LONG EXAM 2 Puberty, Amenorrhea, Menopause, Preoperative Evaluation, Postoperative Management,CIN,VIN

Question 1

What is the potential effect of Ma Huang when given with halothane?

Bleeding
Myocardial ischemia
Hypotension
Ventricular arrhythmias

Answer 1

Ventricular arrhythmias

Question 2

Which BMI of a patient gives clear evidence of malnutrition?

24
22
20
18

Answer 2

18

Question 3

Which one is a correct recommendation for prophylaxis against Bacterial endocarditis?

Amoxicillin 1g IV
Azithromycin 500mg PO
Clindamycin 300 mg IV
Cefazolin 2g PO

Answer 3

Azithromycin 500mg PO

Question 4

This is a non-operative post-hysterectomy infection:

Phlebitis
Abscess
Cellulitis
Myonecrosis

Answer 4

Phlebitis

Question 5

Incidence of wound infection could be decreased by:

Decreasing operative time as much as possible
Patient must shower before surgery
Shaving of the wound site
Proper surgical technique should be done

Answer 5

Decreasing operative time as much as possible

Question 6

What is the most common cause of colonic obstruction in postoperative gynecologic surgery patients?

Ileus secondary of electrolyte imbalance
Advanced ovarian carcinoma
Postoperative adhesion
Bowel ischemia and perforation

Answer 6

Advanced ovarian carcinoma

Question 7

Which statement is true regarding low molecular weight heparin:

Half-life is 2 hours
Has less effect on partial thromboplastin time
Eliminated by the liver
Has less anti-Xa and more antithrombin activity

Answer 7

Has less effect on partial thromboplastin time

Question 8

What is the recommended management of postoperative DVT with a Caprini Risk Score of 2?

Graded compression stocking
Early ambulation
Pneumatic compression
Low dose heparin

Answer 8

Graded compression stocking

Question 9

What is the standard technique in the diagnosis of DVT?

Doppler ultrasound B-mode duplex
Magnetic resonance venography
Venography
Computed tomography scanning

Answer 9

Venography

Question 10

Which one is the recommended treatment of Pulmonary embolism?

Rivaroxaban 20 mg BID
Apixaban 25 mg OD
Dagibatran 150 mg BID
Edoxaban 600 mg once daily

Answer 10

Dagibatran 150 mg BID

Question 11

The current criteria for diagnosis of diabetes include

Weight loss even with increase appetite
Random blood glucose of >250 mg/dL
Fasting glucose < 126 mg/dL
Hemoglobin A1c >6.0%

Answer 11

Weight loss even with increase appetite

Question 12

The preoperative goal is by avoiding ketoacidosis and hypoglycemia and
hyperglycemia which includes:

One-third of usual daily dose of NPH insulin is given prior to surgery
Short-acting insulin without oral intake should be given
Infusion of 5% dextrose should be restricted while on insulin
Additional regular insulin can be administered one day prior to surgery

Answer 12

One-third of usual daily dose of NPH insulin is given prior to surgery

Question 13

A euthyroid state should be maintained for how many months before elective surgery?

2 months
3 months
4 months
5 months

Answer 13

3 months

Question 14

Which statement is true regarding management of hypothyroidism

T4 can be given by the intramuscular or intravenous route after 5 days

Starting dose of thyroxin is 1.6 ug/kg for thyroid hormone replacement

Thyroxin dosage of 0.025 mg OD every 4-6 weeks for elderly patients

T4 therapy can be held for 5 to 7 days once with bowel movement

Answer 14

Starting dose of thyroxin is 1.6 ug/kg for thyroid hormone replacement

Question 15

Which is an intermediate clinical predictor of increased perioperative cardiovascular risk?

Prior ischemic cardiac disease
Decompensated congestive heart failure
Advanced age
Uncontrolled systemic hypertension

Answer 15

Prior ischemic cardiac disease

Question 16

This method may be used to overcome the limitations of exercise stress testing?

Dobutamine stress echocardiography
Exercise stress testing
Dipyridamole-thallium scanning
Angiography

Answer 16

Dipyridamole-thallium scanning

Question 17

What is the treatment for congestive heart failure with the presence of cardiogenic asthma?

Furosemide
Morphine sulfate
Oxygen
Aminophylline

Answer 17

Aminophylline

Question 18

Which one is a sign or symptoms of aortic stenosis?

Diastolic murmur at the apex
Suffused face and lips
Decreased systolic blood pressure
Chest radiography with left atrial dilatation

Answer 18

Decreased systolic blood pressure

Question 19

Treatment for bradycardia that is less than 45 beats per minute is

Propranolol
Atropine
Epinephrine
Digoxin

Answer 19

Atropine

Question 20

Which one is true regarding predictor of postoperative pulmonary complications?

FEV1 = >1L
PaCO2 = >50 mmHg
PaO2 = < 60 mmHg
Maximal breathing capacity = 50% predicted

Answer 20

PaO2 = < 60 mmHg

Question 21

drenarche occurs progressively in late childhood, at what age does this usually start?

6-7 years old
7-8 years old
10-12 years old
12-13 years old

Answer 21

6-7 years old

Question 22

What is the normal characteristic of growth spurt in girls?

It usually occur at 13 years old
Growth usually doubles at increments of 5cm
Occurs 2 years after breast budding
Menarche follows after 2 years

Answer 22

Occurs 2 years after breast budding

Question 23

What is the main factor that influences the onset of puberty?

Genetic
Body weight
General health
Altitude

Answer 23

Genetic

Question 24

This statement best describe the physiology of puberty

a. The brain starts the process with the production of GnRH
b. Testosterone is somewhat responsible for the development of secondary sexual characteristics
c. Estrogen is responsible for the follicular development
d. The ovaries produces hormones responsible for the maintenance of puberty

Answer 24

a. The brain starts the process with the production of GnRH

Question 25

What is the hormone responsible for pubarche in girls? Testosterone Estrogen Androgen Progesterone

Answer 25

Androgen

Question 26

Which among the etiology of secondary amenorrhea is the cause when there is presence of secondary sexual characteristics Androgen insensitivity Hyperprolactinemia Hypopituitarism Gonadal failure

Answer 26

Androgen insensitivity

Question 27

This phase of puberty occurs progressively in late childhood from about 6-7 to adolescence Thelarche Pubarche Menarche Adrenarche

Answer 27

Adrenarche

Question 28

Which character does a child with precocious puberty manifest during adulthood? Premature menopause Normal menstrual cycle Infertility Low verbal IQ score

Answer 28

Normal menstrual cycle

Question 29

At what age do FSH and LH show very low amplitude of episodic release? 4-8 years old 8-13 years old 13-17 years old 1-4 years old

Answer 29

4-8 years old

Question 30

Which statement is true regarding treatment of precocious puberty GnRH analogues? a. The dose of GnRH agonist treatment is monitored by serum FSH levels b. Treatment is stopped when the epiphyses are matched to age c. Discontinuation of therapy may cause premature adrenarche d. GnRH agonist treatment is effective for precocious pseudo-puberty

Answer 30

d. GnRH agonist treatment is effective for precocious pseudo-puberty bonus question ni pero sa answer key ni doc is D

Question 31

Which among the findings suggest a precocious puberty caused by McCune Albright syndrome? a. Increased estradiol level, increased gonadal size, decreased basal FSH and LH, GnRH levels are flat b. Increased estradiol level, decreased gonadal, GnRH levels are decreased, increased basal FSH and LH c. GnRH levels are flat, decreased estradiol level, increased basal FSH and LH, increasde gonadal size d. Decreased gonadal size, increased basal FSH and LH, decreased estradiol level, GnRH levels are increased

Answer 31

a. Increased estradiol level, increased gonadal size, decreased basal FSH and LH, GnRH levels are flat

Question 32

This is a rare genetic disorder that affects the skin color and bones and causes hormonal problems McCune Albright Syndrome Congenital adrenal hyperplasia Autoimmune hypothyroidism Premature Adrenarche Syndrome

Answer 32

McCune Albright Syndrome

Question 33

This hormone is considered critical for the growth of children Estrogen Thyroid hormone Growth hormone Adrenal androgen

Answer 33

Estrogen

Question 34

What is the chromosomal pattern in Turner syndrome? 46XO 45XO 45XX 46XY

Answer 34

45XO

Question 35

Which statement is true regarding complications and prognosis of amenorrhea? a. All women with history of amenorrhea are at significant risk of developing osteoporosis b. Women with amenorrhea without estrogen deficiency are at increased risk of endometrial hyperplasia c. Women with amenorrhea generally do not conceive d. Women with polycystic ovary syndrome are at risk of DM type 2

Answer 35

b. Women with amenorrhea without estrogen deficiency are at increased risk of endometrial hyperplasia

Question 36

The hyperpigmented thickening of the skin folds of the axilla and neck is a sign of profound insulin resistance and is associated with polycystic ovary syndrome (PCOS) and obesity Acanthosis nigricans Discoid rash Malar rash Dark neck syndrome

Answer 36

Acanthosis nigricans

Question 37

The most common cause of hyperprolactinemia is Prolactinoma Nonfunctioning pituitary tumor Drug induced Breast tumor

Answer 37

Prolactinoma

Question 38

fter how many months of progesterone use will a woman experience amenorrhea 3 months 6 months 9 months 12 months

Answer 38

12 months

Question 39

Which one is a primary reason menopausal women seek care from a clinician Vaginal bleeding Dyspareunia Hot flashes Abdominal mass

Answer 39

Hot flashes

Question 40

This drug which is a selective serotonin reuptake inhibitor inhibits the enzyme system that converts tamoxifen to its active form Paroxetine Venlafaxine Escitalopram Bazedoxifene

Answer 40

Paroxetine

Question 41

The oral agent approved for the treatment of moderate to severe dyspareunia associated with VVA. DHEA Estrogen Ospemifene Sildenafil Citrate

Answer 41

Ospemifene

Question 42

What is the primary technique for bone mineral density assessment Dual x-ray absorptiometry T-scoring technique Serum calcium assessment Fracture risk assessment tool

Answer 42

Dual x-ray absorptiometry

Question 43

What is the female most likely to develop CIN after menopause During pregnancy During menarche after menstruation

Answer 43

During menarche

Question 44

This refers to squamous epithelial cells that undergone number of structural changes due to an HPV infection? Metaplasia Dysplasia Neoplasia Koilocytes

Answer 44

Koilocytes

Question 45

Microorganisms found in women with either malignant or negative intraepithelial lesion Gonorrhea Chlamydia Trichomonas Staphylococcus

Answer 45

Trichomonas

Question 46

a simplest method of determining the presence of CIN especially on low resource setting Papanicolaou test Visual inspection acetic acid test Colposcopy Cervicography

Answer 46

Visual inspection acetic acid test ???

Question 47

An abnormal pattern of small blood vessel suggesting a confluence of tile or chicken with reddish borders is called Mosaicism Chimerism Leucoplasia Metaplasia

Answer 47

Mosaicism

Question 48

This statement is true regarding HPV Vaccination? a. Quadrivalent vaccine includes protection against HPV 16 and 18 only b. Protection against HPV 6 and 11 is directed for genital warts c. Booster doses should be given 10 years after the last dose d. Catch up vaccination is recommended for girls starting 8 years old

Answer 48

b. Protection against HPV 6 and 11 is directed for genital warts

Question 49

Description of unifocal type of VIN includes Premenopausal women Postmenopausal women Associated with HPV HPV 31 is involved

Answer 49

Postmenopausal women

Question 50

The goal of treatment of VIN is Wide excision vulvectomy Preservation of vulvar function Prevention of metastasis Expectant management

Answer 50

Preservation of vulvar function