OB/Gyn Final Exam - 2007

Student's name:........................................................... Date:.............................

1. Stress urinary incontinence is characterised by involuntary loss of urine with all of the following except:

1. coughing;

2. laughing;

3. sneezing;

4. exercising;

5. sleeping;

2. Which of the following is prerequisite for accurate cystometry?

1. sterile urine;

2. retrograde filling with large incremental volumes;

3. supine position;

4. expensive equipment;

5. increased intraabdominal pressure;

3. Colposcopic findings that suggest invasive cervical cancer include:

1. abnormal blood vessels;

2. irregular surface contour;

3. loss of surface epithelium;

4. color tone change;

5. all the above;

4. Which of the following statements regarding cervical cancer is false:

1. the prevalence of cervical adenocarcinomas in young women is increasing;

2. squamous cell carcinoma is the most common histologic type of invasive cervical cancer;

3. vaginal bleeding is the most common symptom;

4. nulliparity constitutes a risk factor;

5. Surgery as an initial treatment modality is limited to patients with stage I and Iia;

5. ”The carcinoma extends beyond the cervix but has not extended onto the pelvic wall. Obvious parametrial involvement”. The above description concerns which of the following stages according to FIGO staging classification:

1. Ib;

2. IIa;

3. IIb;

4. IIIa;

5. IIIb;

6. A complete breech presentation is best described by which of the following statements?

1. the legs and thighs of the fetus are flexed;

2. the legs are extended, and the thighs are flexed;

3. the arms, legs, and thighs are completely flexed;

4. the legs and thighs are extended;

5. none of the above;

7. Viral infections during pregnancy are most dangerous for fetus during:

1. 1st trimester of pregnancy;

2. 2nd trimester of pregnancy;

3. 3rd trimester of pregnancy;

4. during labor;

5. Viral infections are not dangerous for fetus;

8. A woman reports to the physician's office on June 14 2007, with a positive pregnancy test. She reports regular 28-day cycles and a last menstrual period began on April 3 2007, and ended April 6, 2007. Her estimated delievery date is:

1. January 1, 2008;

2. January 10, 2008;

3. January 17, 2008;

4. January 15, 2008;

5. January 28, 2008;

9. Toxoplasmosis during pregnancy is treated using:

1. spiramycine;

2. Penicillin G;

3. Gamma-Globulin;

4. immunisation durig 1^st trimester of pregnancy;

5. Toxoplasmosis is not treated during pregnancy;

10. Reactive nonstress test is usually interpreted as:

1. fetal well being;

2. hypoxia or asphyxia of the fetus;

3. excessive uterine activity;

4. Absence of uterine contractions;

5. Presence of uterine contractions;

11. Early decelerations should be interpreted as:

1. lack of feto-maternal oxygen transportation;

2. placental acidemia;

3. reflex from baroreceptors;

4. constriction of fetal arteries;

5. fetal CNS immaturity;

12. Intraamniotic infection is most often seen:

1. following rupture of membranes;

2. following vaginal infections;

3. following general viral infections

4. following general bacterial infections;

5. following complicated labor;

13. One of the main symptoms of intraamniotic infection is:

1. Fetal tachycardia;

2. Fetal bradycardia;

3. Maternal bradycardia;

4. Maternal high blood pressure;

5. Maternal leukopenia;

14. Variable decelerations are usually connected with:

1. discoordinated uterine contractility;

2. compression of the umbilical cord;

3. fetal organic heart disease;

4. overextended uterine muscle in polyhydramnios;

5. administration of narcotic analgesia;

15. Therapeutic management in case of late decelerations:

1. administration of narcotic analgesia;

2. infusion of tocolytic agent and oxygen;

3. intraamniotic administration of physiologic saline;

4. amniotomy;

5. administration of diureties;

16. Contraindications to tocolysis:

1. breech presentation;

2. intraamniotic infection;

3. uterine bleeding;

4. genetic congenital malformations;

5. hypercholesterolemia;

17. What is the usual pH of amniotic fluid?

1. 4.0-4.5;

2. 4.5-5.5;

3. 5.5-7.0;

4. 7.0-7.5;

5. 7.5-8.5;

18. How is hypertension in pregnancy defined?

1. blood pressure 160/100 mmHg or greater;

2. blood pressure 140/90 mmHg or greater;

3. diastolic pressure 90 mmHg or greater;

4. increased systolic pressure by 39 mmHg;

5. increased diastolic pressure by 15 mmHg;

19. Which of the following is NOT a predisposing factor to pospartum hemorrhage?

1. prolonged labour;

2. term twins;

3. rapid labor;

4. patient with <1500 g infant;

5. use of oxytocin;

20. Which of the following tocolytics is a competitive oxytocin-vasopressin antagonist?

1. magnesium sulfate;

2. ritodrine;

3. nifedipine;

4. indomethacin;

5. atosiban;

21. Which of the following tocolytics is associated with premature closure of the fetal ductus arteriosus?

1. magnesium sulfate;

2. ritodrine;

3. nifedipine;

4. indomethacin;

5. atosiban;

22. Approximately the percentage of LSIL (low-grade squamous intraepithelial lesions) cases in the female uterine cervix that could progress to HSIL (high-grade) without any treatment is:

1. 50 %;

2. 20 %;

3. 80%;

4. 5 %;

5. 1%;

23. Urogenital diaphragm consists of the following muscles:

1. m. transversus perinei profundus and m. levator ani, m. sphincter urethrae, m. puborectalis;

2. m. sphincter urethrae and m. levator ani, m. coccygeus, m. transversus perinei superficialis;

3. m. sphincter urethrae and m. coccygeus, m. levator ani, m. puborectalis;

4. m. coccygeus, m. transversus perinei profundus, m. sphincter urethrae, m. levator ani;

5. m. transversus perinei superficialis, m. levator ani, m. puborectalis, m. coccygeus;

24. The uterine tube consists of four parts. Indicate which of the below mentioned parts does not belong to the tube:

1. tubal fimbriated end (infundibulum);

2. tubal ampoulla;

3. tubal fundus;

4. tubal intramural portion.;

5. tubal isthmus;

25. Ovarian arteries are branches of :

1. abdominal aorta;

2. uterine artery;

3. common iliac artery;

4. external iliac artery;

5. obturator artery;

26. Persistent vaginal discharge in a female pediatric patient should prompt a search of which of the following:

1. Pinworms;

2. Vaginal lacerations;

3. Foreign body;

4. Ectopic ureter;

5. Illicit drug use;

27.The most common feature of ovarian neoplasms in adolescents is:

1. germ-cell origin, hormone secreting;

2. coelomic epithelial origin, endocrine secreting;

3. germ-cell origin, non-endcrine secreting;

4. non germ-cell origin;;

5. coelomic epithelial origin

28. Dysgerminoma is a rare type of ovarian malignancy that can be characterized by following facts:

1. approximately 90% of these tumors are found in females<30 years of age;

2. tumors can secrete detectable amounts of hCG;

3. bilaterality occurs in more that 20% of cases;

4. tumors are exquisitely radiosensitive;

5. all answers are correct;

29.Which of the following statements is not characteristic for ovarian cancer:

1. the lifetime risk is approximately 1:70;

2. oral contraceptives have a significantly protective effect;

3. this malignancy is clinically silent during early development;

4. high parity, early childbearing and prolonged breast-feeding are risk factors;

5. family history of ovarian cancer can increase the risk for first-degree relatives as high as 50%;

30.The age when fibroids are usually symptomatic:

1. before menarche;

2. after menopause;

3. in premenopausal women over 40;

4. during pregnancy;

5. during breastfeeding;

31. Choose a false sentence according to pedunculated fibroids:

1. is subserosal or submucosal;

2. may cause acute pain;

3. are difficult in differential diagnosis;

4. often transform into sarcoma;

5. can be asymptomatic;

32. Symptoms most often associated with submucosal fibroid leading to surgical intervention are:

1. enlargement during pregnancy;

2. menorrhagia;

3. urinary incontinuence;

4. urethral obstruction;

5. ascites;

33. Gonadotropins (FSH and LH) are produced in humans by:

1. Anterior pituitary cells;

2. Paraventricular nucleus of the hypothalamus;

3. Ovarian granylosa cells;

4. Posterior pituitary cells;

5. Endometrial cells;

34. Indicate the hormone, which can be used as a presumptive sign that ovulation occurred:

1. Prolactine;

2. Estradiol;

3. Testosterone;

4. Progesteron;

5. Follitropin;

35. Wich hormone is responsible for stimulation of progesterone production by the corpus luteum during pregnancy:

1. Estradiol;

2. FSH;

3. Prolactine;

4. hCG;

5. HSG;

36. The proper position of the vagina is warranted by three levels of support. The level one consist of:

1. Arcus tendineous fascie pelvis;

2. Cardinal ligament;

3. Utero-sacral ligament;

4. Cardinal ligament, Utero-sacral ligament;

5. Perineal body;

37. The preoperative risk factor for thromboembolism are:

1. Age over 70;

2. Presence of varicose veins;

3. Obesity;

4. Gynecological malignancy;

5. All above;

38. The main two indications for hysterectomy are:

1. Leiomyomas, dysfunctional uterine bleeding;

2. Leiomyomas, Pelvic pain;

3. Dysfunctional uterine bleeding, Genital prolapse;

4. Pelvic pain, Pelvic inflammatory diseases;

5. Genital prolapse, Endometriosis;

39. At the present time therapy for women who have mild -to- moderate endometriosis can consist of all the following except

1. Progestins;

2. Dexamethasone;

3. Danazol;

4. oral contraceptives;

5. Gonadotropin releasing hormone (GnRH);

40. Endometriosis can be diagnosed only

1. During physical examination;

2. By ultrasound examination;

3. By CT examination;

4. During laparoscopy or laparotomy;

5. by means of biochemical diagnosis;

41. Endometrial cancer is

1. mainly estrogen-dependent;

2. androgen-dependent;

3. progesterone-dependent;

4. hormonally independent;

5. FSH dependent;

42. Menopause occurs earlier in:

1. cigarette smokers;

2. black women;

3. multiparous women;

4. alcohol abusers;

5. women using IUD;

43. Premature ovarian failure is defined as when menopause occurs spontaneously before:

1. 35 years of age;

2. 38 years of age;

3. 40 years of age;

4. 42 years of age;

5. 45 years of age;

44. Condylomata acuminata are the manifestation of which infection:

1. Haemophilus ducreyi;

2. Gardnerella vaginalis;

3. Herpes Simplex Virus;

4. Chlamydia trachomatis;

5. Human Papilloma Virus;

45. Ectopic pregnancy can be treated:

1. by laparotomy only;

2. by laparoscopy only;

3. by laparotomy or laparoscopy (no conservative treatment applicable);

4. by the use of methotrexate only;

5. by laparotomy, laparoscopy or with the use of methotrexate;

46. The following decription “ uterine bleeding from a gestation of <20 weeks accompanied by cervical dilatation but without expulsion of products of conception through the cervix” “ best applies to:

1. missed abortion;

2. inevitable abortion;

3. complete abortion;

4. threatened abortion;

5. tubal abortion;

47. Which of the following symptoms is not typical for Trichomonas Vaginitis:

1. profuse, purulent, malodorous vaginal discharge;

2. vulvar pruritus;

3. “strawberry” cervix;

4. normal vaginal pH;

5. vaginal secretions may exude from the vagina;

48. The true about progesterone in human pregnancy is:

1. main pro-pregnancy factor, produced mainly by uterine smooth muscle;

2. the main source is corpus luteum until 8^th week of pregnancy and placenta after 8^th week of pregnancy;

3. induces ripening of the uterine cervix;

4. stimulates uterine contractility ;

5. is produced only by corpus luteum;

49. First Leopold's manouver is performed to assess:

1. fetal attitude and presenting part;

2. fetal position and height of uterine fundus;

3. fetal lie and and height of uterine fundus;

4. fetal position and attitude;

5. the number of fetuses;

50. The proper sequence of cardinal movements during normal labor is:

1. engagement, internal rotation, flexion, extension, external rotation;

2. engagement, flexion, internal rotation, extension, external rotation;

3. flexion, engagement, extension, external rotation;

4. internal rotation, engagement, flexion, extension, external rotation;

5. flexion, internal rotation, extension, engagement.

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