Block 7 Reproduction Creighton Univ W Xpl Pt 3
(18).webp "Block 7 Reproduction Creighton Univ W Xpl Pt 3 - Quiz")
- 1.
Which of the following is an action shared by estrogen and progesterone?
- A.
Maintenance of pregnancy
- B.
Positive feedback on FSH and LH
- C.
Development of secondary sex characteristics
Correct Answer
A. Maintenance of pregnancyExplanation
Both estrogen and progesterone are involved in maintaining pregnancy, especially after HCG begins to drop in the second trimester. Estrogen can either have positive or negative feedback on LH and FSH. Progesterone has negative feedback on LH and FSH. Secondary sex characteristics are driven by estrogen.Rate this question:
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- 2.
Which of the following glands does not contribute to semen?
- A.
Prostate
- B.
Epididymis
- C.
Seminal vesicles
- D.
Bulbourethral
- E.
Actually, all the above contribute fluid to semen
Correct Answer
E. Actually, all the above contribute fluid to semenExplanation
All of the glands mentioned in the options (prostate, epididymis, seminal vesicles, and bulbourethral) contribute fluids to semen. Semen is a mixture of sperm cells and various fluids from different glands in the male reproductive system. The prostate gland secretes a milky fluid that helps nourish and protect the sperm. The seminal vesicles produce a fluid that provides energy for the sperm. The bulbourethral glands secrete a clear fluid that lubricates the urethra for the passage of sperm. The epididymis, although not a gland, is a structure that stores and matures sperm. Therefore, all of the mentioned glands contribute to the formation of semen.Rate this question:
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- 3.
Histologically, which of the following appears the closest to normal prostate tissue?
- A.
Epididymis
- B.
Seminal vesicles
- C.
Ductus deferens
- D.
Rete testis
- E.
Seminiferous tubules
Correct Answer
B. Seminal vesiclesExplanation
The seminal vesicles are in close proximity to the prostate, unlike any of the options listed. A crystal clear distinction between the two is that only the prostate will have concretions.Rate this question:
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- 4.
The structure in the center of the picture below is most likely:
- A.
Primordial follicle
- B.
Early primary follicle
- C.
Late primary follicle
- D.
Graafian follicle
- E.
Secondary follicle
- F.
Artery
Correct Answer
B. Early primary follicleExplanation
It is probably an early primary follicle since it has a single layer of cuboidal graulosa cells. The zona pelucida forms at this stage. A late primary follicle would likely have a granulosa layer many cells thick.Rate this question:
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- 5.
This structure found in the cortex of an ovary is most likely in which stage of division:
- A.
Mitosis
- B.
Prophase I
- C.
Metaphase I
- D.
Metaphase II
- E.
The cell is not dividing since it just completed meiosis II
Correct Answer
C. Metaphase IExplanation
This is a primordial follicle, covered by flat epithelial cells. Primordial follicles are arrested in prophase I. Leading up to ovulation, 15 primordial follicles progress to metaphase II. One of these will be released from a Graafian follicle as a secondary oocyte.Rate this question:
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- 6.
A 25 year old man presents with gynecomastia. Which of the following tumors is most likely to produce this effect?
- A.
Leydig cell tumor
- B.
Teratoma
- C.
Spermatocytic seminoma
- D.
Choriocarcinoma
Correct Answer
A. Leydig cell tumorExplanation
Leydig cell tumors are known for their hormonal effects. They can cause precocious puberty and gynecomastia, although the most common symptom is simply testicular swelling. Sertoli cell tumors can also produce these hormonal effects. Spermatocytic seminomas tend to occur in senior citizens. It is slow growing and prognosis is excellent. Neither choriocarcinoma or teratoma have hormonal effects.Rate this question:
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- 7.
Which of the following is not a feature of adenocarcinoma of the prostate?
- A.
Crowded glands
- B.
Bone metastasis
- C.
Perineural invasion
- D.
Absence of basal cells
- E.
PSA > 4ng/mL
- F.
Actually, all of the above are true
Correct Answer
F. Actually, all of the above are trueExplanation
Probably the most important ones for histology to remember are the "back to back" glands and the loss of basal cells. PSA is important in that its rate of change is helpful in guiding therapy. It is a sensitive, but not specific test for prostate cancer.Rate this question:
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- 8.
You are advising a couple on ways to increase fertility. Which of the following would provide the highest likelihood of pregnancy?
- A.
Intercourse 4-5 days before ovulation
- B.
Intercourse 1-3 days before ovulation
- C.
Intercourse on the day of ovulation
- D.
Intercourse 1-3 days after ovulation
Correct Answer
B. Intercourse 1-3 days before ovulationExplanation
The sperm can live for about 3 to 5 days, while the egg is viable for less than one day. Therefore, the highest chance for conception occurs if the sperm is already present when ovulation occurs. This has been backed up in the literature (Barrett et al., Population Studies 1969). see slide 7 of Khandalavala's lecture on natural family planning.Rate this question:
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- 9.
A patient comes to your office seeking birth control pills. She is in overall good heath but says she is currently being treated for epilepsy. Which of the following is appropriate to say to this patient?
- A.
Anti-epileptic drugs do not affect birth control pills
- B.
A birth control pill may be more because of her anti-epileptic medications
- C.
A birth control pill may be less because of her anti-epileptic medications
- D.
Birth control pills are unsafe with her condition. Natural family planning methods should be explored
Correct Answer
C. A birth control pill may be less because of her anti-epileptic medicationsExplanation
St. John's Wort, rifampin, antiepileptic drugs, and anti-HIV drugs are known to induce the cytochrome P450 system in the liver. This results in an increased metabolism of drugs that go through this pathway, such as estrogens. Therefore, their effectiveness is decreased, and unwanted pregnancy may occur. Here's a link to the National Library of Medicine talking about the effects of St. John's Wort.Rate this question:
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- 10.
Which of the following is not an effect of monophasic birth control consisting of estrogen and progestin?
- A.
Inhibition of LH surge
- B.
Inhibition of FSH
- C.
Altered lipid profile
- D.
Induction of PTH
- E.
Decreased antithrombin III
Correct Answer
D. Induction of PTHExplanation
Estrogen tends to oppose the action of PTH, resulting in increased bone formation (or decreased resorption). Estrogens increases many clotting factors and decreases AT III. Lipid profiles often change, although estrogen tends to increase HDL, while progestins decrease HDL.Rate this question:
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- 11.
Which of the following conditions of a patient contraindicates the use of oral contraceptives?
- A.
Obesity
- B.
Smoking
- C.
Hypertension
- D.
Melanoma
- E.
None of the above
Correct Answer
E. None of the aboveExplanation
Conditions which contraindicate oral contraceptives include breast cancer, history of DVT or PE, coronary artery disease, liver disease, and (of course) pregnancy.Rate this question:
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- 12.
Which of the following is incompatible with a female conceiving in the future?
- A.
Vasectomy in male partner
- B.
Bilateral salpingectomy
- C.
Intrauterine device
- D.
15 years of oral contraceptive use
Correct Answer
B. Bilateral salpingectomyExplanation
Removing both fallopian tubes is a bilateral salpingectomy. Dr. Khandalavala made sure to write in big bold letters that tubal ligation should not be done if a patient wants children in the futureRate this question:
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- 13.
A Pap smear reveals cervical intraepithelial neoplasia grade I (CIN I). Progression to carcinoma in situ (CIN III) is
- A.
Unlikely if the patient has HPV 11
- B.
Almost certain if the patient has HPV 16
- C.
Almost certain regardless of which HPV she has
- D.
Avoidable if vaccinated with Gardasil®
Correct Answer
A. Unlikely if the patient has HPV 11Explanation
The low risk HPV include 6 and 11. The high risk HPV include 16 and 18. Patients often spontaneously regress from CIN I. Gardasil® only protects before infection of HPV 6, 11, 16, and 18.Rate this question:
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- 14.
A 27 year old woman presents to the emergency room with extreme abdominal pain. The pain came on suddenly, beginning in the lower left quadrant. She has been in a monogamous sexual relationship for 2 years. She denies any trauma. She says her last menstrual period was about 6 weeks ago. She is afebrile, BP 90/50 and dropping, heart rate 100. Which of the following is the most likely diagnosis?
- A.
Pelvic inflammatory disease
- B.
Appendicitis
- C.
Toxemia of pregnancy
- D.
Fallopian tube rupture from ectopic pregnancy
- E.
Fibroma-thecoma
Correct Answer
D. Fallopian tube rupture from ectopic pregnancyExplanation
The only option that fits all of the woman's symptoms is a ruptured ectopic pregnancy. One in every 150 pregnancies is an ectopic pregnancy, and 90% of those are in the fallopian tubes. Neisseria gonorrhoeae can cause pelvic inflammatory disease leading to scarring of the fallopian tubes, which predisposes to ectopic pregnancy. Appendicitis is possible, but the facts that she is afebrile with lower left pain make it less likely. Moreover, appendicitis tends to occur in adolescents and young adults. This woman's lowering blood pressure indicates that she is bleeding into the abdominal cavity. This is clearly a medical emergency.Rate this question:
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- 15.
A 24 year old primipara woman is in her 35th week of pregnancy. She claims to have had a persistent headache for the last 5 days. She is afebrile, but is hypertensive and is found to have 2+ proteinuria and edema. Which of the following is not true of her condition?
- A.
She is at risk for developing seizures
- B.
Her kidneys would likely show fibrin deposits
- C.
This condition often occurs at any stage in pregnancy
- D.
She is at risk for developing DIC
- E.
She will likely improve upon delivering the baby
Correct Answer
C. This condition often occurs at any stage in pregnancyExplanation
Toxemia of pregnancy tends to occur in the third trimester in primiparas. It is diagnosed as preeclampsia by the gradual onset of hypertension, edema, and proteinuria. Upon CNS involvement (such as seizures), the condition is termed eclampsia. Toxemia resolves spontaneously after the birth of the baby.Rate this question:
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- 16.
Regarding the two layers of the endometrium, the functionalis differs from the basalis in that:
- A.
The functionalis does not breakdown during menses
- B.
The functionalis is largely unresponsive to estrogen
- C.
The functionalis produces estrogen
- D.
The functionalis is more responsive to estrogen
Correct Answer
D. The functionalis is more responsive to estrogenExplanation
The functionalis is the protion of the endometrium that varies throughout the menstrual cycle. It is built up in response to estrogen and sloughed off as both estrogen and progesterone are cut off (all from the corpus luteum). The basalis is essentially unaffected.Rate this question:
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- 17.
Endometrial hyperplasia and excessive bleeding during and between menses can be caused by anovulatory cycles. How do anovulatory cycles produce these effects?
- A.
Prolonged stimulation of the endometrium by estrogen
- B.
Prolonged stimulation of the endometrium by progesterone
- C.
Prolonged stimulation of the endometrium by estrogen and progesterone
- D.
Lack of stimulation of the endometrium
Correct Answer
A. Prolonged stimulation of the endometrium by estrogenExplanation
Normally, before ovulation, the corpus luteum produces only estrogen to prepare the uterus. After ovulation, the corpus luteum normally produces both estrogen and progesterone. If pregnancy occurs, human chorianic gonadotropin (HCG) from the placenta prevents the corpus luteum from atrophy. If pregnancy doesn't occur, the corpus luteum simply regresses and estrogen and progesterone production drop. In the anovulatory cycle, the corpus luteum continues to produce estrogen. This continued bath in estrogen causes the symptoms of menometrorrhagia (excessive bleeding at irregular intervals).Rate this question:
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- 18.
Compared to a 60 year old post-menopausal woman, how is a 30 year old woman different?
- A.
Increased HDL, increased LDL, increased lipoproteins
- B.
Increased HDL, increased LDL, decreased lipoproteins
- C.
Increased HDL, decreased LDL, decreased lipoproteins
- D.
Decreased HDL, decreased LDL, decreased lipoproteins
- E.
Decreased HDL, decreased LDL, increased lipoproteins
Correct Answer
C. Increased HDL, decreased LDL, decreased lipoproteinsExplanation
Estrogen has beneficial effects on both cholesterol and lipoproteins, so the 30 year old has increased HDL, with decreased LDLs and lipoproteins. This helps explain why women have a greater risk for cardiovascular disease after menopause. However, as illustrated in the Women's Health Initiative, estrogen plus progesterone may increase the risk of coronary heart disease if given to healthy postmenopausal women.Rate this question:
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- 19.
Teriparatide is a human recombinant parathyroid hormone (rhPTH) used to prevent bone loss. Which of the following explains why terparatide is given as a daily subcutaneous injection?
- A.
PTH normally stimulates bone resorption, but intermittent PTH stimulates bone formation
- B.
PTH normally stimulates bone formation, and daily injections keep plasma PTH levels continually elevated
- C.
PTH normally stimulates bone resorption, but intermittent PTH causes inhibition of calcitonin
- D.
PTH antagonizes vitamin D excretion, causing increased bone formation
Correct Answer
A. PTH normally stimulates bone resorption, but intermittent PTH stimulates bone formationExplanation
PTH is normally secreted in response to low ionized calcium levels in the plasma. PTH causes bone resorption to restore normal calcium levels. However, intermittent PTH causes the opposite effect.Rate this question:
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- 20.
The finding on a Pap smear which is most indicative of invasive squamous carcinoma is
- A.
Koilocytes with two nuclei
- B.
Hyperchromic nuclei with little cytoplasm
- C.
CIN III on two consecutive Pap smears
- D.
Spindle cells in the presence of CIN III
- E.
All of the above are highly indicative of invasive squamous carcinoma
Correct Answer
D. Spindle cells in the presence of CIN IIIExplanation
Once the basement membrane has been broken (invasive squamous carcinoma) the Pap smear will show oddly shaped cells. These can be described as spindle cells or tadpole cells. The highly dysplastic CIN III cells will also be present since they immediately preceded the invasion of the basement membrane. Answers A and B are CIN I and II, respectively.Rate this question:
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.JPG "The structure in the center of the picture below is most likely:")
.JPG "This structure found in the cortex of an ovary is most likely in which stage of division:")
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