MCQs (Part IV)
- 1.
Which of the following best describes vaginismus?
- A.
Dyspareunia caused by a structurally small vagina
- B.
A voluntary contraction of the vaginal muscles to prevent penetration
- C.
An involuntary contraction of the vaginal and pelvic floor muscles
- D.
A condition associated with general sexual and orgasmic inhibition
Correct Answer
C. An involuntary contraction of the vaginal and pelvic floor muscles -
- 2.
Mucopurulent cervicitis characterized by the presence of visible yellow mucus on the cervix is most likely due to
- A.
Herpes simplex virus type 2
- B.
Trichomonas vaginalis
- C.
Staphylococcus aureus
- D.
Chlamydia trachomatis
- E.
Pseudomonas aeruginosa
Correct Answer
D. Chlamydia trachomatis -
- 3.
Women with polycystic ovary syndrome have a higher risk of which one of the following?
- A.
Sexual dysfunction
- B.
Pituitary adenoma
- C.
Adrenal hyperplasia
- D.
Impaired glucose tolerance
- E.
Ovarian malignancy
Correct Answer
D. Impaired glucose tolerance -
- 4.
Which of the following drugs is an appropriate choice for treating gonococcal urethritis and cervicitis?
- A.
Erythromycin
- B.
Cefoxitin (Mefoxin)
- C.
Metronidazole (Flagyl)
- D.
Ceftriaxone (Rocephin)
- E.
Spectinomycin (Trobicin)
Correct Answer
D. Ceftriaxone (Rocephin) -
- 5.
A palpable ovary in a postmenopausal female should be managed by:
- A.
Following the patient with serial bimanual examinations
- B.
Ordering ultrasonography with repeat ultrasonography in 2 months if the ovary is cystic and measures less than 4 cm in diameter
- C.
Ordering a CT scan, followed by serial ultrasonography if the ovary is cystic and measures less than 4 cm in diameter
- D.
Ordering a CA-125 level and either ultrasonography or a CT scan, followed by repeat evaluation in 3 months if the C-125 level is normal and the ovary is cystic and less than 4 cm in diameter
- E.
Referral to a gynecologist
Correct Answer
E. Referral to a gynecologist -
- 6.
It is important to obtain an adequate sample for a papnicolaou test because cervical intraepithelial neoplasia most often arises flow
- A.
Areas of cervicitis
- B.
The original squamous epithelium
- C.
The squamocolumnar junction
- D.
Cervical erosions
Correct Answer
C. The squamocolumnar junction -
- 7.
Endometrial hyperplasia, a pathologic condition that is usually associated with abnormal uterine bleeding, is caused by:
- A.
The absence of both estrogen stimulation and progestational influence
- B.
The absence of estrogen stimulation and excessive progestational influence
- C.
Persistent estrogen stimulation and excessive progestational influence
- D.
Persistent estrogen stimulation in the absence of progestational influence
Correct Answer
D. Persistent estrogen stimulation in the absence of progestational influence -
- 8.
Following a prolonged labor and traumatic delivery, a 5015 gram male infant holds his right arm in an abducted and internally rotated position with extension at the elbow, pronation of the forearm, and flexion of the wrist. Although the grasp reflex is intact, the biceps and brachioradialis reflexes are absent. The most likely diagnosis is a
- A.
Rotator cuff tear
- B.
Clavicle fracture
- C.
Brachial plexus injury
- D.
Cerebral injury
- E.
Fractured humerus
Correct Answer
C. Brachial plexus injury -
- 9.
Studies indicate that the incidence of spina bifida and anencephaly in newborns is reduced by 50% if women take supplements of which one of the following prior to conception?
- A.
Folic acid
- B.
Vitamin E
- C.
Vitamin C
- D.
Calcium
- E.
Pantothenic Acid
Correct Answer
A. Folic acid -
- 10.
The most common cause of spontaneous abortion in the first 12 weeks of pregnancy is:
- A.
The presence of maternal lupus anticoagulant
- B.
Chromosomal anomalies
- C.
An incompetent cervix
- D.
Maternal tobacco abuse
- E.
Inadequate progesterone during the luteal phase
Correct Answer
B. Chromosomal anomalies -
- 11.
A 28 year old primigravida is found to have a hydatidiform mole on pelvic ultrasonography. The uterine contents are evacuated by suction aspiration and curettage. Subsequent management should include which one of the following?
- A.
Serial measurement of serum human chorionic gonadotropin (HCG) until it remains normal for 1 year
- B.
Therapy with methotrexate within 1 week after uterine evacuation
- C.
Encouraging the patient to conceive 3 months after the mole is removed
- D.
Monthly pelvic ultrasonography
- E.
Use of high-dose oral contraceptives (>50 mcg estrogen)
Correct Answer
A. Serial measurement of serum human chorionic gonadotropin (HCG) until it remains normal for 1 year -
- 12.
A 22 year old white female who works in the newborn nursery of a hospital consults you regarding her exposure yesterday to an infant with congenital rubella. Today she has a positive pregnancy test and is 8 weeks pregnant by dates and examination. Her rubella immunization status is unknown. Your immediate recommendation is:
- A.
A therapeutic abortion
- B.
Intramuscular gamma globulin
- C.
Oral amantadine (symmetrel)
- D.
A rubella antibody test
- E.
An MMR vaccination
Correct Answer
D. A rubella antibody test -
- 13.
Which maternal reproductive record should raise the strongest suspicion of maternal diabetes mellitus?
- A.
Loss of fetal movement and heart tones following acute abdominal pain, early in the third trimester.
- B.
First trimester loss in a primigravida
- C.
Repeated second trimester loss associated with very rapid delivery
- D.
Stillbirth early in the third trimester accompanied by bleeding
- E.
Unexplained stillbirth at term
Correct Answer
E. Unexplained stillbirth at term -
- 14.
Concerning the exogenous control of hyperglycemia in the pregnant woman who has diabetes mellitus
- A.
Oral hypoglycemic agents are useful in women who have either Class A or B diabetes mellitus
- B.
Insulin has the potential to induce hypoglycemia in the infant
- C.
Insulin dosage usually peaks at term
- D.
The primary objective in the use of insulin is to prevent ketacidosis
Correct Answer
C. Insulin dosage usually peaks at term -
- 15.
Which one of the following second trimester findings would most strongly suggest the possibility of a twin gestation?
- A.
Palpation of fetal parts
- B.
A discrepancy between gestational age and uterine size
- C.
Increased levels of chorionic gonadotropins in the urine
- D.
The onset of polyhydramnios
Correct Answer
B. A discrepancy between gestational age and uterine size -
- 16.
A 27 year old nondiabetic multiparous woman at 39 weeks gestation has had a previously uncomplicated pregnancy. Fundal height and estimated of fetal size have been at the upper limits of normal for several weeks. Today the fundus measures 44cm from the pubis and you estimate on palpation that the fetus is large. Clinical pelvimetry is normal. Which one of the following treatment plans is supported by objective clinical evidence?
- A.
Perform external podalic version to breech position and deliver vaginally in order to decrease the likelihood of shoulder dystocia
- B.
Place the mother on a 500 calorie/day diet in order to slow fetal weight gain
- C.
Order ultrasonography and perform a cesarean section if estimated fetal weight is 4000g
- D.
Plan vaginal delivery, with personnel in the delivery room who are trained to assist with a difficult shoulder delivery should it occur
Correct Answer
D. Plan vaginal delivery, with personnel in the delivery room who are trained to assist with a difficult shoulder delivery should it occur -
- 17.
At what age should a female with primary amenorrhea be evaluated, regardless of normal growth and development and the presence of secondary sex characteristics?
- A.
12 years of age
- B.
14 years of age
- C.
16 years of age
- D.
18 years of age
- E.
20 years of age
Correct Answer
C. 16 years of age -
- 18.
Cancer of the cervix has been found to have infiltrated the upper two thirds of a patient's vagina and parametrium but not to extend to the pelvic sidewall. The correct FIGO staging of this carcinoma is:
- A.
Stage IB
- B.
Stage IIA
- C.
Stage IIB
- D.
Stage IIIA
- E.
Stage IIIB
Correct Answer
C. Stage IIB -
- 19.
A 27 year old woman has tried unsuccessfully for 5 months to become pregnant. At this point, the recommended evaluative procedure would be:
- A.
Semen analysis
- B.
Hysterosalpingography
- C.
Endometrial biopsy
- D.
Diagnostic laparoscopy
- E.
None of the above
Correct Answer
E. None of the above -
- 20.
Vulvovaginal trichomoniasis can be described most accurately by which of the following statements?
- A.
Caused by the overgrowth of bacteria native to some individuals
- B.
Not associated with an alteration of normal vaginal pH
- C.
Causes pelvic inflammatory disease
- D.
A sexually transmitted disease
- E.
Diagnosis can be made by obtaining a wet smear and mixing with KOH
Correct Answer
D. A sexually transmitted disease -
- 21.
In patients with small ectopic pregnancies, medical management may include
- A.
Actinomycin D
- B.
Mefiprestone
- C.
Prostaglandin F
- D.
Methotrexate
- E.
Isotretinon
Correct Answer
D. Methotrexate -
- 22.
A 41 year old had a baby with Down Syndrome 10 year ago. She is anxious to know the chromosome status of her fetus in a current pregnancy. The test she can have that the fastest lab processing time for karyotype is:
- A.
Aminocentesis
- B.
Cordocentesis
- C.
Chrionic villus sampling
- D.
Coppler flow ultrasound
- E.
Cystic hygroma aspiration
Correct Answer
C. Chrionic villus sampling -
- 23.
Which of the following statements concerning placenta previa is true?
- A.
Its incidence decrease with maternal age
- B.
Its incidence is unaffected by parity
- C.
The initial hemorrhage is usually painless
- D.
Management no longer includes examination in the theatre
- E.
Vaginal examination should be done immediately
Correct Answer
C. The initial hemorrhage is usually painless -
- 24.
A patient at 17 week gestation is diagnosed as having an intrauterine fetal death. She returns to the clinic 4 weeks later and has not aborted yet. This patient is at increased risk for
- A.
Septic abortion
- B.
Recurrent abortion
- C.
Consumptive coagulopathy
- D.
Future infertility
- E.
Ectopic pregnancy
Correct Answer
C. Consumptive coagulopathy -
- 25.
Although rheumatic heart disease is less common than in previous decades, it still occurs during pregnancy. Deteriorating cardiac status in a pregnant woman is most likely to be associated with
- A.
Aortic regurgitation
- B.
Aortic stenosis
- C.
Mitral regurgitation
- D.
Mitral Stenosis
- E.
Tricuspid regurgitation
Correct Answer
D. Mitral Stenosis -
- 26.
A 35 year old primigravida at 37 weeks gestation is diagnosed to have urinary tract infection, the antibiotic of choice should be
- A.
Cephalosporin
- B.
Tetracycline
- C.
Sulfonamide
- D.
Nitrofurantoin
- E.
Ciprofloxacin
Correct Answer
A. Cephalosporin -
- 27.
The first evidence of pubertal development in the female is usually
- A.
Onset of menarche
- B.
Appearance of breast buds
- C.
Appearance of axillary hair
- D.
Appearance of pubic hair
- E.
Onset of growth spurt
Correct Answer
B. Appearance of breast buds -
- 28.
An 18 year old girl consults you for evaluation of disabling pain with her menstrual period. This pain has been present for the last 4 years and is accompanied by nausea and headache. Physical examination was unremarkable. Your initial treatment will be:
- A.
Ergot derivatives
- B.
Antiprostaglandins
- C.
Danazole
- D.
Gonadotropin releasing hormone analogs
Correct Answer
B. Antiprostaglandins -
- 29.
A 30 year old gravid 5, para 4 woman, has an unplanned intrauterine pregnancy while using intrauterine contraceptive device. On examination, the string of the IUD is noted to be protruding from the cervical os. The most appropriate action is to:
- A.
Leave the IUD in place without any other treatment
- B.
Leave the IUD and continue prophylactic antibiotics throughout pregnancy
- C.
Remove the IUD immediately
- D.
Terminate the pregnancy because of the high risk of infection
- E.
Perform laparoscopy to rule out a heterotopic ectopic pregnancy
Correct Answer
C. Remove the IUD immediately -
- 30.
In addition to effective contraception, health benefits for women taking oral contraceptives include a decrease incidence of which of the following?
- A.
Lung cancer
- B.
Benign breast disease
- C.
Hypertension
- D.
Cervical cancer
- E.
Diabetes
Correct Answer
B. Benign breast disease -
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Current Version
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Feb 18, 2013Quiz Edited by
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May 30, 2012Quiz Created by
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