OB/Gyn Final Exam - 2008
Student's name:........................................................... Date:.............................
Directions: Each of the numbered items or incomplete statements in this section is followed by answers or by completions of the statement. Select the ONE lettered answer or completion that is BEST in each case.
1. The main two indications for hysterectomy are:
A) Leiomyomas, dysfunctional uterine bleeding
B) Leiomyomas, Pelvic pain
C) Dysfunctional uterine bleeding, Genital prolapse
D) Pelvic pain, Pelvic inflammatory diseases
E) Genital prolapse, Endometriosis
2. During an operation, a midline incision was made at an anatomic location 2 cm below the umbilicus. Which of the following lists (in order) the layers of the anterior abdominal wall as they would be incised or separated?
A) skin, subcutaneous fat, superficial fascia (Camper’s), deep fascia (Scarpa’s), fascial muscle cover (anterior rectus sheath), rectus muscle, a deep fascial muscle cover (posterior rectus sheath), preperitoneal fat, and peritoneum.
B) skin, subcutaneous fat, superficial fascia (Scarpa’s), deep fascia (Camper’s), fascial muscle covering (anterior abdominal sheath), transverse abdominal muscle, a deep fascial muscle cover (posterior rectus sheath), preperitoneal fat, and peritoneum
C) skin, subcutaneous fat, superficial fascia (Camper’s), deep fascia (Scarpa’s), fascial muscle cover (anterior rectus sheath), rectus muscle, a deep fascial muscle cover (posterior rectus sheath), peritoneum, and preperitoneal fat
D) skin, subcutaneous fat, superficial fascia (Scarpa’s), deep fascia (Camper’s), fascial muscle cover (anterior rectus sheath), rectus muscle, a deep fascial muscle cover (posterior rectus sheath), preperitoneal fat, and peritoneum
E) skin, subcutaneous fat, superficial fascia (Camper’s), deep fascia (Scarpa’s), fascial muscle cover (anterior rectus sheath), transverse abdominal muscle, a deep fascial muscle covering (posterior rectus sheath), preperitoneal fat, and peritoneum
3. In the female, the true pelvis anatomically
A) has an oval outlet
B) has three defining planes, an inlet, a midplane, and an outlet
C) has an inlet made up of a double triangle
D) is completely formed by two fused bones
E) lies between the wings of the paired ileum
4. The three principal estrogens in women in decreasing order of potency are
A) estriol, estradiol, estrone
B) estrone, estriol, estradiol
C) estradiol, estrone, estriol
D) estradiol, estriol, estrone
E) estriol, estrone, estradiol
5. The normal vaginal pH during the menstrual cycle is
A) 3,0-4,5
B) 4,5-5,5
C) 5,5-6,5
D) 6,5-7,5
E) 7,5-8,5
6. Cardioprotective actions of estrogen may include
A) dilatation of coronary vassels
B) production of thromboxane
C) depression of HDL (high-density lipoprotein) levels
D) elevation of LDL (low-density lipoprotein) levels
E) widening of pulse pressure
7. Stenosis of the cervix can lead to which of the following complications?
A) pyometra
B) adenomyosis
C) primary dysmenorrhea
D) cervical polyps
E) uterus didelphys
8. A 45-year-old patient with uterine leiomyomata found on pelvic examination complains of excessive uterine bleeding. The next step in the management of this patient sholud be
A) myomectomy
B) hysterectomy
C) ultrasonography
D) endometrial biopsy
E) hysteresalpinogography
9. Most neoplastic ovarian masses in postmenopausal women originate from
A) ovarian epithelium
B) ovarian stroma
C) ovarian germ cells
D) ovarian sex cords
E) metastatic disease
10. Indicate the hormone, which can be used as a presumptive sign that ovulation occurred:
A) Prolactine
B) Estradiol
C) Testosterone
D) Progesteron
E) Follitropin
11. Endometrial cancer is
A) mainly estrogen-dependent
B) androgen-dependent
C) progesterone-dependent
D) hormonally independent
E) FSH dependent
12. Endometriosis can be diagnosed only
A) During physical examination
B) By ultrasound examination
C) By CT examination
D) During laparoscopy or laparotomy
E) During X-ray examination
13. A 62-year-old G2P2 woman, menopausal for 12 years, presents to clinic complaining of abdominal bloating for 6 months. During the past 2 monts she has been unable to button her pants, despite a 10-lb weight loss achieved without dieting. A plevic ultrasound reveals massive ascites and a 9 x 10 cm complex right ovarian mass. In addition to obtaining lab work, the next step in management is:
A) Observation with repeat ultrasound in 4 weeks
B) Exploratory laparotomy
C) Diuretic treatment for relief of her ascites
D) A second opinion
E) Chemotherapy
14. A 27-year-old patient complains of 6 months of amenorrhea. A pregnancy test is negative. Which of the following is the most likely cause of secondary amenorrhea in this patient?
A) Abnormal chromosomes
B) Asherman syndrome
C) Hypothyroidism
D) Prolacinomoa
E) Anovulation
15. Mixing vaginal discharge with potassium hydroxide (KOH) creates an odor that is helpful in diagnosing:
A) Bacterial vaginosis
B) Trichomoniasis
C) Moniliasis
D) Gonorrhea
E) Chlamydia
16. Pelvic inflammatory disease is characterized by all of the following EXCEPT:
A) Leukocytosis
B) Pelvic pain
C) Fever
D) Anemia
E) Cervical motion tenderness
17. A postmenopausal women comes to your office for an advice because her best friend has been diagnosed with endometrial cancer. The patient is concerned that she too may develop the disease. You tell her that risk factors associated with endometrial cancer include the following, EXCEPT:
A) Nulliparity
B) Late menopause
C) DES exposure
D) Obesity
E) Polycystic ovarian disease
18. The diagnosis of a complete hydatidiform mole has been confirmed following the suction curettage. What is the most appropriate management for this patient now?
A) Weekly and then monthly hCG testing
B) Repeat D&C if the hCG value is elevated
C) Transvaginal ultrasonographic examination
D) Chemotherapy
E) Radioterapy
19. Fibroids are associated with all of the following except:
A) Hydronephrosis
B) Recurrent pregnancy loss
C) Anemia
D) Endometritis
E) Metrorrhagia
20. What is the most common cystic mass in the vulvovaginal region?
A) Fibroma
B) Epidermal inclusion cyst
C) Hidradenoma
D) Nevus
E) Bartholin cyst
21. A 22-year-old professional dancer (G0) presents with absence of menses for 6 months. Priot to this her cycles had been irregular. Physical examination finds that she is 5’6”, weighs 98 lbs, and is healthy appearing. The cause of her amennorrhea is most likely:
A) Premature ovarian failure
B) Hypogonadotropic hypogonadism
C) Sheehan syndrome
D) Pregnancy
E) Polycystic ovary syndrome
22. All of the following are associated with increased risk of ectopic pregnancy except:
A) Pelvic surgery
B) In vitro fertilization
C) Gonadotropin ovulation induction
D) Salpingitis
E) ...
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