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Flashcards in Quiz 4 Deck (49)
1

What is a risk factor for fetal macrosomia?

Multiparty

2

In order to maximize the response of a tumor to therapy, the goal should be to utilize therapy when the minimum number of tumor cells is in which phase of the cell cycle?

G0

3

The phase of the cell cycle that is the most variable in length and ultimately influences how response a tumor is to chemotherapy is...

G1`

4

The goal of induction chemotherapy is to...

cause a remission

5

A patient has been through surgery for her cancer and it appears that all of the tumor has successfully been removed. The most common follow-up likely would be...

Adjuvant chemotherapy

6

Approximately what percent of patients with molar pregnancy will develop persistent or malignant disease?

20%

7

In comparison to patients with complete molar pregnancies, patients with partial molar pregnancies are more likely to...

Present as a missed abortion

8

The recurrence rate for gestational trophoblastic disease in subsequent pregnancies is approximately...

2%

9

On average, the cure rate for a patient with nonmetastatic cGTN and a FIGO score of 4 is approximately...

100%

10

A 23 year old female nonsmoker presents to the ER with hemoptysis. Chest x-ray reveals three lung lesions. Full body imaging and skin inspection reveal no obvious tumor. She initially denies a history of pregnancy although eventually admits giving a baby up for adoption 4 years ago. A 5-mm reddish nodule is seen in the upper third of the vagina on pelvic exam. What is the appropriate next step in her evaluation?

Biopsy of the vaginal lesion

11

A 42 year old patient is diagnosed with a molar pregnancy complicated by theca lutein cysts and preeclampsia. Her serum quantitative hCG on presentation was 100,000 mIU/mL. The patient tolerates her D&C without complication. She lives near the hospital and has reliably shown up to all her appointments. What is the most appropriate next step in her management?

Serial serum quantitative hCG levels

12

Six months ago a 33 year old patient had a D&C to evacuate a molar pregnancy. Although her serum hCG levels have steadily decreased since then, they are still detectable. The patient has been compliant with contraception. What is the most appropriate next step in management?

Single-agent chemotherapy

13

The pathology report of a D&C performed on a 22 year old woman for a missed abortion 2 weeks ago reveals a partial mole. Serum quantitative hCG levels are still detectable and over the next 4 weeks there is only a 10% variation in levels. What is the most appropriate next step in her management?

Single-agent chemotherapy

14

Which of the following results in the absence of the uterus?

Degeneration of the Mullerian ducts

15

The false pelvis and the true pelvis are separated by the...

Linea terminalis

16

The ligament that provides the primary support to the uterus is the...

Uterosacral ligament

17

The portion of the fallopian tube that adjoins the outer opening into the uterus is the...

isthmus

18

The narrowest fixed distance through which the fetal head must pass in a vaginal delivery is the...

interspinous diameter

19

The fallopian tubes are usually how long?

7-14 cm

20

The cilia of the fallopian tube columnar lining beat...

all toward the uterus

21

What is the distance of the ureter from the uterine sidewall at the point where its path crosses that of the uterine artery?

1.5-3.0cm

22

The innominate bones are composed of the fused ileum, ischium, and

acetabulum

23

The false pelvis and true pelvis are separated by the...

Linea terminalis

24

In clinical pelvimetry, the obstetric conjugate should be at least what measurement?

11.0 cm

25

The transverse diameter of the pelvic inlet should be...

13.0 cm

26

The blood supply to the uterus includes the...

ovarian and uterine artery

27

What would distinguish secondary from primary dysmenorrhea?

Presence of an abnormal pelvic examination

28

A 28 year old woman presents for the evaluation of chronic lower abdominal pain, which has been present and unresolved for the past 2 years. She would like to know how common her problem is. Chronic pelvic pain of greater than 12 months duration is estimated to be present in what percent of women aged 18 to 50 years?

15-20%

29

A patient is referred for evaluation of possible primary dysmenorrhea. Which of the following would cause suspicion of secondary dysmenorrhea>.

Dyspareunia

30

A 23 year old patient complains of increasing pelvic heaviness and cyclic lower abdominal pain. She has been attempting to conceive for the past 3 years. Pelvic examination reveals painful nodules posterior to the cervix. Which of the following is the most likely diagnosis for this patient?

Endometriosis

31

A 26 year old woman presents with 2 years of sever dysmenorrhea associated with diarrhea during her menses. On bimanual exam, you not uterine immobility and tender nodularity posterior to the uterus. What is the most likely cause of this patient's dysmenorrhea?

Endometriosis

32

A 47 year old woman has long-standing pelvic pain associated with endometriosis. A previous laparoscopic ablation of endometriosis has given her several years of relief. Over the last 6 months, her symptoms have gotten progressively worse. The best treatment option for this patient is...

Administration of a GnRH agonist

33

A 23 year old divorced mother of three, on public assistance, comes to your office seeking help for symptoms of lower abdominal pain that began 8 months previously. This coincided with her divorce and the loss of her job at a textile mill. Her pain is located in her left lower quadrant but spreads to the right and her back. The pain is worth with menstruation, bowel movements, and intercourse. She has tried multiple medications without benefit. Past history reveals and abusive marriage and two previous laparotomies for "ovarian cysts." Vital signs are temperature 37.0 C, pulse 68/minute, respirations 18/minute, BP 118/64, weight 56 kg. The examination or procedure that would best support your working diagnosis is...

Bimanual pelvic examination

34

Physical examination is normal except for distractible tenderness around the adnexae, the posterior cul-de-sac and on uterine motion. The most likely diagnosis is...

Depression

35

About what percent of stillborn infants are found to be growth restricted?

25%

36

An efficient screening procedure for IUGR is

Fundal height measurements

37

A 24 year old comes to the office with concerns about heavy vaginal bleeding that started 3 days ago. The patient says that her menstrual periods have been regular in the past and this ️Bleeding roughly corresponded with the onset of her expected period, though it was "three days late." On physical examination today she weighs 47 kg and is 160 cm tall, blood pressure is 118/64. Her general physical and pelvic examinations are unremarkable. In assessing the need for therapy, the most useful information would be the results of a...

Pregnancy test

38

A 38 year old woman reports mild vaginal bleeding for the past 10 weeks since she had a spontaneous abortion at home. What is the appropriate next step in the evaluation of this patient?

Quantitative hCG

39

A 41 year old with a history of a molar pregnancy 3 months ago with poor interval follow-up is diagnosed with Choriocarcinoma. Her brain CT is normal. Her serum quantitative hCG level is 10,000 mIU/mL. Ultrasound has ruled out a new pregnancy. What aspect of her history and workup would suggest high risk disease?

Her age

40

A description of lichen Planus would include

White lacy bands of keratosis

41

What condition may be associated with high urinary oxalis acid concentrations?

Vestibulitis

42

What is a characteristic of Acanthosis?

Hyperkeratosis

43

VIN, usual type, is treated by...

Laser ablation

44

The overall incidence of lymph node metastasis in squamous cell carcinoma of he vulva is approximately...

30%

45

An inclusion cyst arises from...

Imperfect alignment of childbirth lacerations or episiotomy

46

A 37-year patient who has not completed childbearing has a 7 cm symptomatic fibroid. She has had menorrhagia for 6 months and a normal endometrial biopsy. She wants to know what the best option for treatment of this fibroid is. She would like to utilize the least invasive approach to accomplish her treatment goals. You recommend:

Myomectomy

47

A 40 year old patient with irregular ️Bleeding comes to see you. On physical exam you Palpate an enlarged uterus measuring approximately 18 week size. Upon review of her medical record,Chou notice that a prior ultrasound performed 2 years ago demonstrated a uterus measuring approximately 16 weeks size. She desires a definitive management. Prior to performing a hysterectomy, your workup is not complete without...

Endometrial biopsy to asses for endometrial pathology

48

The transverse diameter of the pelvic inlet should be...

13 cm

49

The Interspinous distance should be...

10 cm