Block 15 Pace 5 Prt 3
Questions and Answers
- 1.
During which part of a typical female's life would she expect to find her lowest average plasma concentration of luteinizing hormone?
- A.
At age 5 years
- B.
At age 13 years
- C.
At age 26 years
- D.
At age 56 years
- E.
During the second trimester of her fetal life, four months before her birth
- F.
Six months after her birth
Correct Answer
A. At age 5 years -
- 2.
A 34-year-old woman complains to her gynecologist that her menstrual periods are infrequent, but when they occur, they last for a week, and she bleeds profusely. She finds this distressing for multiple reasons ranging from life disruption to a nagging fear that "something serious is wrong". She reports not having sexual intercourse very frequently; she always uses condoms and occasionally a diaphragm. She has never taken hormonal contraceptives. She denies using any recreational drugs, drinks only on occasion, and does not take any regular medications. Physical exam reveals nothing remarkable. Her Pap smear comes back normal. Before recommending any pharmacotherapy, which of the following substances should be measured?
- A.
A) Estradiol
- B.
B) Progesterone
- C.
C) Luteinizing hormone (LH)
- D.
Chorionic gonadotropin (hCG)
- E.
Follicle stimulating hormone (FSH)
Correct Answer
D. Chorionic gonadotropin (hCG)Explanation
The correct answer is Chorionic gonadotropin (hCG). Chorionic gonadotropin is a hormone that is produced during pregnancy. It is used as an indicator for pregnancy because it is only present in the body when a woman is pregnant. In this case, the woman complains of irregular and heavy menstrual periods, which may be a sign of an underlying issue such as pregnancy. Therefore, measuring hCG levels can help determine if the woman is pregnant and if that is the cause of her symptoms.Rate this question:
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- 3.
Which of the following pharmacologic interventions are likely to regulate her cycle and decrease menstrual bleeding?
- A.
Progestin-only mini-pill
- B.
Combined oral contraceptives
- C.
Estrogen patch
- D.
Leuprolide
- E.
Ibuprofen
Correct Answer
B. Combined oral contraceptivesExplanation
Combined oral contraceptives are likely to regulate the menstrual cycle and decrease menstrual bleeding. This is because they contain both estrogen and progestin hormones, which work together to suppress ovulation and stabilize the uterine lining. By preventing ovulation, combined oral contraceptives can help regulate the menstrual cycle and reduce the amount of bleeding during menstruation.Rate this question:
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- 4.
Two years later, the woman consults her gynecologist because her menstrual periods are infrequent and very light. History reveals no serious previous illness. Pregnancy test is negative. What is the most likely explanation for her concerns?
- A.
Her age
- B.
Estrogen deficiency
- C.
Anxiety
- D.
Oral contraceptives
- E.
Poor diet
Correct Answer
D. Oral contraceptivesExplanation
The most likely explanation for the woman's infrequent and very light menstrual periods is the use of oral contraceptives. Oral contraceptives are known to regulate and sometimes even lighten menstrual periods. Since the woman's pregnancy test is negative and there is no history of serious illness, it is reasonable to assume that the oral contraceptives she is taking are affecting her menstrual cycle.Rate this question:
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- 5.
Which of the following STIs are also associated with adult eye infections? (Ignore late stages of untreated disseminated disease and congenital eye infections.)
- Treponema pallidum
- Chlamydia trachomatis
- Human papillomavirus
- Neisseria gonorrhoeae
- Haemophilus ducreyi
- A.
All
- B.
2, 4, and 6
- C.
1, 2, 4, and 6
- D.
3 and 6
- E.
2 and 4
Correct Answer
B. 2, 4, and 6Explanation
Chlamydia trachomatis, Neisseria gonorrhoeae, and Herpes simplex virus are all STIs that can also cause adult eye infections. Chlamydia trachomatis can cause a type of eye infection called trachoma, which is a leading cause of preventable blindness. Neisseria gonorrhoeae can cause an eye infection called gonococcal conjunctivitis, which can be transmitted to a newborn during childbirth. Herpes simplex virus can cause a condition called herpetic keratitis, which is an infection of the cornea of the eye. Therefore, the correct answer is 2, 4, and 6.Rate this question:
- 6.
Which infection acquired in utero or at birth is preventable by maternal vaccination prior to the pregnancy?
- A.
CMV
- B.
Herpes
- C.
Listeriosis
- D.
Rubella
- E.
Toxoplasmosis
- F.
Syphilis
Correct Answer
D. RubellaExplanation
Rubella is an infection that can be acquired in utero or at birth, but it is preventable by maternal vaccination prior to pregnancy. Rubella, also known as German measles, is caused by the rubella virus and can lead to serious complications if contracted during pregnancy, including congenital rubella syndrome. Vaccination prior to pregnancy helps protect the mother and prevents transmission of the virus to the fetus, reducing the risk of complications and birth defects.Rate this question:
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- 7.
Malignant cells are seen in a Pap smear from a 40-year-old patient. Which of the following best describes the pathogen most likely associated with the malignancy?
- A.
Enveloped, linear double stranded DNA
- B.
Naked, circular double stranded DNA
- C.
Enveloped, partially double-stranded DNA
- D.
Enveloped, linear single-stranded RNA
Correct Answer
B. Naked, circular double stranded DNAExplanation
The correct answer is "Naked, circular double stranded DNA". This is because the presence of malignant cells in a Pap smear suggests the possibility of cervical cancer, which is most commonly caused by infection with high-risk types of human papillomavirus (HPV). HPV is a naked, circular double stranded DNA virus that is known to be associated with the development of cervical cancer.Rate this question:
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- 8.
A 12-year-old girl is brought to her family physician to receive the vaccine that helps prevent cervical cancer and genital warts. Protection against infection with which specific viruses is afforded by this vaccine?
- A.
Adenovirus serotypes 7, 10, 22, and 43
- B.
Herpes simplex viruses types 1 and 2
- C.
Human papillomaviruses (HPV) types 6, 11, 16 and 18
- D.
Parainfluenza viruses 1, 2, 3a, and 3b
Correct Answer
C. Human papillomaviruses (HPV) types 6, 11, 16 and 18Explanation
The vaccine that helps prevent cervical cancer and genital warts provides protection against infection with specific viruses known as Human papillomaviruses (HPV) types 6, 11, 16, and 18. These specific types of HPV are known to be responsible for the majority of cases of cervical cancer and genital warts. By vaccinating against these specific HPV types, the risk of developing these conditions can be significantly reduced.Rate this question:
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- 9.
Referring to the scenario in the previous question,which of the following management steps should be performed next?
- A.
Colposcopic-guided biopsy
- B.
Repeat smear in 6 months
- C.
Ablation
- D.
LEEP
- E.
Conization
- F.
Hysterectomy
Correct Answer
B. Repeat smear in 6 monthsExplanation
Based on the scenario provided in the previous question, the next management step should be to repeat the smear in 6 months. This is because a repeat smear allows for monitoring of any changes in the cervical cells over time. It is a common follow-up procedure to assess the progression or regression of abnormal cells and determine the need for further intervention or treatment. The other options listed are more invasive procedures that are typically performed if there is evidence of persistent or worsening abnormalities after repeat smears.Rate this question:
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- 10.
A 47-year-old woman presents with abdominal distention. The patient reports an appendectomy 2 years ago. Surgical exploration finds viscous fluid in the peritoneal cavity, multiple small irregular peritoneal implants, and significantly enlarged ovaries. A biopsy of one of these peritoneal masses is examined by a pathologist who reports a "mucin-secreting neoplasm". What is the most likely diagnosis?
- A.
Mesothelioma
- B.
Mucin-producing tumor of the appendix
- C.
Ovarian mucinous ovarian cystadenoma
- D.
Krukenberg metastases
- E.
Ovarian mucinous cystadenocarcinoma
Correct Answer
B. Mucin-producing tumor of the appendixExplanation
The most likely diagnosis in this case is a mucin-producing tumor of the appendix. The patient's history of an appendectomy 2 years ago suggests that the tumor may have developed in the appendix after the surgery. The presence of viscous fluid in the peritoneal cavity, multiple small irregular peritoneal implants, and significantly enlarged ovaries are consistent with the spread of the tumor. The pathologist's report of a "mucin-secreting neoplasm" further supports this diagnosis. Mesothelioma, ovarian mucinous cystadenoma, Krukenberg metastases, and ovarian mucinous cystadenocarcinoma are less likely based on the clinical presentation and findings.Rate this question:
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- 11.
A 45-year-old female presents with irregular periods. The patient reports that her cycles have "always" been irregular. Most recently she describes them as occurring every 10 weeks. The bleeding is heavy with her soaking 2-3 pads an hour on her heaviest day. She has never been pregnant and does not use hormonal contraception. Relevant physical examination data: weight 245 lbs; uterine cervix with copious, clear mucus; uterus enlarged to 12 weeks and irregular. Sonography results: enlarged uterus with submucosal and intramural fibroids, thickening of the endometrial stripe, and unremarkable adnexa. What is the most likely cause of her abnormal bleeding?
- A.
Factor VIII deficiency
- B.
Factor V Leiden mutation
- C.
Pregnancy
- D.
Prolactinoma
- E.
Chronic anovulation
Correct Answer
E. Chronic anovulationExplanation
The most likely cause of the patient's abnormal bleeding is chronic anovulation. Chronic anovulation refers to a condition where a woman's ovaries do not release an egg regularly, leading to irregular or absent menstrual periods. This can result in heavy and prolonged bleeding when a period does occur. The patient's history of always having irregular periods and the physical examination findings of an enlarged uterus with fibroids support this diagnosis. Factor VIII deficiency, Factor V Leiden mutation, pregnancy, and prolactinoma are not consistent with the clinical presentation and findings.Rate this question:
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- 12.
A 73-year-old Caucasian man presents with urinary frequency, nocturia, dribbling, and difficulty in starting and stopping urination. Rectal examination reveals the prostate to be enlarged, firm, and rubbery. Examination of the core needle biopsy reveals the tissue glands lined by a double-layer epithelium. What is the most likely diagnosis?
- A.
Benign prostate hyperplasia
- B.
Prostate carcinoma
- C.
Chronic prostatitis
- D.
Prostate atrophy
Correct Answer
A. Benign prostate hyperplasiaExplanation
The symptoms of urinary frequency, nocturia, dribbling, and difficulty in starting and stopping urination, along with an enlarged, firm, and rubbery prostate on rectal examination, suggest benign prostate hyperplasia (BPH). BPH is a noncancerous condition characterized by the enlargement of the prostate gland, which can cause urinary symptoms due to compression of the urethra. The double-layer epithelium seen on core needle biopsy is consistent with BPH. Prostate carcinoma may also cause similar symptoms, but the biopsy findings are more indicative of BPH. Chronic prostatitis and prostate atrophy are less likely to present with these specific symptoms and findings.Rate this question:
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- 13.
Referring to the scenario from question #11, what disease is the patient at risk for?
- A.
Serous endometrial carcinoma
- B.
Uterine leiomyosarcoma
- C.
Endometrioid endometrial carcinoma
- D.
Serous cystadenocarcinoma of the ovaries
- E.
Clear cell carcinoma
Correct Answer
C. Endometrioid endometrial carcinomaExplanation
Based on the scenario provided, the patient is at risk for endometrioid endometrial carcinoma.Rate this question:
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- 14.
To the dismay of the parents, the baby you have delivered is diagnosed with Down syndrome. Which one of the following risk factors should have alerted you to the possibility of your patient producing a baby with Down syndrome?
- A.
The patient is a 40-year-old primagravida
- B.
The patient has diabetes mellitus type 2.
- C.
The patient is being treated for hypertension
- D.
Thepatient's sibling was born with cystic fibrosis.
- E.
The patient has sickle cell disease
Correct Answer
A. The patient is a 40-year-old primagravidaExplanation
Advanced maternal age, particularly being 35 years or older at the time of conception, is a well-known risk factor for having a baby with Down syndrome. The risk increases significantly as the mother's age increases, with the highest risk being in women aged 40 and above. Therefore, the fact that the patient is a 40-year-old primagravida (first-time pregnant woman) should have alerted the healthcare provider to the possibility of the baby having Down syndrome.Rate this question:
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Mar 21, 2023Quiz Edited by
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Oct 31, 2012Quiz Created by
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