Block 7 Reproduction Creighton Univ W Xpl Pt 2
(78).webp "Block 7 Reproduction Creighton Univ W Xpl Pt 2 - Quiz")
- 1.
Which of the following is the most important prognostic factor in breast cancer?
- A.
Lymph node involvement
- B.
Distant metastasis
- C.
Size > 2cm
- D.
Tumor grade
Correct Answer
A. Lymph node involvementExplanation
As reported in the MDC on Feb 6, 2009. 11min 40sRate this question:
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- 2.
A 12 year old boy suddenly doubles over in pain while watching TV, complaining of pain in his scrotum. Which of the following most accurately describes the situation?
- A.
Earlier trauma resulted in an indolent hemorrhagic infarction
- B.
He has cryptorchidism that has spontaneously resolved with the increase in androgens from puberty
- C.
He has torsion of the testis, which requires prompt surgery
- D.
He has a seminoma, a rare cancer affecting boys in puberty
Correct Answer
C. He has torsion of the testis, which requires prompt surgeryExplanation
Torsion of the testis primarily affects adolescent boys and is the result of an anatomic abnormality that allows for increased mobility of the testes. This is an emergency requiring treatment within 6 hours to preserve the testis. No other choice provides a reasonable explanation for the sudden onset of pain.Rate this question:
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- 3.
In females, where would you most likely find the highest concentrations of aromatase, which catalyzes the production of estradiol?
- A.
Theca cells
- B.
Granulosa cells
- C.
Germinal epithelium
- D.
Aromatase is essentially absent in the female
Correct Answer
B. Granulosa cellsExplanation
In the female, theca cells produce testosterone which moves into the granulosa cells to be converted into 17-beta-estradiol by aromatase.Rate this question:
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- 4.
A young couple comes to you asking about the benefits of tracking the woman's body temperature to predict fertile days. Which of the following statements is most accurate?
- A.
Body temperature has been shown to be unrelated to fertility
- B.
Body temperature rises about 5 days prior to ovulation
- C.
Body temperature is highest at the time of ovulation
- D.
Body temperature follows a similar pattern to progesterone (baseline during the follicular phase and highest levels in the luteal phase)
- E.
Body temperature is typically lowest during the luteal phase
Correct Answer
D. Body temperature follows a similar pattern to progesterone (baseline during the follicular phase and highest levels in the luteal phase)Explanation
Body temperature is lowest in the follicular phase and begins to rise roughly at the time of ovulation. It peaks during the luteal phase, similar to progesterone. In fact, progesterone is thought to act on the hypothalamus to cause this change. Costanzo has a nice image of these changes.Rate this question:
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- 5.
During a normal menstrual cycle at the peak of LH, which of the following would you least expect?
- A.
Peak of FSH
- B.
Decreasing levels of 17-beta-estradiol
- C.
Increasing levels of progesterone
- D.
Ovulation
- E.
Decrease in cervical mucus
Correct Answer
E. Decrease in cervical mucusExplanation
The increase LH is the cause of ovulation. There is a concomitant increase in FSH. Meanwhile, estrogen is decreasing and progesterone is just starting to increase. If you were unsure, the process of elimination should have left you with E as the only possible answer. What typically happens is an increase in cervical mucus which is more receptive to sperm, allowing for increased fertility. Some family planning methods rely on observation of the cervical mucus.Rate this question:
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- 6.
The loss of the endometrium is caused predominantly by decreases in which two hormones?
- A.
LH
- B.
FSH
- C.
17-beta-estradiol
- D.
Progesterone
- E.
Testosterone
- F.
B & E
- G.
C & D
Correct Answer
G. C & DExplanation
LH and FSH are not true since their levels peak 14 days before the onset of menses and are virtually at baseline levels 10-12 days before menses. Estradiol and progesterone, on the other hand, do not reach low levels until menses begins.Rate this question:
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- 7.
Ductal carcinoma in situ is most likely to be detected as which of the following?
- A.
Palpable mass
- B.
Irregular mammographic density
- C.
Mammographic calcification
- D.
Incidental finding on biopsy
Correct Answer
D. Incidental finding on biopsyExplanation
Check Robbins 7th pg 1123 and 1124 DCIS is the most associated with calcifications.Rate this question:
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- 8.
You detect numerous calcifications on a routine mammography on a 40 year old woman. Which of the following is not on the differential?
- A.
Sclerosing adenosis
- B.
Hyalinized fibroadenoma
- C.
Apocrine cysts
- D.
Invasive carcinoma
- E.
Actually, all of the above are reasonable causes of calcification
Correct Answer
E. Actually, all of the above are reasonable causes of calcificationExplanation
Robbins 7th 1124 Many things can cause calcifications: secretory material, necrotic debris, and hyalinized stroma. Of course, cancer, such as invasive carcinoma, is high on the list. Routine mammograms typically begin at age 40.Rate this question:
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- 9.
A baby boy is delivered by caesarian section at 32 weeks because of oligohydraminos. Which of the following features are you least likely to find in the baby?
- A.
Renal agenesis
- B.
Pulmonary hypoplasia
- C.
Decreased alveolar phospholipid production
- D.
Birth weight of 2500 grams
- E.
Talipes equinovarus (club feet)
Correct Answer
D. Birth weight of 2500 gramsExplanation
The most common cause of oligohydraminos is an amniotic leak, although it often occurs from renal agenesis, obstructed ureters, cystic kidneys, etc. Oligohydraminos results in features from the baby being squeezed by the uterus: flattened face, low set ears, and club feet. Without sufficient amniotic fluid, the lungs do not develop properly. Hypoplasia and deficient surfactant production (made of phospholipids) will result. Answer D is correct because we would not expect a "normal" birth weight of 2500 grams (or about 5.5 pounds) at 32 weeks, even in the absence of oligohydraminos. Another good question would be "what is the most likely cause of death after a baby is delivered after an extended period of oligohydraminos"? The baby would die from IRDS.Rate this question:
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- 10.
An autopsy is performed on a 4 month old baby that was found dead in his crib sleeping on his stomach. The baby was previously healthy, although he was born 3 week premature. Autopsy findings include periadrenal brown fat, hepatic hematopoiesis, congested lungs without edema, and petichiae on the parietal pleura. What was the cause of death?
- A.
Abuse
- B.
SIDS (Sudden Infant Death Syndrom)
- C.
Bacterial infection
- D.
Congenital malformation of the heart
- E.
IRDS (Infant Respiratory Distress Syndrome)
Correct Answer
B. SIDS (Sudden Infant Death Syndrom)Explanation
All of the findings listed in the question are common in SIDS. SIDS affects children within the first six months of life. It is associated with many factors, perhaps most importantly sleeping in the prone position. Other risk factors include second hand smoke, recent upper respiratory tract infection, prematurity, and low socioeconomic standing. Although many factors play a role, Robbins suggests that the fundamental abnormality is in the arcuate nucleus, which normally arouses the body if stressed during sleep (7th ed pg 497).Rate this question:
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- 11.
Which of the following is least likely to produce precocious puberty?
- A.
Leydig cell tumor
- B.
Granulosa cell tumor
- C.
21-β-hydroxylase deficiency
- D.
Teratoma
Correct Answer
D. TeratomaExplanation
Only teratomas are not associated with excessive hormone production. Teratomas are common germ cell tumors of the ovary that are usually benign.Rate this question:
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- 12.
Which of the following plays the largest role in maintaining the blood-testis barrier?
- A.
Myoid cell
- B.
Leydig cell
- C.
Sertoli cell
- D.
Spermatogonia
- E.
Connective tissue
Correct Answer
C. Sertoli cellExplanation
The occluding junctions between Sertoli cells play a crucial role in maintaining the barrier. Spermatogonia lie on the basal compartment below the blood-testis barrier. As divisions occur, cells move past the basal compartment and move into the adluminal compartment. (Junqueira et al. Basic Histology, 11th Ed pgs 426, 427)Rate this question:
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- 13.
Which of the following is not true regarding breast density in mammography?
- A.
Lower density tends to be found in fatty breast tissue
- B.
Lactating women tend to have lower density breast tissue
- C.
Breast density is a significant risk factor for breast cancer
- D.
Dense breasts are better imaged with digital mammography
Correct Answer
B. Lactating women tend to have lower density breast tissueExplanation
When lactating the breast is filled with fluid, which appears dense (white) in mammography. Fat appears black. Younger women and lactating women tend to have the densest breasts.Rate this question:
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- 14.
Which of the following is not true about the BI-RADS (Breast Imaging Reporting and Data System)
- A.
It standardizes breast imaging reporting
- B.
It facilitates outcome monitoring
- C.
It standardizing terminology and report organization
- D.
Applies to mammography, ultrasound, and MRI of the breast
- E.
Actually, all of the above are true
Correct Answer
E. Actually, all of the above are trueExplanation
The BI-RADS is a "quality assurance guide" that covers all of the features listed in the question. Source: frequently asked questions about BI-RADS on the American College of Radiology websiteRate this question:
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- 15.
Primary spermatocytes are derived from:
- A.
Spermatogonia
- B.
Secondary spermatocytes
- C.
Spermatids
- D.
Myoid cells
- E.
Sertoli cells
Correct Answer
A. SpermatogoniaExplanation
The primary spermatocytes come from type B spermatogonia, and are undergoing the first meiotic division.Rate this question:
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- 16.
Where it is thinnest, the barrier between maternal blood and fetal blood consists of all except:
- A.
Synctiotrophoblasts
- B.
Basement membrane
- C.
Fetal capillary endothelium
- D.
Hofbauer cells
Correct Answer
D. Hofbauer cellsExplanation
Synctiotrophoblasts provide the immunologic protection for the fetus by shrouding the villus in a placenta. The Hofbauer cell is essentially a macrophage in the villus.Rate this question:
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- 17.
Where is the male reproductive tract will you most likely find true cilia?
- A.
Seminiferous tubule
- B.
Rete testis
- C.
Efferent duct
- D.
Epididymis
- E.
Ductus deferens
Correct Answer
C. Efferent ductExplanation
Only the efferent duct expresses cilia. They are identified by their star-like shape. The epididymis and ductus deferens do exhibit stereocilia, but these are microvilli, not true cilia. The epididymis and ductus deferens moves sperm via peristalsis. Therefore, we expect to see more smooth muscle lining these structures than the efferent duct.Rate this question:
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- 18.
What structure in the male reproductive tract provides secretions that allow sperm to be motile?
- A.
Seminiferous tubule
- B.
Rete testis
- C.
Efferent duct
- D.
Epididymis
- E.
Ductus deferens
Correct Answer
D. EpididymisExplanation
The epididymis provides the secretions that allow for the sperm to be motile. The epididymis is made of pseudostratified columnar epithelium with microvilli.Rate this question:
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- 19.
Which of the following women has the greatest chance of developing breast cancer?
- A.
75 year old woman in good health
- B.
35 year old woman with age of menarche of 11
- C.
50 year old woman on post-menopausal estrogen
- D.
60 year old woman with a BMI of 35
Correct Answer
A. 75 year old woman in good healthExplanation
The 75 year old woman has a 17 fold increased risk of developing cancer since she is over 70. The other three present with mild risk factors (~1.5x chance). These risks are age of menarche less than 12, post-menopausal estrogen, and BMI greater than 31.Rate this question:
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- 20.
Which of the following contains a secondary oocyte? (there may be more than one answer)
- A.
Primordial follicle
- B.
Primary follicle
- C.
Early primary follicle
- D.
Secondary follicle
- E.
Graafian follicle
Correct Answer
E. Graafian follicleExplanation
Seems like a good test question. Source: Dr. Nichols lecture on Histo of the Female slide 4. Although, after looking at slide 9 in his lecture it looks like D could also be correct.Rate this question:
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