COMLEX Level 1 TrueLearn COMBank - Questions
Answered With Expert Insights
Failure to deliver the placenta within 30 mins of birth
Manual extraction may result in profuse, uncontrollable bleeding,
w/ retention of most or all of the placental tissue
Emergent hysterectomy is required
Placental villi attach to the surface of the myometrium Correct
Answer - Placenta accreta
What are the risk factors of placental accreta spectrum Correct
Answer - Hx of c-section
Hx of uterine procedures (dilation, curettage, myomectomy, uterine
ablation, Asherman syndrome)
Placental previa
What is included in placenta accreta spectrum and describe each
Correct Answer - Placenta accreta: placental villi attach to the
surface of the myometrium
Placenta increta: chorionic villi penetrate into the myometrium
Placenta precreta: chorionic villi penetrate through the
myometrium to the uterine serosa or adjacent organs
Secondary amenorrhea (absence of periods for 3 cycles) following a
dilation and curettage (D&C) Correct Answer - Asherman
syndrome
,- Trauma to stratum basalis --> absence of the stratum basalis layer
of the endometrium
Etiology of secondary amenorrhea Correct Answer -
Hypothalamic: Functional hypothalamic amenorrhea
Pituitary: Hyperprolactinemia, empty sella syndrome, Sheehan
syndrome
Ovary: Plycystic ovary syndrome, premature ovarian failure
Uterus: Asherman syndrome
Other: Congenital adrenal hyperplasia, hypothyroidism, adrenal
tumors
List the disease for each histology:
1. Abscent stratum basalis in an endometrial biopsy
2. Benign keratinocytes within the epidermis
3. Enlarged ovaries w/ multiple cystic follicles
4. Hyperplasia of lactotroph cells within the anterior pituitary
5. Numerous corpora albicans and a fibrotic cortex Correct
Answer - 1. Asherman syndrome
2. Imperforate hymen
3. Polycystic ovary syndrome
4. Prolactinoma
5. Atrophic ovary
Diagnosed in infants (< 1 year)
M > F predominance
Most common in Caucasian populations
,Symptoms of severe anemia --> pallor, fatigue, cyanosis
Webbed neck (can be confused for Turner syndrome)
Cleft pallet
Triphalangeal thumbs
Macrocytic anemia (nonmegaloblastic)
Decreased reticulocyte count (< 1% in infants)
Normal leukocytes and platelets
Bone marrow biopsy --> absence of erythroid precursors
Increased HbF on electrophoresis
Nonmegaloblastic macrocytic anemia Correct Answer -
Diamond-Blackfan anemia
- Turner syndrome does not cause macrocytic anemia
Treatment for Diamond-Blackfan anemia Correct Answer -
Corticosteroids
Transfusion
Hematopoietic stem cell transplant
Defect in erythropoiesis --> Pure Red Cell Aplasia (PRCA)
Erythroblasts in bone marrow undergo premature apoptosis
, Common mutations result in ribosome protein synthesis defect -->
TP53 activation --> increased apoptosis Correct Answer -
Diamond-Blackfan anemia
Megaloblastic macrocytic anemias (3) Correct Answer - B12
deficiency
Folate deficiency
Orotic aciduria
Nonmegaloblastic macrocytic anemias (4) Correct Answer -
Diamond-Blackfan anemia
Alcohol use
Liver disease
Thyroid disease
Normocytic anemia
Maybe due to: viral infections (eg., parvovirus), radiation,
medications (eg, antimetabolites), and toxin exposure
Pncytopenia (anemia, thrombocytopenia, leukopenia) Correct
Answer - Aplastic anemia
Autosomal recessive
Defect in DNA repair mechanisms
Either normocytic or macrocytic anemia
Pancytopenia (labs show anemia, thrombocytopenia, leukopenia)
Correct Answer - Fanconi anemia
Autosomal recessive
Answered With Expert Insights
Failure to deliver the placenta within 30 mins of birth
Manual extraction may result in profuse, uncontrollable bleeding,
w/ retention of most or all of the placental tissue
Emergent hysterectomy is required
Placental villi attach to the surface of the myometrium Correct
Answer - Placenta accreta
What are the risk factors of placental accreta spectrum Correct
Answer - Hx of c-section
Hx of uterine procedures (dilation, curettage, myomectomy, uterine
ablation, Asherman syndrome)
Placental previa
What is included in placenta accreta spectrum and describe each
Correct Answer - Placenta accreta: placental villi attach to the
surface of the myometrium
Placenta increta: chorionic villi penetrate into the myometrium
Placenta precreta: chorionic villi penetrate through the
myometrium to the uterine serosa or adjacent organs
Secondary amenorrhea (absence of periods for 3 cycles) following a
dilation and curettage (D&C) Correct Answer - Asherman
syndrome
,- Trauma to stratum basalis --> absence of the stratum basalis layer
of the endometrium
Etiology of secondary amenorrhea Correct Answer -
Hypothalamic: Functional hypothalamic amenorrhea
Pituitary: Hyperprolactinemia, empty sella syndrome, Sheehan
syndrome
Ovary: Plycystic ovary syndrome, premature ovarian failure
Uterus: Asherman syndrome
Other: Congenital adrenal hyperplasia, hypothyroidism, adrenal
tumors
List the disease for each histology:
1. Abscent stratum basalis in an endometrial biopsy
2. Benign keratinocytes within the epidermis
3. Enlarged ovaries w/ multiple cystic follicles
4. Hyperplasia of lactotroph cells within the anterior pituitary
5. Numerous corpora albicans and a fibrotic cortex Correct
Answer - 1. Asherman syndrome
2. Imperforate hymen
3. Polycystic ovary syndrome
4. Prolactinoma
5. Atrophic ovary
Diagnosed in infants (< 1 year)
M > F predominance
Most common in Caucasian populations
,Symptoms of severe anemia --> pallor, fatigue, cyanosis
Webbed neck (can be confused for Turner syndrome)
Cleft pallet
Triphalangeal thumbs
Macrocytic anemia (nonmegaloblastic)
Decreased reticulocyte count (< 1% in infants)
Normal leukocytes and platelets
Bone marrow biopsy --> absence of erythroid precursors
Increased HbF on electrophoresis
Nonmegaloblastic macrocytic anemia Correct Answer -
Diamond-Blackfan anemia
- Turner syndrome does not cause macrocytic anemia
Treatment for Diamond-Blackfan anemia Correct Answer -
Corticosteroids
Transfusion
Hematopoietic stem cell transplant
Defect in erythropoiesis --> Pure Red Cell Aplasia (PRCA)
Erythroblasts in bone marrow undergo premature apoptosis
, Common mutations result in ribosome protein synthesis defect -->
TP53 activation --> increased apoptosis Correct Answer -
Diamond-Blackfan anemia
Megaloblastic macrocytic anemias (3) Correct Answer - B12
deficiency
Folate deficiency
Orotic aciduria
Nonmegaloblastic macrocytic anemias (4) Correct Answer -
Diamond-Blackfan anemia
Alcohol use
Liver disease
Thyroid disease
Normocytic anemia
Maybe due to: viral infections (eg., parvovirus), radiation,
medications (eg, antimetabolites), and toxin exposure
Pncytopenia (anemia, thrombocytopenia, leukopenia) Correct
Answer - Aplastic anemia
Autosomal recessive
Defect in DNA repair mechanisms
Either normocytic or macrocytic anemia
Pancytopenia (labs show anemia, thrombocytopenia, leukopenia)
Correct Answer - Fanconi anemia
Autosomal recessive
