Rotation 10 Ert - Aub Labor Menopause

34 Questions | Total Attempts: 44

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Rotation 10 Ert - Aub Labor Menopause

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Questions and Answers
  • 1. 
    Which of the following hormones does not decrease significantly in the first two years after a woman goes through menopause?
    • A. 

      Thyroxin (T4)

    • B. 

      Prolactin

    • C. 

      Testosterone

    • D. 

      Progesterone

    • E. 

      17-Beta-estradiol

  • 2. 
    Studies show that nearly 90% of woman experience hot flushes during menopause. What percent of these woman experience more than 10 hot flushes per day?
    • A. 

      10%

    • B. 

      18%

    • C. 

      33%

    • D. 

      60%

    • E. 

      87%

  • 3. 
    All of the following central pathophysiologic mechanism have been implicated as a potential cause of vasomotor symptoms EXCEPT?
    • A. 

      Serotonergic

    • B. 

      Autonomic

    • C. 

      Noradrenergic

    • D. 

      Thermoregulation

    • E. 

      Neurogenic

  • 4. 
    Premarin (Conjugated Estrogen) is a commonly used form of systemic hormone replacement therapy. This agent is best categoried or derived from what source?
    • A. 

      Animal derived

    • B. 

      Phytoestrogen

    • C. 

      Synthetic xeno estrogen

    • D. 

      Mycoestrogen

    • E. 

      None of the above

  • 5. 
    The Women's health Initiative (WHI) was a randomized, prospective, research study evaluating the effects of systemic hormone replacement therapy in postmenopausal woman. The study concluded woman taking combine hormone replacement therapy demonstrated a higher risk of all the following conditions and events EXCEPT?
    • A. 

      Breast Cancer

    • B. 

      Venous thromboembolism (VTE)

    • C. 

      Coronary Heart Disease

    • D. 

      Stroke

    • E. 

      Colon Cancer

  • 6. 
    This agent is a novel hormonal replacement agent approved by the FDA in 2013. It is unique in that it contains Bazedoxifene which is best categorized as?  
    • A. 

      A Selective-Estrogen Receptor Modulator

    • B. 

      A Progesterone

    • C. 

      A Testosterone Derivative

    • D. 

      An Estrogen Agonist/ Antagonist

    • E. 

      A Gonadotropin Releasing Analogue

  • 7. 
    HRT regimens with  testosterone have been studied and have shown benefit relating to what condition/symptoms?
    • A. 

      Improving lipid panel

    • B. 

      Improving libido

    • C. 

      Decreasing breast cancer risk

    • D. 

      Improvement in skin health (acne and hirsuitism)

    • E. 

      None of the above

  • 8. 
    All of the following non-hormonal agents, although not necessarily FDA approved for the indication, have  demonstrated some efficacy in managing  menopausal vasomotor symptoms EXCEPT?
    • A. 

      Paroxitene (Paxol®)

    • B. 

      Gabapentin (Nuerontin®)

    • C. 

      Ospemifene (Osphena®)

    • D. 

      Clonodine (Catapress®)

    • E. 

      Desfenlafaxine (Prestiq®)

  • 9. 
    A 55 year-old female, with menopause at age 51, presents with 10 months of vaginal itching, burning, and superfical dyspareunia. Examination reveals the following. She denies vasomotor symptoms and has a positive family historyof breast cancer. The best step in managing this patient is?
    • A. 

      Vulvar biopsy

    • B. 

      Empiric treament with Lotrisone (Clortrimazole + Betamethsone) cream for 3 months and re-evaluation

    • C. 

      Initiation of vaginal and vulvar estrogen with followup in 6 months

    • D. 

      Start systemic hormone replacement therapy and followup on symptoms in 2 months.

    • E. 

      Refer to gynecologic oncology for assessment and wide local excision of the vulva

  • 10. 
    In regards to complementary botanicals and similar products used for the treatment of vasomotor symptoms which of the following statements is true?
    • A. 

      Most of the complementary therapies that have been marketed for the treatment of vasomotor symptoms are approved and well tested by the FDA in regards to efficacy and safety.

    • B. 

      A cochrane database meta-analysis confirmed significant benefit with the use of phytoestrogens when adminitistered in high doses only

    • C. 

      Specific products found to offer the greatest benefit in managing vasomotor symptoms include Ginseng and Saint John's Wort.

    • D. 

      Black Cohosh has demonstrated potential benefit in managing vasomotor symptoms but has also been shown to cause liver toxicity.

    • E. 

      Lifestyle modification including optimization of diet and weight bearing exercise has shown good benefit in managing the frequency and intensity of vasomotor symptoms.

  • 11. 
    All of the following agents are classified as Selective Estrogen receptor modulators (SERMs) EXCEPT?
    • A. 

      Raloxifene (Evista ®)

    • B. 

      Clomiphene Citrate (Clomid®)

    • C. 

      Tamoxifene (Nolvadex®)

    • D. 

      Letrozole (Femora®)

    • E. 

      Ospemifene (Osphena®)

  • 12. 
    This over the counter agents is classified as a non-hormonal vaginal moisturizer and may be used as an alternative to topical estrogen for the management of postmenopausal vaginal atrophy and dyspareunia?
    • A. 

      Replens

    • B. 

      Vagifem

    • C. 

      Vagisil

    • D. 

      Astroglide

    • E. 

      Mineral Oil

  • 13. 
    A 22 year-old primigravid patient with a fetus estimated to weigh 3400 grams receives epidural anesthesia at 6cm dilation. An arrest of dilation ensues and she is treated with oxytocin augmentation. At full dilation the fetal position is occiput posterior with a -1 station. Pitocin is continued resulting in contractions that occur every 2 minutes and last a full minute. She is pushing with each contraction and the fetal monitor tracing is category I. Three hours later the presentation and station are unchanged but caput and molding of the fetal head is at a +2 station. The next best step in management is?
    • A. 

      Allow the patient to continue pushing and completely discontinue epidural

    • B. 

      Insert an intrauterine pressure catheter and calculate montevideo units (MVUs)

    • C. 

      Arrange for operative vaginal delivery using vacuum device

    • D. 

      Arrange for primary cesarean delivery

    • E. 

      Increase oxytocin with close monitoring of fetal monitor strip

  • 14. 
    This image demonstrates a fetus with what presentation?
    • A. 

      Vertex

    • B. 

      Military

    • C. 

      Face

    • D. 

      Brow

    • E. 

      Sinciput

  • 15. 
    The stage of labor that begins when cervical dilation is complete and ends with the delivery of the fetus is which of the following?
    • A. 

      First stage

    • B. 

      Second stage

    • C. 

      Third stage

    • D. 

      Fourth stage

    • E. 

      Second (latent)and third (active) stage

  • 16. 
    A 25 year-old, G2P1, presents at 41 weeks gestation. Her cervix is unfavorable with a Bishop score of 3. You counsel her on induction of labor and the use of intravaginal misoprostil (Cytotec) as preinduction cervical ripening agent. The most common complication of this agent is?
    • A. 

      Chorioamnionitis

    • B. 

      Uterine tachysystole

    • C. 

      Chemical vaginitis

    • D. 

      Maternal nausea and vomiting

    • E. 

      Vaginal bleeding

  • 17. 
    Which of the following is a physiologic change associated with an intravenous bolus of oxytocin?
    • A. 

      Increase blood pressure

    • B. 

      Decreased cardiac output

    • C. 

      Increased heart rate

    • D. 

      Increased body temperature

    • E. 

      Decrease in oxygenation

  • 18. 
    The attached figure represents a fetal head in which position? 
    • A. 

      Left Occiput Posterior (LOP)

    • B. 

      Left Occiput Anterior (LOA)

    • C. 

      Right Occiput Posterior (ROP)

    • D. 

      Right Occiput Anterior (ROA)

    • E. 

      Right Occiput Transverse (ROT)

  • 19. 
    A 32 year-old primigravid woman present at 39 weeks gestation with frequent uterine contractions and pain over the past 6 hours. On repeated examinations, the cervix is 1 cm dilated and 70% effaced with the fetal vertex at a -3 station. The fetal heart rate tracing is reassuring. The best next step in management is....?
    • A. 

      Oxytocin administration

    • B. 

      Expectant Management

    • C. 

      Artificial rupture of membranes

    • D. 

      Initiate oxytocin induction

    • E. 

      Offer elective primary cesarean section delivery

  • 20. 
    Delaying cord clamping after delivery by 3 minutes has been encouraged by some because it provides an additionasl 80 mg of blood to the neonate. The possible disadvantage of this includes which of the following?
    • A. 

      Exsanguination

    • B. 

      Hyperbilirubinemia

    • C. 

      Hypoglycemia

    • D. 

      Meconium Aspiration syndrome

    • E. 

      Postpartum uterine atony and hemorrhage

  • 21. 
    The following diagram demonstrates a vaginal laceration  that occurs in about 1-2% of vaginal deliveries? It is associated with all of the following EXCEPT?
    • A. 

      Primiparity

    • B. 

      Macrosomia

    • C. 

      Vaginal birth after cesarean section (VBAC)

    • D. 

      Operative vaginal delivery

    • E. 

      Persistent occiput posterior position

  • 22. 
    Compared with mediolateral episiotomy, the main drawback of midline epsiotomy is which of the following?
    • A. 

      Surgical repair is more difficult

    • B. 

      It is more likely to extend into a fourth degree laceration

    • C. 

      It is more likely to break down

    • D. 

      There is decrease blood loss

    • E. 

      Less pleasing cosmetic result.

  • 23. 
    Hemabate (Carboprost®) is a uterotonic commonly used for postpartum atony. It is categorized as a prsotanoid and more specifically contains?
    • A. 

      Prostaglandin PG E2

    • B. 

      Prostaglandin PG F2 Alpha

    • C. 

      Leukotriene (LTC4)

    • D. 

      Thromboxane (TXA2)

    • E. 

      Ergot Alkaloid

  • 24. 
    All EXCEPT which of the following definitions of abnormal bleeding is true?
    • A. 

      Metrorrhagia describes intermenstrual bleeding

    • B. 

      Oligomenorrhea refers to cycles with intervals that are shorter than 35 days

    • C. 

      Hypomenorrhea refers to menses with diminished or shortened interval

    • D. 

      Menorrhagia is defined as prolonged or heavy cyclic menstruation

    • E. 

      Amenorrhea is a term for the absence of menses

  • 25. 
    A 33 year-old, G2P2, present to your office with post-coital bleeding. Pelvic examination is unremarkable including speculum and bimanual examination. You perform a pap smear. Which of the following may also be reasonable in the evaluation of this patient's complaint?
    • A. 

      Colposcopy

    • B. 

      LEEP procedure of the cervix

    • C. 

      Cystoscopy

    • D. 

      Proctoscopy

    • E. 

      CT Scan or MRI of the pelvis