Blood pressure changes during pregnancy can be attributed to the following, EXCEPT? *
a. Components of the renin-angiotensin-aldosterone axis are decreased in normal pregnancy
b. Cardiac output at rest is increased in early pregnancy and continues to increase and remain elevated all througout the pregnancy
c. Vascular resistance decreased
d. There is ensuing hypervolemia in the pregnant patient
e. All statements are true regarding blood pressure changes in the patient
A. Components of the renin-angiotensin-aldosterone axis are decreased in normal pregnancy
- The RAAS components are actually increased in pregnancy
The average weight gain of a pregnant woman is approximately?
A) 11.5kg B) 12 lbs C) 12.5kg D) 13 lbs E) 12.5 lbs
C) 12.5kg
A 26 year old female came in for prenatal checkup. Upon thorough examination, her obstetrician noted a darker than usual areola and larger, pigmented nipple. What could possible explain the change noted in the patient? A. Melasma gravidarum B. Chadwicks sign C. Spider telangiectasia D. Ballotment E. Prominence of montgomery tubercles
E. Prominence of montgomery tubercles
Which of the following is considered a probably sign of pregnancy? A. Positive pregnancy test B. Balottment C. Thermal changes D. A and B only E. All of the above
D. A and B only
- Positive pregnancy test & Balottment
-  Thermal changes is a presumptive sign of pregnancy.
A 34 year old single pregnant came in for prenatal check up. Her 1st 2 pregnancies were carried to term and were delivered NSVD. She also had primary CS for preterm twins and 1 spontaneous abortion. She now has four live children. What is her OB score? A. G5P3(22214) B. G6P4(2214) C. g5p2(2114) D. G5P4(2214) E. G6P3(2133)
A. G5P3(22214)
G: 4 pregnancies + present
P: 3
F: 2 pregnancies were carried to term
P: preterm twins
A: 1 spontaneous abortion
L: 4 live children
Ductus arteriosus which is the fetal counterpart of ligamentum arteriosum, anatomically closes at what age? A. 10-96 hours B. 10-12 hours C. 3-4 days D. Several minutes after birth E. 2-3 weeks after birth
E. 2-3 weeks after birth
*anatomical closure
Which of the following antibiotics is teratogenic and could cause hypoplastic left heart syndrome? A. Aminoglycoside B. Chloramphenicol C. Nitrofurantoin D. Tetracyclines E. Sulfonamides
C. Nitrofurantoin
Which of the following statements accurately describes hcg?
A. It is produced by cytotrophoblasts
B. Detected in maternal serum only after 3 weeks from ovulation
C. Molar pregnancy and multiple pregnancy can cause an overly elevated serum hcg levels
D. A and C are correct
E. None of the above statements are correct
D. A and C are correct
*C. Molar pregnancy and multiple pregnancy can cause an overly elevated serum hcg levels.
Anna 26/f consulted on october 28, 2016 because of missed menses. Last menstrual period was april 4, 2016. She claims to have regular menses. Pregnancy test was positive. What is her age of gestation at the time of consult? A. 29 4/7 weeks B. 29 3/7 weeks C. 30 1/7 weeks D. 30 2/7 weeks E. 30 3/7 weeks
A. 29 4/7 weeks AOG
Using naegele's rule, calculate the EDC of the above patient? A. February 11, 2017 B. January 11, 2016 C. January 18, 2017 D. February 18, 2017 E. January 11, 2017
E. January 11, 2017
Which of the following homologues is/are incorrectly paired? A. Labia minora-Ventral raphe B. Prostate gland-skene's glands C. Scrotum-Mons pubis D. Round ligament-Gubernaculum testis E. All are correctly paired
C. Scrotum-Mons pubis
A 16 year old female, still with no menses but has some development of breasts and pubic jair. She is phenotypically and endocrinologically female with a karyotype of 46,xx. What is your diagnosis?
A. Mullerian agenesis
B. Androgen insensitivity syndrome
C. Kallman syndrome
D. Mayer Rokitansky Kuster Hauser Syndrome
E. A and D are correct
E. A and D are correct
- Mullerian agenesis / Mayer Rokitansky Kuster Hauser Syndrome
- The case is typical of Mullerian agenesis. AIS has 46, xy karyotype and has male levels of testosterone. Kallman syndrome is congenital absence of GnRH with assoc anosmia. A and D means the same thing
If a transrectal ultrasound was done in the patient above, what is the likely finding? A. Bifid uterus B. Uterine didelphys C. Blind vaginal pouch D. Absent uterus E. Combination of C&D
E. Combination of C&D
- Blind vaginal pouch and Absent uterus
- Mullerian derivatives are absent (Fallopian tube, uterus, and upper third of the vagina).
Diethylstilbestrol could predispose what histologic type of carcinoma? A. Sarcoma botryoides B. Adenosquamous carcinoma C. Squamous cell CA D. Basaloid carcinoma E. Clear cell adenocarcinoma
E. Clear cell adenocarcinoma
*Infants with mothers exposed to prenatal DES is pedisposed to vaginal clear cell adenoCA.
32 year old female, G0, no history of sexual contact, came in to the clinic with complaint of lower abdominal pain. Serum pregnancy test was negative. History revealed that she experiences midline lower abdominal pain, sometimes suprapubic location, associated with dysuria and cyclic hematuria. What is the likely diagnosis? A. Complicated uti B. Condyloma acuminata C. Endometriosis D. Leiomyoma E. Vaginal Adenocarcinoma
C. Endometriosis
*symptoms being cyclic in nature points to endometriosis. In this case, predominance of urinary symptoms may indicate that probably endometriotic implants are located somewhere in the bladder. (indeed the actual diagnosis is Bladder endometriosis)
Which of the followig cardiovascular changes occuring in pregnancy may be considered abnormal?
A. Heart is displaced to the left and upward
B. Apex is moved laterally from its usual position
C. Some degree of pericardial effusion
D. Slight right axis deviation
E. All can be considered physiologically normal in pregnancy
D. Slight right axis deviation
- if the heart is displaced to left and upward, we should expect a lext axis deviation. A right axis deviation may be abnormal.
Medical management of endometriosis entails different approaches. What pharmacologic agent is used for "medical oophorectomy"? A. Danazol B. Leuprolide C. OCP D. Progestins E. Bisphosphonates
B. Leuprolide
- Danazol- pseudomenopause
- OCP-pseudopregnancy state
- Bisphosphonates has no role in endometriosis
Which of the following statements regarding endometrial cancer is/are true?
A. The most common cause of death from gynecologic malignancy
B. Third most common gynelogic malignancy
C. Most common histologic type is adenocarcinoma
D. Risk factor is multiple sexual partners and multiparity
E. Depth of myometrial invasion is not related to tumor grade
C. Most common histologic type is adenocarcinoma
- Endom CA is the most common maligancy in the gynecologic tract, and is the third most common cause of death in gyne cancer.
- Depth of invasion is related to tumor grade.
A 7 year old female patient came in due to abdominal enlargement. PE confirms a movable pelvic mass. Ultrasound revealed unilateral, smooth, unilocular and totally cystic structure with inctracystic calci`cations. The mass measures 6 cm in greatest diameter. Which of the following findings suggests that the mass be malignant? A. Age of the patient B. Size of the mass C. Symptoms caused by the pelvic mass D. Characteristic findings of the mass E. A and B
A. Age of the patient
- A size of >8 cm usually suggests its malignant. The characteristic described is that of a benign adnexal mass.
- Any adnexal mass in a pre menarchal patient, you consider it malignant.
A 46 year old female underwent salpingooophorectomy for ovarian new growth. Upon histologic section, solid mass or nests of epithelial cells and a surrounding fibrous stroma was noted. Epithelial cells have a "coffee bean" appearance. What is the diagnosis? A. Serous cystadenoma B. Mucinous cystadenoma C. Brenner tumor D. Benign cystic teratoma E. Fibroma
C. Brenner tumor
- “coffee bean” appearance is the buzz word to watch out for in brenner tumors
- epithelium in brenner tumor is composed of transitional epithelium(same with the bladder)
*Brenner=Bladder
