Block 7 Fertilization & Pregnancy MCQ's

18 Questions | Total Attempts: 841

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Block 7 Fertilization & Pregnancy MCQ

Questions and Answers
  • 1. 
    During the process of fertilization of an oocyte, what function do oocyte cortical granules have, and what is their site of action? 
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 2. 
    A 30-year-old female came to your office with a complaint of infertility. Five years ago she had a daughter who was delivered at full term. However, she developed severe bleeding postpartum, lost consciousness, and experienced severe hypotension. She was in the intensive care unit for several days during which time she began to have unusually large urine volumes (> 0.5 L/hr). She was successfully stabilized and treated with a brief course of glucocorticoids. She has not had normal menstrual periods for the past four years. Recent laboratory tests revealed low plasma levels of estradiol, luteinizing hormone (LH), and follicle stimulating hormone (F51-1). What is the most likely explanation for her infertility?
    • A. 

      Involution of the fallopian tubes.

    • B. 

      Gonadotropin releasing hormone (GnRH) tumor in the hypothalamus

    • C. 

      Destruction of primordial follicles

    • D. 

      Loss of normal pituitary function.

    • E. 

      Hypersecretion of adrenal cortical hormones

  • 3. 
    A female in her early twentes takes an oral contraceptive pill which contains a synthetic progestin. What is the most likely explanation for the contraceptive action of this drug?
    • A. 

      Replacement of the LH surge by an FSH surge.

    • B. 

      Abolition of the LH surge

    • C. 

      Enhanced positive feedback of the hypothalamic-pituitary-gonadal axis.

    • D. 

      Increased conversion of testosterone to estradiol.

    • E. 

      Inadequate decidualization of the uterus.

  • 4. 
    A male (Mr. K) in his early twenties comes to your office with concerns that he and his wife (Mrs. K) have not been able to conceive. When you do a review of systems and brief history, you note that this man has had chronic respiratory problems typified by inability to clear his airways of mucous. You then proceed to do a physical examination. When you auscultate for breath sounds, you hear some crackles (rales). Both testes have descended and there do not appear to be any masses in the testes. Otherwise, your physical exam indicates that he is healthy. The patient informs you that he is able to achieve and maintain an erection. Moreover, he believes that his ejaculation is normal. To gather additional information that might explain a possible fertility problem in this young man, you obtain blood and ask that he provide you with a semen sample. The results of the blood work are presented in the accompanying table. When his semen was analyzed, it was found to have a normal number of sperm per milliliter. However, the laboratory report commented that more than 50% of the sperm had motility problems. You are asked by the chief of the urology service to investigate if there might be any connection between this young man's respiratory problems and his apparent infertility. Table; Blood work analysis   Patient Normal range LH (mIU/m1) 20 6-23 FSH (rnIU/m1) 18 4-25 Testosterone (ngidL) 900 300-1,100 Total T4 (pgicIL) 10 5-12 Hb (g/dL) 15 13.5-17.5 If this patient has a chronic respiratory problem, what similar problem may explain this condition and infertility?
    • A. 

      Emphysema

    • B. 

      Immunological disorder of the vagina

    • C. 

      Hyperprolactinemia

    • D. 

      Kartagener's syndrome

    • E. 

      Klinefelter syndrome

  • 5. 
    A male (Mr. K) in his early twenties comes to your office with concerns that he and his wife (Mrs. K) have not been able to conceive. When you do a review of systems and brief history, you note that this man has had chronic respiratory problems typified by inability to clear his airways of mucous. You then proceed to do a physical examination. When you auscultate for breath sounds, you hear some crackles (rales). Both testes have descended and there do not appear to be any masses in the testes. Otherwise, your physical exam indicates that he is healthy. The patient informs you that he is able to achieve and maintain an erection. Moreover, he believes that his ejaculation is normal. To gather additional information that might explain a possible fertility problem in this young man, you obtain blood and ask that he provide you with a semen sample. The results of the blood work are presented in the accompanying table. When his semen was analyzed, it was found to have a normal number of sperm per milliliter. However, the laboratory report commented that more than 50% of the sperm had motility problems. You are asked by the chief of the urology service to investigate if there might be any connection between this young man's respiratory problems and his apparent infertility. Table; Blood work analysis   Patient Normal range LH (mIU/m1) 20 6-23 FSH (rnIU/m1) 18 4-25 Testosterone (ngidL) 900 300-1,100 Total T4 (pgicIL) 10 5-12 Hb (g/dL) 15 13.5-17.5 Which of the following statements may account for the apparent infertility problem in this patient?  
    • A. 

      Insufficient supply (release) of FSH

    • B. 

      Lack of production of inhibin

    • C. 

      Inability of sperms to undergo capacitation

    • D. 

      Inability of Leydig cells to respond to LH

    • E. 

      Lack of dynein

  • 6. 
    A male (Mr. K) in his early twenties comes to your office with concerns that he and his wife (Mrs. K) have not been able to conceive. When you do a review of systems and brief history, you note that this man has had chronic respiratory problems typified by inability to clear his airways of mucous. You then proceed to do a physical examination. When you auscultate for breath sounds, you hear some crackles (rales). Both testes have descended and there do not appear to be any masses in the testes. Otherwise, your physical exam indicates that he is healthy. The patient informs you that he is able to achieve and maintain an erection. Moreover, he believes that his ejaculation is normal. To gather additional information that might explain a possible fertility problem in this young man, you obtain blood and ask that he provide you with a semen sample. The results of the blood work are presented in the accompanying table. When his semen was analyzed, it was found to have a normal number of sperm per milliliter. However, the laboratory report commented that more than 50% of the sperm had motility problems. You are asked by the chief of the urology service to investigate if there might be any connection between this young man's respiratory problems and his apparent infertility. Table; Blood work analysis   Patient Normal range LH (mIU/m1) 20 6-23 FSH (rnIU/m1) 18 4-25 Testosterone (ngidL) 900 300-1,100 Total T4 (pgicIL) 10 5-12 Hb (g/dL) 15 13.5-17.5 What is the most likely option for this couple in terms of in vitro fertilization?  
    • A. 

      Artificial insemination using the husband's sperm and oocytes from Mrs. K

    • B. 

      Artificial insemination using the husband's sperm and oocytes from a female other than Mrs. K

    • C. 

      Artificial insemination using sperm from a male other than Mr. K and oocytes from Mrs. K

    • D. 

      Intracytoplasmic sperm injection using Mr. K's sperm

  • 7. 
    What are the molecular machinery (i.e. proteins) responsible for motility of mature sperm?
    • A. 

      Skeletal muscle type of actin and myosin

    • B. 

      Smooth muscle type of actin and myosin

    • C. 

      Dynein and microtubules

    • D. 

      Actin and microtubules

    • E. 

      Myosin and microtubules

  • 8. 
    A lesbian couple asks you whether you can make them a baby with two mothers by fusing two oocytes. What should you tell them?
    • A. 

      No problem, this can be done without a risk of major complications

    • B. 

      Can be done, but there is an increased risk of neurological abnormalities and mental retardation in the child

    • C. 

      This is technically possible but it is not a medically approved procedure, so I cannot do this

    • D. 

      This should not be attempted because there is a high risk of aneuploidy

    • E. 

      Sorry, can't be done because of imprinting

  • 9. 
    During the fertilization process, what specific mechanism is responsible for polysperrny block?
    • A. 

      Hardening of the zona pellucida

    • B. 

      Loss of the corona radiate

    • C. 

      Inhibition of sperm mitochondria

    • D. 

      Formation of male pronucleus

    • E. 

      Formation of the female pronucleus

  • 10. 
    In-vitro fertilization requires the induction of superovulation by means of hormone treatment. Which of the following is most suitable for the induction of superovulation?
    • A. 

      FSH

    • B. 

      An androgen antagonist

    • C. 

      Prednisone (a synthetic glucocorticoid)

    • D. 

      Progesterone

    • E. 

      A nonselective COX inhibitor

  • 11. 
    During pregnancy, the uterine smooth muscle is quiescent. As a result, forceful uterine contractions do not occur until the ninth month of pregnancy. What explains the quiescence of uterine smooth muscle during gestation?
    • A. 

      Oxytocin inhibits contraction of uterine smooth muscle

    • B. 

      Low levels of blood flow to uterine smooth muscle

    • C. 

      Prostaglandins such as prostaglandin E2 (PGE2) inhibit contraction of uterine smooth muscle,

    • D. 

      High levels of progesterone suppress contractile activity of uterine smooth muscle.

    • E. 

      Absence of luteinizing hormone (LH) receptors until the ninth month of pregnancy.

  • 12. 
    Which of the following statements about amniotic fluid is INCORRECT?
    • A. 

      Amniotic fluid is primarily derived from maternal blood

    • B. 

      A reduced volume of amniotic fluid is called Oligohydramnios

    • C. 

      The fetus contributes urine to the amniotic fluid

    • D. 

      Amniotic fluid contains nutrients and is the main nutritional support for the fetus

    • E. 

      The fetus swallows its own amniotic fluid which is important for maintaining the correct volume of fluid in the amnion

  • 13. 
    After the twentieth week of gestation, a thinned vasculosyncytial placental membrane is formed consisting of the following three layers:
    • A. 

      Syncytiotrophoblast - cytotrophoblast - fetal capillary endothelium

    • B. 

      Maternal capillary endothelium - syncytiotrophoblast - fetal capillary epithelium

    • C. 

      Syncytiotrophoblast - connective tissue of the villus - fetal capillary endothelium

    • D. 

      Connective tissue of the villus - syncytiotrophoblast - maternal capillary endothelium

    • E. 

      Maternal capillary endothelium - syncytiotrophoblast - cytotrophoblasy

  • 14. 
    Ectopia cordis or Pentalogy of Cantrell is a congenital malformation of the anterior body wall that includes a defect of the lower sternum, a deficient anterior diaphragm, and a heart that lies outside the chest. This condition is primarily a defect in what embryological process?
    • A. 

      Formation of the intraembryonic coelom

    • B. 

      Lateral folding

    • C. 

      Formation of the intermediate mesoderm

    • D. 

      Longitudinal folding

    • E. 

      Formation of the head fold

  • 15. 
    A 20-year-old female college student complains of breakthrough bleeding 3 months after starting to use a low-dose combined oral contraceptive regimen. Her physician questions her carefully about her pill-taking habits, and is satisfied that the patient has been taking the pills on a regular basis. Which of the following might be the most reasonable next step for this patient to continue to sustain reliable contraception with minimal adverse events?
    • A. 

      Switch to a progestin-only mini-pill

    • B. 

      Switch to a depot progesterone method

    • C. 

      Switch to a combined OC with a different E component

    • D. 

      Switch to a combined OC with a higher dose E component

    • E. 

      SWitch to a combined OC with a higher dose P component

  • 16. 
    A 25-year-oId woman is conferring with her gynecologist regarding treatment options for debilitating endometriosis. She wishes to have children in the future and hopes to get her endometriosis under control without further compromising her fertility. They decide to try depot injections of leuprolide for the next 6 months and then re-evaluate the condition. In addition, the physician prescribes a low dose combined oral contraceptive preparation. What is the most likely reason for adding the low-dose OC?
    • A. 

      To prevent pregnancy during exposure to leuprolide

    • B. 

      To prevent bone loss

    • C. 

      To maintain normal menstrual periods

    • D. 

      To maintain body weight

    • E. 

      To prevent hypotension

  • 17. 
    For a woman in the 14th week of pregnancy, which of the following substances is the LEAST likely to cross the placenta from the mother's blood into the fetal circulation?
    • A. 

      Estradiol

    • B. 

      Glucose

    • C. 

      Carbon dioxide

    • D. 

      Androstenedione

    • E. 

      Insulin

  • 18. 
    Which of the following is characteristic of the stratum basale?
    • A. 

      Contains cells that are highly responsive to progesterone

    • B. 

      Includes the uterine surface epithelium

    • C. 

      Contains coiled arteries

    • D. 

      Is the layer that undergoes shedding

    • E. 

      Contains cells that replace the surface epithelium after menstruation

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