Old Wall Quiz #9 Flashcards

1
Q
1. What is the second most common cause of
primary amenorrhea?
A. Polycystic ovarian syndrome
B. Kallman's syndrome
C. Pregnancy
D. Gonadal dysgenesis
E. Mullerian agenesis
A

e

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2
Q
2. A 27 y/o G0 requests updating all her
vaccinations prior to leaving for graduate school.
All of the following immunizations should be
current EXCEPT:
A. Tdap
B. Meningococcal
C. Influenza
D. MMR
E. Pneumococcal
A

e

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3
Q
  1. Your patient has been diagnosed with Turners
    syndrome. Which of the following medications is
    indicated to stimulate growth?
    A. Estrogen
    B. Anabolic steriods
    C. Growith hormone
    D. Norethindrone acetate
    E. GnRH antagonist
A

c

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4
Q
4. Which study design is severely limited by lack
of comparison group?
A. Randomized clinical trial
B. Cohort study
C. Observational study
D. Case series
E. Cross sectional study
A

d

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5
Q
  1. What percentage of females age 25-44 report
    having anal sex with an opposite sex-partner?
    A. 15%
    B. 20%
    C. 25%
    D. 30%
    E. >35%
A

e

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6
Q
7. The inlet of the true pelvis is associated with all
of the following EXCEPT?
A. Sacral promontory
B. Horizontal rami of pubic bones
C. Top of the symphysis pubis
D. Ischial tuberosity
E. True conjugate
A

d

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7
Q
8. What is the average rate of miscarriage for
women aged 35-37 years old?
A. 1%
B. 3%
C. 5%
D. 14%
E. 25%
A

d

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8
Q
9. How many days are there in a normal
pregnancy from conception to due date?
A. 294
B. 280
C. 270
D. 266
E. 256
A

d

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9
Q
  1. What percent of female sexual assault victims
    report an intimate partner as the perpetrator?
    A. 10%
    B. 20%
    C. 30%
    D. 40%
    E. 50%
A

e

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10
Q
  1. All of the following are theories for the
    mechanism of action for the fetal
    neuroprotective effects of Magnesium sulfate
    EXCEPT:
    A. Reduction of inflammatory cytokines
    B. Inhibition of ionotropic glutamate receptors
    C. Decrease in cerebral blood flow
    D. Stabilization of fluctuations in BP in neonate
    E. Reduction of free radicals
A

c

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11
Q
14. Initial manifestations of early reversible shock
include:
A. Reduced cardiac output
B. An increase in SVR
C. Oliguria
D. Disorientation
E. Cold clammy skin
A

c

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12
Q
17. Which of the following is a second line
pharmacotherapy for urge incontinence?
A. Solifenacin
B. Oxybutynin
C. Mirabegron
D. Onabotulinimtoxin A
E. Trospium
A

d

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13
Q
19. Which of the following anti-epileptic drugs
places a gravida at the least risk for having a child
with a neural tube defect?
A. Phenytoin
B. Carbamazepine
C. Valproic Acid
D. Levetiracetam
E. Gabapentin
A

d

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14
Q
  1. Which of the following is not one of the
    criteria used to diagnose postmolar GTD?
    A. An hCG plateau of 3 values plus or minus
    10% over 2 weeks (days 1,7,14)
    B. An hCG level increase of more than 10% of 4
    values recorded over 3 weeks (days 1,7,14,
    and 21)
    C. Persistence of detectable hCG >6 months
    post evacuation
    D. New IUP not yet ruled out
A

d

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15
Q
  1. Elective prophylactic appendectomy during
    gynecologic surgery is most appropriate during
    which of the following conditions?
    A. Severe endometriosis
    B. Pelvic radiation is anticipated
    C. Extensive pelvic surgery, i.e. adhesions
    D. In the developmentally disabled
    E. Patients concern of developing future
    appendicitis
A

e

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16
Q
  1. A 30 y/o G4P3 presents to L&D at 37 weeks in
    active labor frank breech 7cm dilated. She has
    history of three SVDs and requests a vaginal
    breech delivery. All of the following are
    recommended guidelines EXCEPT:
    A. EFW 2500-4000 g
    B. EGA >37 weeks
    C. Low dose oxytocin augmentation
    D. Frank or Complete breech
    E. Adequate maternal pelvis
A

c

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17
Q
  1. Which of the following is true about Spinal
    Muscular Atrophy (SMA)?
    A. It is caused by a mutation in the SMN1 gene
    B. It is X-Linked recessive
    C. Type III spinal muscular atrophy is the most
    severe
    D. The incidence is approximately 1 in 20,000
    live births
    E. ACOG recommends prenatal screening for all
    patients at this time
A

a and e

Autosomal recessive

18
Q
27. All of the following are helpful basic
diagnostic assessment tools in a patient with
suspected interstitial cystitis EXCEPT:
A. Hydrodistension cystoscopy
B. Urinalysis
C. Urine culture
D. Potassium sensitivity test
E. Urine cytology
A

d

19
Q
28. Patients with uncomplicated labor may be
allowed modest amounts of all the following
fluids EXCEPT:
A. Orange juice with pulp
B. Sports drinks
C. Water
D. Coffee
E. Coke Zero
A

a

20
Q
  1. Which of the following is true about air
    travel in pregnancy?
    A. Most airlines allow travel up to 38 weeks
    B. The most common emergencies occur in the
    second trimester
    C. Cosmic radiation presents a risk at 8-15
    weeks
    D. Turbulence can present the biggest risk
    E. Carbonated soda may help with nausea
A

d

21
Q
  1. In its analysis of sentinel events, the Joint
    commission found that almost two thirds of the
    events involved which of the following as the root
    cause?
A. Documentation
B. Omitting Time Out
C. Miscommunication
D. Taking verbal orders
E. Medication errors
A

c

22
Q
  1. Which of the following is the first line
    recommended treatment for Citrate toxicity?
    A. Insulin and glucose
    B. Magnesium Sulfate
    C. Protamine sulfate
    D. Calcium gluconate
    E. Calcium chloride
A

e

gluconate is processed in the liver. Cannot give when there is abnormal liver function.

chloride must be given through central line to avoid tissue necrosis when infused peripherally.

chloride provides more calcium per 10cc than gluconate.

23
Q
32. Which of the following is true about
Methamphetamine?
A. Increases the release of epinephrine
B. It is less potent than Amphetamines
C. It blocks re-uptake of Dopamine
D. Potent depressive drug post use
E. Parent drug to cocaine
A

c

24
Q
  1. The mullerian anomaly associated with the
    most reproductive success is:
    A. Septate uterus
    B. Bicornuate uterus
    C. Didelphic uterus
    D. Unicornuate uterus
    E. Unicornuate with non-communicating horn
A

c

25
Q
34. What phase in the cell cycle does
Methotrexate act?
A. G1
B. S
C. G2
D. M
E. G0
A

b

26
Q
35. Which of the following structures contribute
to the “white line”?
A. The obturator internus
B. The coccygeus fascia
C. The obturator externus fascia
D. The piriformis fascia
E. The levator ani fascia
A

e

27
Q
36. Which of the following is not a first line
therapy for an inverted uterus immediately post
vaginal delivery?
A. MgS04
B. Terbutaline
C. Nitroglycerine
D. Haultin procedure
E. Halogenated general anesthetics
A

d

28
Q
37. Which of the following is a cause of
secondary post partum hemorrhage?
A. Uterine Atony
B. Uterine rupture
C. Uterine inversion
D. Endometritis
E. Acquired coagulopathy
A

d

29
Q
  1. Interactions between OCPs and other
    medications can cause alteration of therapeutic
    medication level, increased toxicity, and decreased
    contraceptive efficacy. Which of the following
    medications would not be affected?
    A. Levetiracetam
    B. Phenytoin
    C. Carbamazepine
    D. Efavirenz
    E. Topiramate
A

a

30
Q
  1. ACOG has all the following
    recommendations for the Tdap vaccine EXCEPT:
    A. Tdap should be given between 27 and 36
    weeks gestation
    B. Family and caregivers should receive Tdap 2
    months before infant contact
    C. Other family members should receive Tdap
    D. Caregivers should receive Tdap
    E. Vaccinating family, and caregivers is called
    “cocooning”
A

b

31
Q
  1. All of the following are recommended as
    management in a subsequent pregnancy after a
    stillbirth EXCEPT:
    A. Detailed medical and obstetrical history
    B. Smoking cessation
    C. Genetic counseling
    D. Weight loss
    E. Diabetes screening
A

d

32
Q
  1. When your patient reports her progesterone
    implant is not palpable, all the following are
    appropriate courses of action EXCEPT:
    A. A pregnancy should be excluded
    B. A back up method should be recommended
    C. Emergency contraception, if appropriate
    should be recommended
    D. Excise implant immediately
    E. If she is pregnant, you should reassure her it
    is not a teratogen
A

d

33
Q
  1. A 24 year old G1 presents to L&D for late-term induction. Which of the following facts in her history would make endocarditis prophylaxis appropriate?
A. Current IV drug use with heroin with a history of
needle sharing
B. History of bacterial endocarditis
C. Current mitral valve stenosis
D. Current aortic stenosis
E. Mitral valve insufficiency
A

b

34
Q
  1. Which of the following is true regarding
    second trimester abortion?
    A. Medical abortion has fewer complications
    than D&E
    B. The most common complication of medical
    abortion is infection
    C. D&E is more cost effective
    D. Medical abortion involves less pain
    E. D&E has a much higher complication rate
A

c

35
Q
44. Women who have sex with women have a
higher incidence of which of the following
infections?
A. HIV
B. Trichomoniasis
C. Bacterial vaginosis
D. Chlamydia
E. HPV
A

c

36
Q
  1. Which of the following statements is FALSE
    about the ring pessary?
    A. Supported by the levator muscles
    B. It is made from silicone
    C. It can be worn during coitus
    D. It provides support to anterior vaginal wall
    defects
    E. It contains a spring mechanism providing
    support
A

a

37
Q
46. Which of the following drugs can prolong
the Q-T interval when given with
Ondansetron(Zofran)?
A. Vancomycin
B. Propofol
C. Fluoxetine
D. Methotrexate
E. Griseofulvin
A

c

38
Q
  1. Which of the following does not increase the
    risk for obstetric anal sphincter injuries?
    A. Labor augmentation
    B. Pregnancy duration
    C. Operative vaginal delivery
    D. Midline episiotomy
    E. Asian ethnicity
A

b

Maternal age, pregnancy duration, BMI, duration of second stage of labor were not different between women who had OASIS and women who did not.

39
Q
  1. All of the following are true about C. difficile
    infections EXCEPT:
    A. C. difficile is a gram positive anaerobe
    B. Antibiotics used perioperatively may result in
    overgrowth of C difficile
    C. Follow up stool assays are recommended 2
    weeks post treatment
    D. Metronidazole or Vancomycin may be used for
    treatment
    E. The condition may be fatal
A

c

40
Q
49. In disclosing adverse outcomes, it is helpful to
incorporate all the following into the discussion
EXCEPT:
A. Who
B. What
C. When
D. Where
E. Why
A

e

41
Q
  1. Which of the following is a relative
    contraindication to aerobic exercise in pregnancy?
    A. Restrictive lung disease
    B. Extreme underweight (BMI < 16)
    C. Hemodynamically significant cardiac disease
    D. Placenta previa after 26 weeks
    E. Severe anemia
A

b