Resident CREOG Questions #2 1. Which of the following may be involved in the pathophysiology of twin-twin transfusion? Multiple superficial vascular anastamoses Solitary deep arteriovenous channels Venous-venous connections Arterial-arterial connections 2. The majority of pregnancies with upper GI bleeding have which of the following? Boerhaave syndrome Stomach cancer Mallory-Weiss tears Peptic ulceration 3. Which of the following has the most influence on iron stores in the infant? Maternal iron status Timing of cord clamping Maternal vitamin C intake Blood loss at time of delivery 4. What is the fetal or neonatal risk of maternal ITP? Increased abortion rate Thrombocytopenia Necrotizing enterocolitis No rish 5. What is the most common form of cancer encountered in pregnancy? Breast Melanoma Hematologic Genital 6. On examination, a 12-year-old female demonstrates the following sexual characteristics: a secondary mound of areola and papilla above the breasts bilaterally and abundant, adult-type hair limited to the mons pubis. What is her Tanner stage of Development? Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 7. A 35-year-old Caucasian female presents to your office for amenorrhea for the last 6 months. Lab results reveal a negative pregnancy test, a normal TSH, and a normal prolactin. Her LH is normal at 6 mIU/ml. Her FSH is 50 mIU/ml and estradiol is 30 pg/ml. A 12 day regimen of Provera fails to cause vaginal bleeding. Her diagnosis is: Polycystic ovary disease Primary amenorrhea Premature ovarian failure Androgen insensitivity 8. Your patient is a 26 year old caucasian, nulliparous female with complaints of depressed mood, lack of energy, insomnia, irritability, anxiety, and breast tenderness to such a degree that it has affected her performance at work. She states that these symptoms are only associated with the days prior to menses. You recommend the following treatment Drospirenone Massage therapy Sumatriptan Naproxen 9. During your patient's annual gynecology physical exam she complains of an odd discharge. On exam you note a white vaginal discharge and collect a specimen to view under the microscope. While performing the KOH and Wet Prep you note an odd foul odor and numerous squamous cells laden with bacteria. You also note a vaginal pH of 5.0. What are the best treatment options for this patient? Provide no medical intervention. The findings on examination are normal. Rocephin 125mg IM x1 to effectively treat this gram negative organism. Instruct the patient to avoid tight fitting garments of natural fibers. Clindamycin cream, 2%, one full applicator (5 g) per vagina at bedtime for 7 days. 10. This describes multiple anomalies due to a single malformation. Malformation Disruption Deformation Sequence Syndrome 11. This describes an abnormal form, shape, or position of a part of the body due to mechanical force. Malformation Disruption Deformation Syndrome Sequence 12. This describes a defect that results from a developmental process which has been abnormal from the beginning of conception at very early in the life of the embryo. Malformation Disruption Deformation Syndrome Association 13. This describes a developmental defect that results from an intrinsic or extrinsic factor that interferes with the normal development process. Malformation Disruption Deformation Syndrome Association 14. This describes multiple anomalies resulting from a single known or presumed malformation, deformation, or disruption. Malformation Disruption Deformation Syndrome Sequence 15. Occurrence of multiple anomalies associated with a known or unknown malformation in two or more persons. Malformation Disruption Deformation Syndrome Association 16. The major source of lubrication during sexual arousal is Bartholin's glands Skene's glands vaginal transudation Cervical glands 17. A 22-year-old primigravid woman is in labor at term. X-ray pelvimetry is obtained after failure of labor to progress with the cervix dilated 6 cm and the fetal vertex at -2 station. Clinical pelvimetry shows a diagonal conjugate of 11 cm, convergent pelvic sidewalls, prominent ischial spines, a narrow sacrosciatic notch, and forward inclination of the sacrum. The pelvis is gynecoid android anthropoid platypelloid 18. A 22-year-old woman has a biopsy-proven carcinoma-in-situ of a single warty lesion in the posterior fourchette. The best treatment is skinning vulvectomy total vulvectomy trichloroacetic acid ablation topical 5-fluorouracil wide local exicision 19. In performing an omentectomy, which of the following should be ligated? Omental branch of the abdominal aortic artery Middle colic artery Gastroepiploic arteries Middle sacral artery Epigastric artery 20. Ten hours after a rapid vaginal delivery, a patient has lower abdominal and pelvic pain. She appears pale, her pulse is 125/min, and her blood pressure is 80/40 mm Hg. A right adnexal mass is palpable on both pelvic and abdominal examinations. The most likely diagnosis is appendiceal abscess broad ligament hematoma torsion of an ovarian cyst ovarian vein thrombosis uterine atony 21. You are called to labor and delivery to see a patient who has the following fetal tracing: Which of the following is the most likely etiology of the fetal tracing? Fetal anemia Maternal fever Fetal sepsis Reaction to meperdine 22. The most intense sensory mode of erotic stimulation is vision touch hearing smell taste 23. A 21-year-old nulliparous woman has a history of regular menses occurring every 30 days. It is now 16 days after the date of her expected period and she is having light vaginal spotting. A quantitative beta-HCG assay showed 140,000 mIU/ml. Which of the following is the most likely diagnosis? Multiple gestation Ectopic pregnancy Intrauterine pregnancy and ovarian dysgerminoma Blighted ovum Normal intrauterine pregnancy 24. Of the following, which is the most common cause of immediate postpartum hemorrhage? Retained placental fragment Uterine atony Cervical laceration Vaginal laceration Disseminated intravascular coagulation 25. A 24-year-old American woman, gravida 2, para 1, previously delivered an anencephalic infant. She now is 8 weeks' gestation and seeks your advice concerning the possibility of having a second affected infant. You should inform her that the risk of a neural tube defect in the next pregnancy is less than 0.5% 1 to 2% 4 to 5% 8 to 9% 12 to 13% 26. A 20-year-old, gravida 1, is bearing down uncontrollably with painful contractions in the second stage of labor. Lidocaine 35mg is administered for spinal block. Three minutes after being turned from the lateral recumbent position onto her back, she has numbness and tingling of both hands followed by respiratory depression. The most likely explanation is high spinal anesthesia hyperventilation syndrome hysterical reaction lidocaine toxicity inferior vena cava compression 27. A 78-year-old woman has biopsy-confirmed squamous cell carcinoma of the clitoris. The lesion is 3 x 2 cm, ulcerated and infiltrating the left labium majus. The urethra, vagina, and rectum are clinically uninvolved. The groin nodes are palpable, small (less than 0.5 cm), soft, and freely movable. Findings on a roentgenogram of the chest are unremarkable. This carcinoma is stage I II III IV 28. An 18-year-old primigravid woman is at 26 weeks' gestation. Culture of a mucopurulent endocervical discharge is positive for Chlamydia trachomatis. Which of the following antibiotics would be most appropriate for treatment of this infection? Dicloxacillin Azithromycin Ampicillin Vancomycin Erythromycin 29. A 22-year-old girl is being evaluated for primary amenorrhea. She is 155 cm (61 in) tall and sexually infantile. The cervix is visualized and the uterus palpated. She does not have phenotypic features of Turner's syndrome. The most appropriate next step in the management of this patient is to measure serum estradiol and estrione measure serum gonadotropins obtain a karyotype inspect the gonads by laparoscopy obtain a complete endocrine profile 30. The wolffian duct empties into the urogenital sinus coelomic cavity yolk sac allantois urachus 31. In living tissue the biologic (therapeutic) effects of irradiation depend on the presence of sulfhydryl groups oxygen carbohydrates hydrogen nitrates 32. You are called to the ED to evaluate a patient. She is a 32yo G0 who has been taking gonadotropins for infertility. She is experiencing severe abdominal pain and SOB. Physical examination reveals ascites. Ultrasound reveals ovaries >6cm in size bilaterally. Laboratory findings suggest renal failure. Which of the following medications should she receive? Ampicillin hCG Heparin Letrazole 33. Dihydrotestosterone (DHT) is the major androgen working at the hair follicle. Testosterone is converted to DHT by which of the following enzymes? 17-alpha hydroxylase 5-alpha reductase 11-beta hydroxylase 7-alpha reductase 34. Which of the following is considered to be a benefit of subtotal hysterectomy? Reduction of bladder dysfunction post hysterectomy Improved quality of orgasmic function post hysterectomy Limited blood loss intraoperatively Limiting the incidence of rectocele post hysterectomy 35. A patient with hemoglobin AS is NOT at increased risk for which of the following? Preeclampsia SGA infants Endometritis Cesarean section 36. Two days post op from an unscheduled cesarean section, secondary to presumed abruption, a patient develops a fever of 101.1 F. Which of the following is the greatest risk factor for this condition? Multiple vaginal exams Abdominal delivery Internal fetal monitoring Lack of perioperative antibiotics 37. Which of the following regarding prediction of preterm delivery is true? One-half of preterm deliveries occur in women without risk factors. Uterine contraction monitoring is superior to fetal fibronectin. Fetal fibronectin is superior to cervical length. Up to two-thirds of preterm deliveries occur in women with a history of prior preterm birth. 38. A patient comes to you complaining of a chronic, relapsing pattern of abdominopelvic pain and bowel dysfunction with constipation and/or diarrhea. Which of the following is true? Is rarely associated with chronic pelvic pain. Symptoms consistent with this disorder are found in 50-80% of women presenting to the gynecologist with chronic pelvic pain. An increased incidence of diverticulitis 35-85% of women presenting to the gynecologist with chronic pelvic pain have this disorder. 39. Which of the following is correct regarding cystic fibrosis screening? Cystic Fibrosis screening should be made available to caucasian couples. A negative carrier screen eliminates the risk of being a CF carrier. CF carrier screening should be offered before conception or early in pregnancy when both partners are of Caucasian, European, or Ashkenazi Jewish ethnicity. Complete analysis for CFTR gene by sequencing is often indicated for screening purposes. 40. The fetus of which mother has the highest risk of developing a hemolytic disease: AB-positive with an anti-M titer of 1:256. AB-negative with an anti-D titer of 1:16. AB-positive with an anti-Lewis titer of 1:128. O-negative with an anti-D titer of 1:16. 41. The maternal mortality rate for patients with Marfan's syndrome is: 25% 10% 15% 50% 42. ACOG recommends first visit to the OB/GYN for screening and provision of preventative health care services and guidance occurs between ages: 9-12 13-15 16-21 21-39 43. A 26yo AFrican American female with documetned sickle cell disease presents to your office with severe chest and joing pain with fevers. Patient denies productive cough however reports difficulty breating. An office CXR is completed which reveals pulmonary infiltrate SaO2 is 87 on RA revealing oeidosis. What disease process is being completed Pneumonia Bronchitis Acute chest syndrome another answer is needed here 44. The human placenta is hemochorial endotheliochorial syndesmochorial epitheliochorial 45. Angiotensin converting enzyme converts: renin to angiotensin angiotensinogen to angiotensin I angiotensin I to angiotensin II angiotensin II to thromboxane A2 angiotensin II to aoldosterone 46. An invasive squamous cell carcinoma of the vulva measuring 2.8 cm in a patient with no suspicious groin nodes is FIGO stage: I II III IV V 47. The recommended intravenous dose of epinephrine in patients with cardiovascular collapse is 0.1 ml of 1:1000 solution 1 ml of 1:10,000 solution 1 ml of 1:100,000 solution 5 ml of 1:1000 solution 5 ml of 1:10,000 solution 48. A patient has recently undergone a third spontaneous abortion, and the 8-week fetus is found to have a chromosomal anomaly. Which of the following would be the most likely karyotype of the fetus? Autosomal trisomy Mosaic Triploidy Translocation 47,XXX 49. The proportion of first-trimester abortions attributable to chromosomal abnormalities is approximately 10% 25% 33% 50% 75% 50. A 22-year-old woman who delivered her first infant 17 days ago has a six-hour history of malaise, fever to 38.9C (102F) and pain in the right breast and axilla. Physical examination shows a 4-cm erythematous, tender area in the upper outer quadrant of the right breast and enlarge axillary lymph nodes. Which of the following antibiotics is most appropriate for treatment of this condition? Dicloxacillin Metronidazole Doxycycline Clindamycin Ampicillin Loading...
