2012 final

Question 1

What exerts negative feedback on FSH?

Answer 1

Inhibin-A

Question 2

Biopsy of a 27-year old showed neurofibrillary tangles and plaques. Diagnose.

▪ Down syndrome
▪ Alzheimer’s disease

Answer 2

▪ Down syndrome

Question 3

What is the effect of inflammatory cytokines on recurrent miscarriage?

Answer 3

Apoptosis of trophoblasts

Question 4

Which breast quadrant is the most involved in pathologies?

Answer 4

Upper outer

Question 5

A pregnant woman was examined and the baby’s head was in the suprapubic area and the back was in the left middle area. Where will you auscultate for the heart sounds?

▪ Left upper abdominal area
▪ Left lower abdominal area
▪ Above the umbilicus

Answer 5

▪ Left lower abdominal area

• Auscultation is best heart at the most convex area, i.e. baby’s back in this case is in the left lower abdominal area

Question 6

Which drug if used in the first trimester causes nasal hypoplasia?

Answer 6

Warfarin

Question 7

What is true regarding norgestimate?

▪ Estrogen analog
▪ Can be taken in pregnancy
▪ Contraindicated in breast feeding 
▪ Minimal androgenic activity
▪ Increase HDL

Answer 7

▪ Minimal androgenic activity

Question 8

What is true regarding hormone replacement therapy for menopausal woman?

▪ More effective if given earlier
▪ Reverses bone damage
▪ Cause hot flashes

Answer 8

▪ More effective if given earlier

Question 9

What is the normal length of the menstrual cycle?

Answer 9

21 to 35 days

Question 10

Calculate the delivery date if the last menstrual period is 10 – 1 – 2016.

Answer 10

17–10–2016

Question 11

A 22-year old women who is pregnant for the 5t​ h​ time has a history of 2 spontaneous abortions at 8 and 9 weeks of gestation, respectively. She also has a history of 2 preterm deliveries with 2 live babies. What is the parity code?

Answer 11

G5 P(0+2+2+2)

Question 12

What best describes a parasitic infection transmitted from the mother to the fetus during the first trimester of pregnancy?

▪ Microvascular disease 
▪ Cerebral infarction
▪ Cerebral hemorrhage 
▪ Ring enhancing lesion 
▪ Multiple abscess
▪ Multiple tumors 
▪ Encephalitis
▪ Meningoencephalitis

Answer 12

▪ Ring enhancing lesion

• Due to toxoplasmosis

Question 13

What best cerebral malaria?

▪ Ring enhancing lesion
▪ Cerebral infarction
▪ Cerebral hemorrhage 
▪ Multiple abscess
▪ Multiple tumors
▪ Encephalitis
▪ Microvascular disease 
▪ Meningoencephalitis

Answer 13

▪ Microvascular disease

Question 14

Accelerated follicular atresia with abnormal ovulation occur in which case?

Answer 14

48-year old woman with irregular menstrual cycles

Question 15

A decrease in progesterone and estradiol after disintegration of the corpus luteum with constriction of the spiral arteries causes blood loss from endometrium. In which case does the previous scenario apply?

Answer 15

A 20-year old female with regular menstrual cycle

Question 16

Which of the following conditions is a contraindication for the use of contraceptives?

▪ Thromboembolic disease
▪ Uterine fibroids
▪ Hypoglycemia
▪ Functional ovarian cysts 
▪ Endometrial carcinoma

Answer 16

▪ Thromboembolic disease

Question 17

What is responsible for expelling the final residue of semen or urine?

▪ Deep perineal pouch 
▪ Bulbospongiosus
▪ Coccygeus
▪ Ischiocavernosus
▪ Levator ani

Answer 17

▪ Bulbospongiosus

Question 18

What describes a menstrual cycle of 6-7 days every 45 days?

▪ Hypomenorrhea
▪ Oligomenorrhea
▪ Amenorrhea

Answer 18

▪ Oligomenorrhea

Question 19

Call-Exner bodies are seen in which tumor?

Answer 19

Granulosa-theca cell tumor of the ovary

Question 20

A 23-year old male came with gynecomastia and testicular mass showing reinke crystals. Diagnose.

Answer 20

Leydig cell tumor

Question 21

Where does fertilization occur in the fallopian tube?

▪ Isthmus
▪ Fimbria
▪ Infundibulum
▪ Ampulla

Answer 21

▪ Ampulla

Question 22

From which fold does the labia minora come from?

▪ Urethral 
▪ Urogenital
▪ Urosacral 
▪ Genital
▪ Labial

Answer 22

▪ Urogenital

Question 23

What is the mechanism of action of prostaglandin-induced labor?

▪ Increased sensitivity of endometrium to oxytocin
▪ Decreased myometrial ionic gap junctions
▪ Increased asynchronous endometrial contractions
▪ Increased oxytocin secretion
▪ Decreased relaxin

Answer 23

▪ Increased sensitivity of endometrium to oxytocin

Question 24

What controls menstrual cycle?

▪ Thyroid gland
▪ Cerebral cortex
▪ Local endometrial factors
▪ Anterior pituitary gland
▪ Coagulative and fibrinolytic system

Answer 24

▪ Anterior pituitary gland

Question 25

What cell is derived from the genital ridge mesenchyme? ``` ▪ Leydig cell ▪ Granulosa cell ▪ Secondary spermatocytes ▪ Rete testis ▪ Zona pellucida ```

Answer 25

▪ Leydig cell

Question 26

What forms the primitive sex cells?

Answer 26

Primary sex cords

Question 27

What is used to view critical appraisal summaries of selected, clinically important articles? ``` ▪ PubMed ▪ Up-To-Date ▪ Cochrane ▪ ACP Journal Club ▪ Evidence-Based Medicine ```

Answer 27

▪ ACP Journal Club * For systemic review (meta-analyses), PubMed and Cochrane are used. For critical appraisal summaries, critically-appraised topics (CAT’s) are used including: ACP Journal Club, Essential Evidence Plus, TRIP Database, and JAMA Evidence. Online updated textbooks include Up-To-Date and MD Consult.

Question 28

What describes ectopic endometrial tissue in the ovary?

Answer 28

Chocolate cyst

Question 29

What corresponds to L4?

Answer 29

Iliac crest

Question 30

A male patient with a history of unprotected sexual intercourse presented with a painful ulcer in the prepuce of his penis with a necrotic yellow base preceded by papules. Which bedside test is done to confirm his diagnosis? ``` ▪ Tzanck smear ▪ PAS stain ▪ Electron microscopy ▪ Direct fluorescence ▪ H&E stain ```

Answer 30

▪ H&E stain

Question 31

Biopsy of the endometrium showed cellular stroma with circular glands and mitosis. What describes the cycles?

Answer 31

Anovulatory

Question 32

Why is heparin, which doesn’t cross the placenta, always given to pregnant women who need anticoagulation? ▪ High molecular weight ▪ Non-protein bound ▪ Lipid soluble ▪ Very short half-life

Answer 32

▪ High molecular weight

Question 33

What is the cause of biconruate uterus?

Answer 33

Failure of paramesonephric duct fusion

Question 34

What gives rise to primordial germ cells? ``` ▪ Urogenital sinus ▪ Coelmic epithelium ▪ Urachus ▪ Processus vaginalis ▪ Interstitial cells of Leydig ▪ Primary sex cords ```

Answer 34

▪ Urachus * Remember that the origin of the primordial germ cells is the wall of the yolk sock or the endoderm around the allantois, and the urachus is the fibrous remnant of the allantois

Question 35

What moves along the path made by the gubernaculum from the abdomen? ▪ Processus vaginalis ▪ Urogenital sinus ▪ Coelmic epithelium

Answer 35

▪ Processus vaginalis

Question 36

Which of the following describes an opening that is 30 cm transversely and 11 cm from anterior to posterior? ▪ Pelvic outlet ▪ Android pelvis ▪ Pelvic inlet

Answer 36

▪ Pelvic inlet

Question 37

What is limited by the sacrotuberous ligament, inferior border of the pelvic bone, and inferior tuberosity? ▪ Pelvic outlet ▪ Android pelvis ▪ Pelvic inlet

Answer 37

▪ Pelvic outlet

Question 38

Which of the following is characterized by a narrow subpubic arch, prominent ischial spines, and is heart-shaped? ▪ Pelvic outlet ▪ Android pelvis ▪ Pelvic inlet

Answer 38

▪ Android pelvis

Question 39

On examination of a pregnant woman, the baby’s head was in the left flank and his butt at the right flank. What describes his lie? ▪ Transverse ▪ Horizontal ▪ Oblique

Answer 39

▪ Transverse