Resident CREOG Questions #1 1. Which of the following lung parameters is unchanged during pregnancy? Vital capacity Residual volume Inspiratory capacity Expiratory capacity 2. Ovulation occurs: 15 days after menstruation 7 days after menstruation 14 days before menstruation 20 days after menstruation 10 days before menstruation 3. How many times a year will a healthy 25 year old woman ovulate? 5 to 7 times 9 to 11 times 13 to 14 times 15 to 20 times 4. Ovulation is best proven by: Laparoscopy Endometrial biopsy Basal body temperature Vaginal epithelial cell histology 5. This condition results from a strong desire for pregnancy and resultant physical changes: Pseudocyesis Factitious disorder Dissociative disorder Somatoform disorder 6. During the first trimester, the source of elevated estrogen and progesterone is: the placenta fetal liver corpus luteum maternal ovaries fetal adrenal gland 7. Which of the following immunoglobulins cross the placenta and provide immunity for the newborn? IgG IgA IgM IgD IgE 8. Levels of hCG are highest at: 10 weeks 12 weeks 22 weeks 25 weeks 28 weeks 9. Causes of melasma include: Pregnancy Birth control pills Both pregancy and birth control pills Neither pregnancy or birth control pills 10. Which of the following is decreased during pregnancy? Cardiac output Urinary frequency Gastrointestinal motility Gastroesophageal reflux 11. What is the most common cerebral neoplasm during pregnancy? Glioma Meningioma Neurofibroma Pituitary adenoma 12. A 25-year-old G0, presents for preconception counseling. She is a marathon runner and wants to continue to train during her pregnancy. This patient wants to know if there are any potential adverse affects of exercise during pregnancy. What do you advise her? During pregnancy, she should stop exercising to reduce the risk of intrauterine growth retardation (IUGR) in the fetus. Exercise should be performed in the supine position to increase venous return and cardiac output. She may continue to exercise throughout pregnancy as long as her heart rate does not exceed 160 bpm. Non-weight-bearing exercises are optimal because they minimize the risks of maternal and fetal injuries. Immediately following delivery, patients can continue to exercise at prepregnancy levels. 13. A 26 G1P0 is seronegative for rubella. You advise her to avoid exposure to rubella early in pregnancy because it can result in an infant with which of the following? Thrombocytosis and hyposplenism Hypertelorism (wide-set eyes) Glaucoma Tetralogy of Fallot Hydocele 14. Abuse of which of the following substances is associated with multiple fetal congenital anomalies including microcephaly, cardiac anomalies, and growth retardation? Cocaine Amphetamines Heroine Alcohol Marijuana 15. A 42 year old female presents with abnormal bleeding. On exam, there is a large, ulcerative mass on the cervix that measures 5 cm. Biopsy reveals squamous cell carcinoma. The patient has ended her child-bearing. There is no other evidence of metastatic disease. Which of the following is the most appropriate treatment? Radical trachelectomy with pelvic lymph node dissection. Combined external beam radiation with brachytherapy and chemotherapy. Cisplatin alone. Radical hysterectomy with bilateral pelvic lymphadenectomy. Cold knife conization. 16. Which of the following is the major dose-limiting toxicity of Cisplatin? Ototoxicity Neutropenia Nephrotoxicity Neurotoxicity Nausea and vomiting 17. Methotrexate is an example of what class of chemotherapeutic drugs? Intercalating agent Antimetabolite Alkylating agent Topoisomerase inhibitor 18. First line treatment for gestational trophoblastic disease includes methotrexate or which of the following: Bleomycin Daunorubicin Gemcitabine Dactinomycin 19. Which of the following tumor markers is specific for yolk sac tumors of the ovary? AFP Beta-HCG CA 19-9 CA 125 20. The quadrivalent human papilloma virus (HPV) (Gardasil) offers protection against which viral subtypes? 16, 18 , 31, 33 6, 11, 16, 18 6, 11, 31, 33 6, 16, 18, 31 21. The drug Mesna is given along with cyclophosphamide to prevent which Mouth ulcerations Bone marrow suppression Hemorrhagic cystitis Alopecia 22. Which of the following is true regarding cervical dysgenesis? Cervical agenesis is the most common mullerian anomaly There is one type of cervical dysgenesis Creation of a passage between the uterus and the vagina is a simple, highly successful procedure Conservative management, with hormonal suppression of endometrial stimulation, is appropriate for young patients 23. Which degenerative changes in leiomymata are the least common? Hyaline degeneration Red or carneous degeneration Necrosis Sarcomatous degeneration 24. Which of the following are true regarding verbal orders? They should only be used in urgent/emergent situations. The physician should request that the order be read back. The indication for the drug should be included to help avoid confusion with similar sounding drug names. Specific dosing and route of administration information should always be detailed. All of the above. 25. A group of women who work in a battery factory are recruited and compared to a matched control group over a ten year period. Outcomes such as miscarriage rate and rate of birth defects are compared. This type of study is an example of a: Cross-sectional study Prospective cohort study Nonrandomized controlled trial Time-trend study Case-control study 26. Which of the following factors has not been identified by JCAHO that contribute to increased risk of wrong-site injury? Multiple surgeons involved in case Multiple procedures during a single surgical visit Preoperative verification process Unusual time pressures to start or complete procedure Unusual physical characteristics, including morbid obesity or physical deformity 27. Which of the following abbreviations is on the JCAHO official Do Not Use" list?""hich of the follo" QID PV MgSO4 QHS PRN 28. Skin lesions consistent with secondary syphilis closely resemble: Lichen planus Psoriasis Seborrheic dermatitis Pityriasis rubra pilaris Pityriasis rosea 29. Systemic therapy of psoriasis includes one of the following: Methotrexate Doxyrubicin 5-FU Taxol Cisplatin 30. A mother brings her daughter to see you for concerns of no menses by the age of 16. On examination, pubic and axillary hair are absent. Ultrasonography reveals absence of the uterus. The most likely diagnosis is: Mayer-Rokitansky-Kuster-Hauser Syndrome Incomplete androgen insensitivity Turner Syndrome Androgen insensitivity 31. Which of the following is the most discriminating value for infertility based on semen analysis? Motility Morphology Concentration Volume 32. Which of the following should be used as antepartum prophylaxis for preeclampsia? ASA Calcium supplementation Antioxidants (e.g. Vit. E) Diuretics None of the above 33. Which of the following are absolutely contraindicated in the management of hypertension in pregnancy? Ganglionic blockers Diuretic therapy Ace Inhibitors Both A and B Both A and C 34. All of the following are risk factors for osteoporosis except: Female gender Menopause less than age 40 Inadequate exercise Obesity Alcohol intake greater than 2 drinks/day 35. Which T-score below indicates osteoporosis? -2.0 -2.5 -1.5 2.0 2.5 36. Which of the following is an absolute contraindication to exercise in pregnancy? Poorly controlled Type I Diabetes Poorly controlled hypertension Persistent second or third trimester bleeding IUGR in current pregnancy 37. A 24 year old woman underwent cesarean delivery 96 hours ago. For the past 10 hours, she has had increasing abdominal distention, nausea, and malaise. No erythema or induration is seen along the margin of the incision, but a copious amount of serosanguineous fluid is draining from the wound. The most likely diagnosis is: Wound hematoma Wound infection Wound dehiscence Portal vein thrombosis Enterocutaneous fistula 38. Pseudomembranous enterocolitis seen in a patient after 14 days of antibiotics is caused by Local hypersensitivity in the antibiotics Cytotoxin secreted by Clostridium difficile Colonic overgrowth of S. aureus Infection of the intestinal mucosa with C. perfringens 39. A 57 year old woman complains of postmenopausal bleeding for the last 3 months. Findings on exam are normal. The uterus sounds to 7 cm. Endometrial biopsy produces tissue that is reported to be moderately well-differentiated adenocarcinoma. Results of the endocervical curettage (ECC) are negative. Surgery is performed and the lesion is found to be confined to the uterine corpus with superficial invasion. What is the FIGO state of her disease? IA, grade 2 IA, grade 3 IB, grade 1 IB, grade 2 40. In a patient with precocious puberty and no discernible pathologic findings, appropriate treatment is administration of oral contraceptives conjugated estrogens cyclic estrogen and progesterone therapy gonadotropin-releasing hormone (GnRH) agonist 41. One week after a total abdominal hysterectomy, a 47 year old woman has temperature up to 39.4 C (103 F). An intravenous pyelogram (IVP) shows a ureteral obstruction low in the pelvis. The initial procedure of choice is uterovesical anastomosis with psoas hitch ureteroureteral anastomosis deligation of the ureter percutanous nephrostomy ureteral catheterization 42. Which of the following is the appropriate vacuum for evacuating an incomplete abortion? 60 mm Hg 40 mm Hg 30 mm Hg 20 mm Hg 10 mm Hg 43. A 23 year old primigravid woman is having her first prenatal examination at 14 weeks of gestation. She underwent subtotal thyroidectomy for Graves disease 3 years ago. She is not on any medications. Total thyroxine (T4) concentration is 14 mg/dl (Normal 5-12), triidothyronine resin uptake (T3RU) is 20% (Normal 25-35%), and thyroid-stimulating hormone (TSH) is 4 mU/ml (Normal 0-6 mU/ml). The next step in management should be determination of the serum concentration of long-acting thyroid stimultor (LATS) ultrasound examination of the thyroid administration of propylthiouracil radionuclide scan of the thyroid no treatment 44. An 18 year old primigravid patient is admitted for preterm, premature rupture of membranes at 31 weeks of gestation. She is afebrile and tests positive for group B streptococci. Which of the following is the most appropriate management of this patient? Steroid administration now and antibiotics during labor only Antibiotics and immediate cesarean delivery Antibiotics and immediate induction of labor Steroids, antibiotics and continued expectant management Antibiotics, steroids, and induction of labor in 48 hours 45. You perform an ultrasound examination on a 21 year old nulliparous woman whose uterus measures larger than expected for her dates. The vertical depth of the largest amniotic fluid pocket is 10 cm. Which of the following conditions is most likely to be associated with this ultrasound finding? Intrauterine growth restriction (IUGR) Postdate pregancy Duodenal atresia Renal agenesis Hydrocephalus 46. Which of the following is the most common histiologic type of breast cancer? Fibrosarcoma Tubular sarcoma Colloid carcinoma Mucious carcinoma Infiltrating ductal carcinoma 47. Five days ago a 34 year old woman had a total abdominal hysterectomy and bilateral salpingo-oopherectomy for extensive endometriosis. For the past 3 days, she has had chills, fever, and tenderness of the costovertebral angle. These symptoms have not responded to parenterally administered antibiotics. The most appropriate next step in the evaluation of this patient is Laparotomy Laparoscopy Gallium scan Intravenous pyelogram (IVP) discontinuation of antibiotics and repeat urine culture 48. The primary rationale for performing a pelvic exenteration is to perform cytoreduction of a large central pelvic malignancy remove recurrent cervical malignancy in the central pelvis palliate recurrent pelvic cancer divert the lower urinary system remove infected pelvic tissue 49. A patient experiences premature rupture of membranes at 29 weeks of gestation. Which of the following is most compatible with a diagnosis of chorioamnionitis? Fetal heart rate of 160 bpm Malodorous vaginal discharge Bacteria in fluid from amniocentesis Elevated C-reactive proten in maternal serum Maternal temperature of 37.3 C (99.2 F) 50. Which of the following is increased when twin pregnancies are compared to singletons? Perinatal mortality Structural abnormalities Cerebral palsy All of the above Loading...
