q 
A 25-year-old had a 2 cm cyst removed from the lateral vaginal wall. Pathology showed: “Cystic structure lined with cuboidal epithelium.” This cyst is most likely a remnant of the:
A. Müllerian ducts
B. Urogenital sinus 
C. Mesonephric ducts 
D. Endocervical canal 
E. Bartholin gland
A

C. Mesonephric ducts

49
Q 
Which of the following is the most likely side effect of Paroxetine?
A. Gastrointestinal 
B. Renal
C. Neurologic
D. Cardiac
E. Dermatologic
A

C. Neurologic

50
Q 
A 27 yo women G3P0 with a h/o 3 first trimester losses is seen for infertility. HSG shows two uterine cavities. MRI of the uterus shows smooth contour to the external fundus and 3mm uterine septum. What is the next step in management?
A. Hysteroscopic metroplasty 
B. Modified Jones metroplasty 
C. Strassman procedure
D. Thyroid hormone
E. No additional treatment
A

A. Hysteroscopic metroplasty

Wall Quizzes (12 decks)

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