Resident CREOG Questions #3 1. A 37-year-old woman is hospitalized with biopsy-confirmed epidermoid carcinoma of the cervix. On clinical examination both parametria are nodular and apparently infiltrated. Both vaginal fornices are infiltrated, but the bladder and rectum are not. The IVP shows hydronephrosis without evidence of calculus; findings on a roentgenogram of the chest are unremarkable. The CT scan shows enlarged para-aortic lymph nodes. The FIGO stage is IIA IIB IIIA IIIB IVB 2. A pregnant woman is concerned about the possibility of giving birth to a second child with Tay-Sachs disease. Which of the following studies will show whether the fetus is affected? Measurement of alpha-fetoprotein in maternal serum Measurement of glucose 6-phosphate dehydrogenase in amniotic cells Preparation of a karyotype from cultured amniotic cells Measurement of hexosaminidase A in cultured amniotic cells 3. The congenital anomaly most likely to be associated with use of valproic acid (Depakene) in pregnancy is cleft palate spina bifida anencephaly hydrocephalus patent ductus arteriosus 4. The volume of amniotic fluid is maximum at a gestational age of 25 to 26 weeks 28 to 29 weeks 32 to 34 weeks 36 to 37 weeks 39 to 40 weeks 5. The risk of uterine perforation at the time of first trimester elective abortion is decreased by increasing gestational age use of laminaria tents use of general anesthesia a history of full term deliveries use of Hegar dilators 6. Which of the following is a risk factor for the development of uterine sarcoma? Use of exogenous estrogens Multiparity Family history Prior pelvic irradiation Multiple sex partners 7. At the time of cesarean delivery, numerous slightly raised, red-pink excrescences are noted on the surface of normal-sized ovaries. These findings most likely indicate ovarian cancer Walthard's rests decidual reaction corpus luteum of pregnancy endometriosis 8. Appropriate therapy for stage II carcinoma of the vulva is wide local incision of the lesion with a 3-cm margin wide local incision of the lesion and superficial lymphadenectomy of the ipsilateral groin radical vulvectomy and radiation therapy of the ipsilateral groin radical vulvectomy with bilateral superficial and deep femoral lymphadenectomy simple vulvectomy 9. Which of the following is the most common disorder in infants with congenital rubella? Patent ductus arteriosus Glaucoma Cerebral palsy Cataract Deafness 10. Which of the following is the earliest sign of sexual arousal in the female? Increase in size of the labia minora Increase in size of the clitoris Increase in vaginal moisture Increase in length of the vaginal canal Skin flush 11. Which of the following forceps can be used safely to apply traction to a transverse vertex in the midpelvis with a flat sacrum? Kielland's Tucker-McLane Barton Simpson's Elliott 12. Endodermal sinus tumors of the ovary are characteristically associated with elevated levels of alpha-fetoprotein carcinoembryonic antigen Ca125 beta-hCG hPL 13. A 28-year-old woman, gravida 3, para 2, is 16 weeks pregnant. Her prenatal Papanicolaou smear is reported as compatible with intraepithelial neoplasia. Colposcopically directed biopsies show questionable microinvasion. The most appropriate management is cold knife conization laser conization observation until after delivery cryosurgery simple hysterectomy 14. A hepatitis B screening test is positive for antibody to core protein but negative for surface antigen and antibody. This indicates that the patient is a chronic carrier the surface antibody will probably become positive soon the patient probably never had hepatitis B there has been a cross-reaction with hepatitis A the patient has a high rate of infectivity 15. The first maturation division of the ovum occurs in the oviduct after fertilization in the graafian follicle in the germinal epithelium in the uterus 16. Signet ring cells are characteristic findings in which of the following tumors of the ovary? Brenner tumor Krukenberg's tumor Dermoid cysts Endometroid carcinoma Dysgerminoma 17. What type of inheritance is most likely to be associated with the pedigree shown above? Autosomal dominant Autosomal recessive X-linked dominant X-linked recessive Multifactorial 18. The maximal pubertal growth spurt in girls follows breast budding by approximately one year occurs at the same age as in boys occurs simultaneously with menarche is associated with a decrease in total body fat is associated with a fivefold increase in muscle mass 19. The most common cytogenetic pattern in hydatidiform mole is diploidy with predominantly XX features polyploidy with an equal number of XY and XX features 47, XXY triploidy with predominantly XX features 20. A 55-year-old woman has been treated for stage III ovarian carcinoma by hysterectomy, bilateral salpingooophorectomy, and 80% reduction of the tumor mass, followed by multiple-agent chemotherapy. She now has large intra-abdominal masses. Further therapy is not possible. Her terminal state is most likely to be associated with ureteral obstruction intestinal obstruction urinary retention brain metastases bone metastases 21. An 18-year-old primigravid woman at 39 weeks' gestation had a normal first stage of labor under epidural anesthesia. The second stage of labor has lasted 150 minutes. The fetal vertex is markedly molded at +3 station in the occiput anterior position. The estimated fetal weight is 3250 g. THe patient is very tired and has difficulty bearing down effectively. Which of the following forceps would be most appropriate for effecting delivery in this patient? Kielland's Barton Bailey-Williamson Tucker-McLane Simpson's 22. During preconceptual counseling, a 21-year-old, healthy, nulligravid woman states that her younger brother has cystic fibrosis. Her empiric risk of being a carrier of the gene for cystic fibrosis is 1/4 1/3 1/2 2/3 3/4 23. Each of the following features of the sexual response decreases in menopausal women EXCEPT rate of vaginal lubrication amount of vaginal lubrication strength of orgasmic contractions amount of vaginal tenting sexual interest 24. Each of the following is an ovarian germ cell neoplasm EXCEPT granulosa cell tumor embryonal carcinoma dysgerminoma teratoma endodermal sinus tumor 25. Each of the following statements concerning chronic hypertension in pregnancy is true EXCEPT The risk of abruptio placentae is increased Outcome is worsened by the development of superimposed preeclampsia Patients with uncomplicated mild hypertension have a similar perinatal outcome as the general population Treatment with antihypertensives prevents superimposed preeclampsia Severe hypertensive disease increases the risk of early pregnancy loss 26. Each of the following erythrocyte antigens causes hemolytic disease of the newborn EXCEPT Duffy ABO KIDD Lewis Kell 27. Each of the following statements concerning monozygotic twins is true EXCEPT Perinatal mortality rate is greater than for dizygotic twins Placental vascular anastomoses are more common than for dizygotic twins Intrauterine growth retardation is asymmetric The ovum most commonly splits before day 8 The incidence increases with use of clomiphene citrate (Clomid) 28. Each of the following is a recognized risk factor for preterm birth EXCEPT previous preterm birth smoking Black race previous cesarean delivery for dystocia previous second-trimester spontaneous abortion 29. Each of following statements concerning the levator ani muscle is true EXCEPT It constricts the vagina It draws the rectum forward and upward It lies between the skin and external pelvic fascia It hypertrophies during pregnancy It has fibers interdigitating with superficial transverse muscles of the perineum 30. Each of the following statements concerning amniotic fluid in normal pregnancy is true EXCEPT The concentration of bilirubin pigment decreases approaching term It is bacteriostatic The concentration of creatinine increases approaching term Osmolality increases approaching term L/s ratio increases approaching term 31. Each of the following statements concerning transvestism is true EXCEPT Transvestites commonly become transsexuals Transvestites are predominantly heterosexual males Sexual arousal is enhanced by cross-dressing Transvestism usually begins before adulthood Transvestites are at higher than normal risk for depressive disorders 32. Select the tumor most likely associated with the finding of Psammoma bodies Granulosa cell tumor Adult cystic teratoma Endodermal sinus tumor Sertoli-Leydig cell tumor Serous cystadenocarcinoma 33. Select the tumor most likely associated with the finding of Call-Exner bodies Granulosa cell tumor Adult cystic teratoma Endodermal sinus tumor Sertoli-Leydig cell tumor Serous cystadenocarcinoma 34. Which tumor is most likely associated with Rokitansky's protuberance? Granulosa cell tumor Adult cystic teratoma Endodermal sinus tumor Sertoli-Leydig cell tumor Serous cystadenocarcinoma 35. Adenoma of Pick is most likely associated with Granulosa cell tumor Adult cystic teratoma Endodermal sinus tumor Sertoli-Leydig cell tumor Serous cystadenocarcinoma 36. Select the most reactive absorbable suture Polyglycolic acid Prolene Chromic catgut Braided silk Silver wire 37. Select the least reactive absorbable suture Polyglycolic acid Prolene Chromic catgut Braided silk Silver wire 38. Toxic shock syndrome includes anemia hypothermia in early stages positive blood culture desquamative rash 39. The majority of patients with hydatidiform mole have vaginal bleeding in the first or early second trimester preeclampsia thyrotoxicosis uterine size smaller than normal for gestational dates 40. Important factors associated with the presence of drugs in breast milk include lipid solubility maternal plasma concentration protein binding interval since administration all of the above 41. Conditions that increase the likelihood of vasa previa include all EXCEPT placenta circumvallata multiple pregnancy velamentous cord insertion 42. Predictors of prognosis for a patient with adenocarcinoma of the endometrium include all EXCEPT cell type histologic grade depth of myometrial invasion concomitant adenomyosis 43. The Müllerian duct gives rise to the upper vagina and fallopian tube vaginal introitus coelomic cavity 44. Gonadectomy is indicated in Swyer's syndrome a phenotypic female with mixed gonadal dysgenesis complete androgen insensitivity syndrome 45,X/46,XY karyotype all of the above 45. A patient experienced tissue necrosis around her IV site, requiring surgical excision. Which drug was she most likely receiving? Paclitaxel Penicillin Doxorubicin Methotrexate Gentamicin Loading...
