Gynecology and OB

Question 1

Ligament of the uterus that provides substantial uterine support

Answer 1

Cardinal ligament
Uterosacral

Level I

Question 2

Point of reference to compute POP Pelvic Organ Prolapse scoring

Answer 2

Hymen

Question 3

Risk factor associated to 10 fold higher odds of POP

Answer 3

vaginal birth

Question 4

Initial incision to the parietal peritoneum to gain access to the retroperitoneal space

Answer 4

Round ligament

Question 5

Artery that courses through round ligament

Answer 5

Sampson artery

Question 6

Sampson artery is a branch of the

Answer 6

uterine artery from internal iliac

Question 7

Suspensory ligament of the ovary

Answer 7

Infundibulopelvic ligament

with ovarian vessels

Question 8

Ovarian arteries are direct branch of

Answer 8

Aorta

Question 9

R ovarian vein drains to

Answer 9

IVC

Question 10

L ovarian vein drains to

Answer 10

Lef renal

Question 11

Blood vessel in cervix is located at

Answer 11

3 o clock

9 o clock

Question 12

Most common site of cervical dysplasia

Answer 12

Transformation zone

Old -> new squamocolumnar junction

Question 13

Ovarian artery is a branch of

Answer 13

Aorta

Question 14

Uterine artery is a branch of the

Answer 14

Internal iliac artery

Question 15

Water under the bridge

Answer 15

Uterine artery above ureter

Question 16

Ligated to control hemorrhae

Answer 16

Internal iliac artery

Ovarian artery

Question 17

Hyperflexion of the leg in lithotomy injures what nerve

Answer 17

Femoral nerve

Question 18

Hyperflexion of the knee during lithotomy injures the

Answer 18

Common peroneal nerve

Question 19

Most catastrophic bleeding occurs when implantation site is in the

Answer 19

Intramural segment (anastomosis of ovarian and uterine artery)

Question 20

Preferred site to apply occlusive device such as clip for female sterilization

Answer 20

Isthmus

Question 21

Honeycomb pattern

Snowstorm pattern

Answer 21

Molar pregnancy

Question 22

Structures that originate from Mullerian duct

Answer 22

Fallopian tube
Uterus
Cervix

Question 23

Absence/agenesis of Mullerian Duct

Cc: Primary amenorrhea

XX

With vagina upon IE but no cervix, uterus and fallopian tube

With ovary

Answer 23

Mayer Rokitansky Kuster Hauser Syndrome

Question 24

Cervic
Uterus
Fallopian tube

All from Mullerian duct are lined by

Answer 24

Columnar epithelium

Question 25

True conjugate Obstetric conjugate Diagonal conjugate

Answer 25

12 10 11.5 TOD Subtract 1.5 - 2 cm from True conjugate

Question 26

End product of follicular phase

Answer 26

Estrogen high

Question 27

Aromatization of adrostenedione and testosterone into estrogen and progesterone is made possible by this hormone

Answer 27

Progesterone

Question 28

LH surge is caused by

Answer 28

High output estrogen

Question 29

Primary oocytes are arrested in this phase of meiosis I?

Answer 29

Prophase I

Question 30

End product of luteal phase

Answer 30

Progesterone

Question 31

Secondary arrest of primary oocyte happens in what phase of meiosis II

Answer 31

Metaphase

Question 32

First histologic indication of progesterone

Answer 32

Subnuclear vacuoles

Question 33

Stimulates GnRH

Answer 33

Neuroepinephrine Neuropeptide Y Glutamate

Question 34

Inhibitory to GnRH

Answer 34

GABA Beta endorphin CRH dopamine

Question 35

Estrogen is secreted by

Answer 35

Dominant follicle of ovary

Question 36

Estrogen target organs

Answer 36

Hypothalamus AP Endometrium + feedback growth of endometrium

Question 37

Inhibin is secreted by

Answer 37

Dominant follicle of ovary

Question 38

Inhibin targets the

Answer 38

Anterior pituitary - feedback to inhibit FSH to promote ovulation

Question 39

Progesterone is secreted by

Answer 39

Corpus luteum of ovary Targets endometrium Secretion of glands and hyperplasia

Question 40

Clomiphene citrate MOA

Answer 40

Estrogen antagonist for anovulation to stimulate inc FSH

Question 41

Letrozole

Answer 41

Aromatase inhibitor that inhibits enzyme that hydrolzes enzyme for aromatization

Question 42

Best time to perform UTZ in AUB

Answer 42

Day 4-6 menstruation = 5 mm rules out endometrial carcinoma

Question 43

Endometrial biopsy is done if

Answer 43

age >40 years risk factors for endometrial CA failure of medical treatment breast CA patient on tamoxifen with AUB

Question 44

Attenuated androgen | Produces hypoestrogenic and hyperandrogenic effect

Answer 44

Danazol

Question 45

Level II De Lancey support

Answer 45

Pubocervical fascia anteriorly Rectovaginal fascia posteriorly Levator ani (through tendinous fasciae)

Question 46

Level III De Lancey Support

Answer 46

Perineal membrane

Question 47

Relaxin is secreted by the

Answer 47

Corpus luteum along with progesterone

Question 48

Palpable lateral bulge or soft prominence one of the locations where the uterine tube meets the uterus

Answer 48

Piskacek sign

Question 49

Ferning is by the hormone

Answer 49

estrogen

Question 50

Response to pregnancy/progesterone by vaginal cells

Answer 50

Navicular cell | Naked cell

Question 51

All clotting factors are increased in pregnancy except

Answer 51

XI XIII Inc 50% of fibrinogen

Question 52

All CV functions increased except

Answer 52

SVR

Question 53

Anemia threshold in pregnancy

Answer 53

First - 11 g/dl Second - 10.5 g/dl Third - 11 g/dl

Question 54

Pregnant is more prone to GERD due to laxity because of

Answer 54

Progesterone

Question 55

Hyperemesis gravidarum tx

Answer 55

Doxylamine with Pyridoxine

Question 56

No pregnancy >20 weeks

Answer 56

Nullipara | But Gravida

Question 57

Iron requirement

Answer 57

60 mg/day elemental iron 100 mg ferrous fumarate 150 ng ferrous sulfate