TESTBANK Beckmann and Ling’s Obstetrics and Gynecology 8th Edition Casanova

TESTBANK Beckmann and Ling’s Obstetrics and Gynecology 8th Edition Casanova TESTBANK Beckmann and Ling’s Obstetrics and Gynecology 8th Edition Casanova Table of Contents Chapter 1: Women’s Health Examination and Women’s Health CareManagement ...................................2 Chapter 2: The Obstetrician–Gynecologist’s Role in Screening andPreventive Care ............................... 10 Chapter 3: Ethics, Liability, and Patient Safety inObstetrics and Gynecology .............................................. 15 Chapter 4: Embryology and Anatomy ............................................................................................................ 20 Chapter 5: Maternal–Fetal Physiology ........................................................................................................... 27 Chapter 6: Preconception andAntepartum Care ............................................................................................ 35 Chapter 7: Genetics and Genetic Disorders in Obstetrics andGynecology ................................................. 45 Chapter 8: Intrapartum Care ........................................................................................................................... 53 Chapter 9: Abnormal Labor and Intrapartum FetalSurveillance ................................................................. 62 Chapter 10: Immediate Care of the Newborn ................................................................................................ 71 Chapter 11: Postpartum Care .......................................................................................................................... 79 Chapter 12: PostpartumHemorrhage ............................................................................................................. 87 Chapter 13: MultifetalGestation ....................................................................................................................... 91 Chapter 14: Fetal Growth Abnormalities: IntrauterineGrowth Restriction and Macrosomia ..................... 98 Chapter 15: Preterm Labor ............................................................................................................................ 106 Chapter 16: Third-Trimester Bleeding........................................................................................................... 114 Chapter 17: Premature Rupture of Membranes ......................................................................................... 120 Chapter 18: Post-termPregnancy ................................................................................................................... 126 Chapter 19: Ectopic Pregnancy andAbortion .............................................................................................. 133 Chapter 20: EndocrineDisorders ................................................................................................................... 143 Chapter 21: Gastrointestinal, Renal, and Surgical Complications .............................................................. 145 Chapter 22: Cardiovascular and Respiratory Disorders ............................................................................. 150 Chapter 23: Hematologic and ImmunologicComplications ....................................................................... 159 Chapter 24: InfectiousDiseases ...................................................................................................................... 165 Chapter 25: Neurologic and Psychiatric Disorders .................................................................................... 175 Chapter 26: Contraception ............................................................................................................................. 177 Chapter 27: Sterilization ................................................................................................................................. 183 Chapter 28: ...................................................................................................................................................... 191 Chapter 29: Sexually TransmittedInfections ................................................................................................ 199 Chapter 30: Pelvic Support Defects, UrinaryIncontinence, and Urinary Tract Infection .......................... 210 Chapter 31: Endometriosis ........................................................................................................................... 218 Chapter 32: Dysmenorrhea and Chronic Pelvic Pain ................................................................................. 225 Chapter 33: Disorders ofthe Breast ............................................................................................................. 235 1 | P a g eChapter 34: Gynecologic Procedures ........................................................................................................... 242 Chapter 35: Human Sexuality ........................................................................................................................ 248 Chapter 36: Sexual Assault and Domestic Violence .................................................................................... 253 Chapter 37: Reproductive Cycles .................................................................................................................. 257 Chapter 38: Puberty ....................................................................................................................................... 263 Chapter 39: Amenorrhea and Abnormal Uterine Bleeding ....................................................................... 271 Chapter 40: Hirsutism and Virilization ......................................................................................................... 277 Chapter 41: Menopause ................................................................................................................................. 285 Chapter 42: ...................................................................................................................................................... 293 Chapter 43: Premenstrual Syndrome andPremenstrual Dysphoric Disorder ........................................ 299 Chapter 44: Cell Biology and Principles of Cancer Therapy ...................................................................... 304 Chapter 45: Gestational TrophoblasticNeoplasia ......................................................................................... 310 Chapter 46: Vulvar and Vaginal Disease and Neoplasia ............................................................................. 315 Chapter 47: Cervical Neoplasia and Carcinoma ......................................................................................... 323 Chapter 48: Uterine Leiomyoma andNeoplasia .......................................................................................... 333 Chapter 49: Cancer of theUterine Corpus ..................................................................................................... 338 Chapter 50: Ovarian and Adnexal Disease .................................................................................................. 344 Chapter 1: Women’s Health Examination and Women’s Health CareManagement 1: Elevating the head of the examining table approximately 30 degrees facilitates a: the observation of the patient's responses b: the ability of the patient to comfortably look around to distract her from the examinationc: the contraction of the abdominal wall muscle groups, making the examination easierd: comfortable blood pressure measuremente: the physician not being distracted by eye contact with the patient 2: Which of the following uterine positions is most associated with dyspareunia?a: Midposition, retroflexed b: Retroverted, anteflexed c: 2 | P a g eAnteverted, anteflexed d: Retroverted, retroflexed e: Midpostion, anteflexed 3: Inquiry concerning adult and child history of sexual abuse should be included in the sexual history a: if time permits b: in visits where there are suspicious physical findings but not otherwisec: in visits where sufficient time is allotted d: in all new patient visits e: in visits where a specific indication is noted 4: Peau d'orange change in the breast is associated with a: edema of the lymphatics b: jaundice c: too vigorous breastfeeding d: overly tight undergarments e: galactorrhea 5: Which kind of speculum is often most suitable for examination of the nulliparous patient? a: 3 | P a g eMorgan's speculum b: Endoscopic speculum c: Ling speculum d: Graves speculum e: Pederson speculum 6: Which uterine configuration is most difficult to assess for size, shape, configuration, and mobility? a: Midposition b: Anteverted c: There is no difference in difficulty d: Retroverted 7: Which type of speculum is most appropriate for the examination of a parous menstrual woman? a: Ling speculum b: Graves speculum c: Pederson speculum d: Endoscopic speculum e: Morgan's speculum 8: 4 | P a g eMenopause is defined as the cessation of menses for greater than e: 24 months 9: In a woman describing sufficiently frequent sexual encounters, infertility typically is described as afailure to conceive after a: 3 months b: 9 months c: 12 months d: 18 months e: 6 months 10: During bimanual examination of the adnexa in normal premenopausal women, the ovaries are palpable e: about one-quarter of the time 11: If a patient becomes uncomfortable with a topic during a history-taking session, the best response of the physician is to a: address the patient's discomfort in a positive and supportive mannerb: discontinue discussion of the topic to avoid further patient discomfortc: discontinue discussion to avoid damage to the patient-physician relationshipd: continue after making a joke to relieve tension e: ignore the discomfort and proceed with questioning 12: Which of the following statements about the steps in the breast examination is correct? e: 5 | P a g eInspection is done first 13: Questions that promote the physician's fullest understanding of the patient's situation are best characterized as a: compassionate b: chronological c: sympathetic d: emphatic e: evidence based 14: The last menstrual period is dated from the 15: The passage of clots during menstruation a: is always abnormal b: may be either normal or abnormal c: is always normal d: is extremely rare 16: In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-"1" stands for the number of a: living children b: pregnancies c: 6 | P a g eterm pregnancies d: preterm pregnancies e: abortions 17: a: living children b: pregnancies c: term pregnancies d: preterm pregnancies e: abortions 18: In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-"3" stands for the number of a: living children b: pregnancies c: term pregnancies d: preterm pregnancies e: abortions 19: a: living children b: pregnancies 7 | P a g ec: term pregnancies d: preterm pregnancies e: abortions 20: In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-"5" stands for the number of a: living children b: pregnancies c: term pregnancies d: preterm pregnancies e: abortions 21: Tanner's classification with respect to the breast relates to changes in the breast before and after lactation b: associated with malignancy c: associated with maturation d: associated with galactorrhea e: associated with fibrocystic changes 22: The rectovaginal examination should be performed a: 8 | P a g eafter 52 years of age b: at the initial patient visit c: only for the evaluation of chronic pelvic paind: only when there are symptoms of pelvic relaxation e: at intervals of 5 years 23: In the gynecologic history, it is often possible to distinguish between vaginitis and pelvic inflammatory disease by inquiring about the duration of the pain b: the symptoms present (fever/chills, itching) c: the timing of pain in relation to menses d: the association of pain with body positione: the use of topical medications 24: The most common reason for failure to visualize the cervix during the speculum examination is a: failure to use lubricant b: a full bladder c: failure to fully insert the speculum d: use of a speculum that has not been warmede: use of the wrong speculum 25: Prehypertension is defined as a blood pressure range of a: 9 | P a g e80-90/120-139 b: 90-100/120-139 c: 80-90/110-129 d: 70-80/110-129 e: 70-80/120-139 ANS: 1-25. [A, D, D, A, E, D, B, C,C,C,A,E,D,A,B,B,C,D,E,A,C,B,E,C,A] Chapter 2: The Obstetrician–Gynecologist’s Role in Screening andPreventive Care 1: The sensitivity of a screening test is defined as the proportion of a: unaffected individuals that test positive b: affected individuals that test positive c: unaffected individuals that test negative d: affected individuals that test negative 2: The specificity of a screening test is defined as the proportion of a: affected individuals that test negative b: unaffected individuals that test positive c: affected individuals that test positive d: unaffected individuals that test negative 10 | P a g e3: Counseling an obese patient to lose weight is an example of a: secondary prevention b: primary prevention c: empathy d: engagement 4: In women, the thyroid-stimulating hormone screening test should be performed at what interval? a: Every 1-2 years from age 40 years, then yearly after age 50 yearsb: Every 5 years after age 50 years c: Annually from puberty or from the onset of sexual activityd: Every 5 years from age 19 years, then every 3-5 years after age 65 years 5: The Pap smear for cervical dysplasia should be performed at what interval? a: Every 2-3 years after age 30 years if three consecutive annual tests are negativeb: Every 5 years from age 19 years, then every 3-5 years after age 65 yearsc: Every 1-2 years beginning at age 65 years d: Every 1-2 years from age 40 years, then yearly after age 50 years 6: A cholesterol/lipid profile should be performed for women without risk factors at what interval? a: Every other year from age 40 years, then yearly after age 50 years b: 11 | P a g eEvery 5 years after age 45 years c: Every 3-5 years after age 65 years d: Every 5 years from age 19 years, then every 3-4 years after age 65 years 7: A mammography to detect breast cancer should be performed at what interval in women at averagerisk? a: Every 1-2 years after age 65 years b: Every 5 years after age 19 years, then every 3-4 years after age 65 years c: Every other year from age 40 years, then yearly after age 50 years d: Every 3-5 years after age 45 years 8: A colonoscopy to detect colorectal cancer should be performed at what interval for women at averagerisk? a: Every 10 years starting at age 50 years b: Every 1-2 years starting at age 40 years c: Every 10 years starting at age 65 years d: Every 10 years from age 19 years, then every 3-4 years after age 65 years 9: Which of the following is the most appropriate screening mechanism for cervical dysplasia? a: Pap smear b: Serum HPV titer 12 | P a g ec: HPV-DNA testing d: Colposcopy of suspicious lesions 10: Which of the following is the most appropriate screening mechanism for colorectal cancer? a: Hemogram b: Colonoscopy c: Physical examination of suspicious lesions d: CT scan 11: Which of the following is the most appropriate screening mechanism for thyroid disease? a: Thyroid-stimulating hormone b: Free thyroxine c: Yearly physician examination d: Thyroid-binding globulin 12: What is the appropriate interval for Pap testing in women who have had a total hysterectomy forreasons other than cervical dysplasia? a: Every 2 years following the hysterectomy b: Every 5 years following the hysterectomy 13 | P a g ec: No additional Pap testing is needed d: Every year following the hysterectomy 13: In sexually active women age 25 or younger, regular screening for Chlamydia should occur a: only if the woman is at high risk for infection b: every 3-5 years c: annually d: every 2 years 14: Bone mineral density testing is recommended for women without risk factors for osteoporosis beginningat what age? a: 40 years b: 65 years c: 50 years Testing is not recommended for women with no risk factors 15: A 40-year-old woman comes for an initial visit. Her BMI is 30 and she had previously given birth to an infant weighing 9.5lb. Which of the following initial screening tests is indicated for this patient? a: Fasting blood glucose b: Colonoscopy c: 14 | P a g eTSH level d: Bone mineral density testing ANS: [b,d,b,b,a,b,c,a,a,b,a,c,c,b,a] Chapter 3: Ethics, Liability, and Patient Safety inObstetrics and Gynecology 1: The principle that the patient should be given what is "due" most closely matches the principle of a: justice b: nonmaleficence c: beneficence d: autonomy 2: The principle that there should be respect for the patient's right to make choices based on her beliefsand values best matches the principle of a: beneficence b: nonmaleficence c: justice autonomy 3: The principle that there is a duty not to inflict harm or injury best matches the principle of a: nonmaleficence 15 | P a g eb: autonomy c: justice d: beneficence 4: The principle that there is a duty to promote the well-being of the patient best matches the principle of a: justice b: autonomy c: beneficence d: nonmaleficence 5: A 32-year-old patient has delivered at 23 weeks of gestation, 3 days after premature rupture of the membranes. She has discussed the circumstances with her obstetrician and requests that no attempts at resuscitation should be made. At delivery there are rare gasping, breathing movements. The pediatrician recommends that intubation be done. In this case, the individual with the clearest primary responsibility for this decision is the a: obstetrician b: pediatrician c: hospital risk manager d: mother e: hospital attorney 6: Respect for patient wishes (autonomy) primarily requires that there be assessment of which of the 16 | P a g efollowing? a: Cost of the proposed treatment b: The legal risk to the physician and hospital c: Patient's ability to consider information d: Physician's concurrence with the patient's wishes e: Standards of care 7: A 62-year-old woman with newly diagnosed stage III ovarian cancer refuses chemotherapy. She wants to"go home to die." The next step in evaluating this patient is to a: determine insurance coverage for this action b: call the family for a conference c: accept the patient's wishes and discharge her from the hospitald: call the state medical licensing board and hospital attorneye: assess the patient's comprehension and look for evidence of impaired decision making 8: If a pregnant woman rejects medical recommendations, relying on care given in similar cases would bean example of a: principle-based ethics b: virtue-based ethics c: feminist ethics d: communication-based ethics 17 | P a g ee: case-based ethics 9: The concept of informed consent best relates to the principle of a: autonomy b: justice c: beneficence d: nonmaleficence 10: Paternalism violates the ethical principle of a: nonmaleficence b: beneficence c: standard of care d: justice e: autonomy 11: The person with primary responsibility to providing informed consent is a: the person or physician's staff assigned the task b: the patient c: the social worker assigned to the patient 18 | P a g ed: the hospital administrator e: the physician 12: In medical liability cases the complaint comes from the a: defendant b: judge c: jury d: attorney e: plaintiff 13: Most medical errors are associated with a: the use of care guidelines b: the use of medications c: the use of standards of care d: the use of hospital regulations e: the use of improper surgical technique ANS:[a,d,a,c,d,c,e,e,a,e,e,e,b] 19 | P a g eChapter 4: Embryology and Anatomy 1: The genital system develops from the embryonic a: yolk sac b: endoderm c: mesoderm d: ectoderm e: cytotrophoblast 2: The urogenital ridges give rise to elements of the a: cardiovascular system b: reproductive system c: muscular system d: skeletal system e: gastrointestinal system 3: Congenital adrenal hyperplasia ultimately affects the development of the genitalia of female fetusesthrough the a: stimulation of cortisol production b: stimulation of cortisone production 20 | P a g ec: stimulation of androgen production d: inhibition of the SRY gene e: inhibition of the WNT4 gene 4: Primary oocytes first appear at what stage of development a: In the primordial follicles b: At puberty c: In the primary sex cords d: At birth e: In the embryonic yolk sac 5: Primordial germ cells can be identified during the third week of development in the a: vaginal plate b: urogenital sinus c: cortical cords d: gonadal ridge e: yolk sac 6: In the female, which of the following persists to form the major parts of the reproductive tract? 21 | P a g ea: Mesonephric (wolffian) ducts b: Prmary sex cords c: Paramesonephric (Mullerian) ducts d: Gubernaculum 7: Gartner cysts result from remnants of the a: tunica albuginea b: primary sex cords c: Mullerian ducts d: mesonephric ducts 8: Transverse ultrasonography can begin to reliably distinguish between the two sexes at about how many weeks of gestation a: 15 weeks b: 5 weeks c: 10 weeks d: 20 weeks e: 25 weeks 22 | P a g e9: Which of the following results in the absence of the uterus? a: Degeneration of the Mullerian ducts b: Degeneration of the mesonephric ductsc: Lack of fusion of the inferior parts of the paramesonephric ductsd: Failure of migration of the primordial germ cells 10: Which of the following results in the formation of a double uterus (uterus didelphys)? a: Lack of fusion of the inferior parts of the Mullerian ductsb: Failure of migration of the primordial germ cells c: Degeneration of the mesonephric ducts d: Degeneration of the Mullerian ducts 11: The labia minora develop from the a: urogenital folds b: labioscrotal swellings c: urogenital sinus d: genital tubercle 12: The labia majora develp from the a: labioscrotal swellings 23 | P a g eb: urogenital sinus c: genital tubercle d: urogenital folds 13: The clitoris develops from the a: urogenital folds b: genital tubercle c: labioscrotal swellings d: urogenital sinus 14: In the female, the embryologic homologue of the penis is the a: frenulum b: labia majora c: labia minora d: clitoris 15: The false pelvis and the true pelvis are separated by the a: linea terminalis b: acetabulum 24 | P a g ec: obturator membrane d: pelvic outlet e: sacrospinous ligament 16: The diagonal conjugate is defined as the distance a: between the true and false pelvis b: between the lower border of the pubis anteriorly and the lower sacrum at the level of the ischial spinesc: between the upper border of the pubis anteriorly and the lower sacrum at the level of the ischial spinesd: measured at the greatest width of the superior aperturee: between the ischial spines 17: Which of the following contains the uterine arteries and veins and the ureters? a: Infundibulopelvic ligament b: Broad ligament c: Uterosacral ligament d: Sacrospinal ligament e: Cardinal ligament 18: The ligament that provides primary support to the uterus is the a: uterosacral ligament b: 25 | P a g einfundibulopelvic ligament c: broad ligament d: sacrospinal ligament e: cardinal ligament 19: The epithelial lining of the fallopian tube is a: Columnar b: Transitional c: Simple squamous d: Stratified columnar e: Stratified squamous 20: The fallopian tubes enter into which part of the uterus a: Fundus b: Cornu c: SQ junction d: Lower uterine segment e: Mesosalpinx 21: The two main anatomic divisions of the uterus are the corpus and the 26 | P a g ea: uterotubal junction b: cornu c: fundus d: isthmus e: cervix ANS: [c,b,c,a,e,c,d,a,a,a,a,a,b,d,a,b,b,a,a,b,e] Chapter 5: Maternal–Fetal Physiology 1: Oxygen crosses the placenta by a: pinocytosis b: facilitated diffusion c: simple diffusion d: active transport e: phgocytosis 2: Glucose crosses the placenta by a: facilitated diffusion b: simple diffusion c: active transport d: 27 | P a g ephagocytosis e: pinocytosis 3: Amino acids cross the placenta by a: facilitated diffusion b: active transport c: pinocyctosis d: simple diffusion e: phagocytosis 4: Pregnancy has what effect on gastric motility? a: Gastric motility typically remains the same b: The effect on gastric motility is unpredictable c: Gastric motility typically increases d: Gastric motility typically decreases 5: Pregnancy has what effect on gastric reflux? a: The effect on gastric reflux is unpredictable b: Gastric reflux is typically unaffected c: Gastric reflux typically decreases 28 | P a g ed: Gastric reflux typically increases 6: "Morning sickness" typically begins during which weeks of pregnancy? a: 1-3 weeks b: 16-22 weeks c: 10-12 weeks d: 14-18 weeks e: 4-8 weeks 7: Changes in gastrointestinal motility during pregnancy are related to increased levels of human chorionic gonadotropin c: estrogen d: oxytocin e: progesterone 8: Transit time in the stomach and small bowel increases by what percent in the second and thirdtrimesters of pregnancy? a: 60%-70% b: 1%-15% c: 45%-60% d: 29 | P a g e30%-45% e: 15%-30% 9: Epulis is a pregnancy-related vascular swelling of the pharynx c: nares d: gums e: epiglottis 10: Which of the following pulmonary measurements is decreased in pregnancy? a: Carbon dioxide pressure b: Tidal volume c: Oxygen pressure d: Oxygen requirement e: Residual volume 11: During pregnancy, total body oxygen consumption a: decreases by 50% from nonpregnant levels c: increases by 50% from nonpregnant levels d: decreases by 20% from nonpregnant levels 30 | P a g ee: increases by 70% from nonpregnant levels 12: By term in a normal pregnancy, maternal blood volume a: increases by 15% b: increases by 50% c: decreases by 15% d: decreases by 35% e: increases by 35% 13: Iron supplementation in pregnancy is mainly used to maintain maternal hemoglobin concentrationd: prevent iron deficiency in both the mother and the fetuse: prevent iron deficiency in the fetus 14: Which of the following measures of pulmonary function decreases in late pregnancy? a: Tidal volume b: Residual volume c: Respiratory rate d: Expiratory volume e: Inspiratory capacity 15: 31 | P a g eThe increased nasal stuffiness and perception of increased nasal secretions during prenancy areassociated with increased airway conductance d: decreased airway conductance e: mucosal hyperemia 16: Maternal arterial blood gas analysis during pregnancy would show a: mild metabolic acidosis b: mild respiratory alkalosis c: mild metabolic alkalosis d: mild respiratory acidosis e: moderate metabolic alkalosis 17: As compared with the nonpregnant state, the risk of thromboembolism during pregnancy a: is not effected by pregnancy d: is increased during pregnancy and decreased in the puerperiume: is decreased during pregnancy and increased in the puerperium 18: Displacement of the maternal heart during pregnancy is caused by a: constriction of the anteroposterior diameter of the thoraxb: enlargement of the liver c: 32 | P a g eelevation of the diaphragm d: widening of the mediastinum e: increased lung volume 19: Which of the following best describes the change in position of the maternal heart during pregnancy? Displaced downward and to the left into a more vertical positione: Displaced further into the thoracic cavity 20: When do changes in maternal cardiac output begin during pregnancy? a: Early second trimester b: First trimester c: Late first trimester d: Third trimester e: Late second trimester 21: As compared with the nonpregnant state, the overall increase in maternal cardiac output duringpregnancy is approximately 50%-60% e: 60%-80% 22: Which of the following factors contributes to the changed maternal cardiac output during pregnancy? a: Increased peripheral vascular resistance b: 33 | P a g eDecreased maternal heart rate c: Increased stroke volume d: Decreased stroke volume e: Increased venous return 23: During pregnancy, maternal ciculating blood volume increases about how much over nonpregnantlevels? 5% e: 15% 24: When does the increase in circulating maternal blood volume reach its peak during pregnancy? a: 18 weeks b: 32 weeks c: 12 weeks d: 38 weeks e: 24 weeks 25: What percent of cardiac output does the uterus receive at term? a: 10% e: 50% 26: Occlusion of the vena cava by the gravid uterus results in shunting of venous return from the lower 34 | P a g eextremities primarily through the a: mesenteric circulation b: portal vein circulation c: paravertebral circulation d: ovarian circulation e: renal circulation ANS: [c,a,b,d,d,e,d,e,d,a,b,e,b,b,e,b,b,c,b,b,a,c,c,b,c,c] Chapter 6: Preconception andAntepartum Care A 22-year-old primigravida patient who is approximately 3 months' pregnant expresses concern that she has not felt the baby move yet. She should be informed that "quickening" generally occurs at how many weeks of gestation? a: 12-14 b: 8-10 c: 22-24 d: 18-20 2: Congestion and a bluish color of the vagina in early pregnancy is called a: Stoppard sign b: Newman sign c: Hegar sign d: Chadwick sign 35 | P a g e3: A softening of the cervix on physical examination in early pregnancy is referred to as a: Doderlein sign b: Hegar sign c: Naegele sign d: Chadwick sign 4: Fetal heart tones in a normal, viable pregnancy may routinely be heard by simple, nonelectricallyamplified auscultation at or beyond how many weeks of gestational age? a: 12-14 b: 18-20 c: 21-23 d: 15-17 5: Commonly used electronic Doppler devices will usually detect fetal heart tones initially at approximately how many weeks of gestation? a: 12 b: 10 c: 8 d: 36 | P a g e14 6: A 21-year-old patient whose last menstrual period started 3 weeks ago calls the doctor's office becauseshe is concerned that she might be pregnant. She should be informed that home urine pregnancy tests typically become positive approximately how many weeks following the first day of the last normal menstrual period? a: 6 b: 2 c: 4 d: 8 7: A 30-year-old patient with a history of ectopic pregnancy presents with 5 weeks of amenorrhea and a positive home pregnancy test. Intrauterine pregnancy is generally detectable by transvaginal ultrasonography when the beta-human chorionic gonadotropin concentration is greater than a: 5,000-6,000 mIU/mL b: 3,000-4,000 mIU/mL c: 1,000-2,000 mIU/mL d: 500-750 mIU/mL 8: "Normal" pregnancy lasts 40 weeks from the first day of the last menstrual period with a margin of errorof how many weeks? a: 1 b: 4 37 | P a g ec: 3 d: 2 9: A woman comes for her initial prenatal visit and wants to know her estimated date of delivery (EDD).Her last menstrual period began January 14. According to Naegele's rule, her EDD will be a: October 1b: October 14 c: October 21 d: October 28 10: In normal singleton pregnancy, from 18 weeks of gestation until 36 weeks of gestation, the fundal heightin centimeters is roughly equal to a: one-half the number of weeks of gestational ageb: the number of weeks of gestational age minus 5c: the number of weeks of gestational age d: twice the number of weeks of gestational age 11: In a woman with a BMI in the normal range, the generally prescribed recommendation for weight gain during pregnancy is a: 15-20 lb b: 25-35 lb c: 50-55 lb 38 | P a g ed: 40-45 lb 12: A 25-year-old primigravida patient at 24 weeks of gestation has gained 8 lb since her last prenatal visit a month ago. What is the most appropriate initial intervention? a: Insulin b: Dietary counseling c: Hospitalization d: Metformin 13: A 25-year-old G2P1 patient at 20 weeks of gestation is concerned that her child will be breech like her first child was. She can be informed that cephalic presentation occurs in what percentage of deliveries? a: 15% b: 3.5% c: 95% d: 1% 14: At 36 weeks of gestation, examination in the office reveals that the fetus is in breech presentation.Breech presentation occurs in what percentage of deliveries? a: 3.5% b: 1% c: 95% d: 39 | P a g e15% 15: An ultrasound performed at 30 weeks of gestation shows the fetus to be lying transverse. An explanation of the implications of this finding may include the reassurance that shoulder presentationoccurs in what percentage of deliveries? a: 3.5% b: 95% c: 1% d: 15% 16: An abnormal contraction stress test includes which of the following fetal heart rate findings? a: Decreases in response to maternal respirations b: Increases in response to maternal position changec: Decreases in response to a uterine contraction d: Increases in response to fetal movement 17: A biophysical profile in which there is one or more episodes of fetal breathing in 30 minutes, three ormore discrete movements in 30 minutes, opening/closing of the fetal hand, a nonreactive nonstress test, and no pockets of amniotic fluid greater than 1 cm would have a total score of a: 4 b: 8 c: 2 40 | P a g ed: 6 18: Exclusive of the fetal heart rate reactivity, which of the following elements of the biophysical profile is generally considered most important? a: Fetal breathing b: Qualitative amniotic fluid volume c: Fetal tone d: Gross body movement 19: Repetitive decelerations following each contraction when three contractions occur in a 10-minutewindow is generally an indication of a: fetal well-being b: nonreassuring fetal status c: increased placental blood flow d: reduced amniotic fluid 20: At how many weeks of gestational age does phospholipid production increase, resulting in a positive phosphatidylglycerol test? a: 33 b: 31 c: 35 41 | P a g ed: 29 21: In counseling a patient about activities during the antepartum period, which of the following activities is generally contraindicated? a: Regular, non-weight-bearing activity on a three-times-per-week scheduleb: Bathtub bathing c: Supine exercises d: Air travel after 28 weeks 22: A 20-year-old pregnant patient requests information about food cravings in pregnancy. She should be informed that pica is often associated with which of the following? a: Hyperthyroidism b: Anemia c: Substance abuse d: Diabetes 23: At the initial prenatal visit, a 30-year-old primigravida woman asks about traveling for businesspurposes. Which of the following recommendations is appropriate? a: Limit air travel to the first two trimesters b: Avoid travel of any kind after 36 weeks c: Avoid extended periods of inactivity d: Use seat belts up to 20 weeks of gestation 42 | P a g e24: The FDA category PRF X carries what important clinical implication? a: Animal reproduction studies have demonstrated an adverse fetal effect and there are no controlledhuman studies b: Controlled human studies demonstrate no evidence of risk in pregnancy in any trimesterc: Adequate studies have demonstrated positive evidence of fetal riskd: Animal reproduction studies have not demonstrated fetal risk and there are no controlled humanstudies 25: A 24-year-old pregnant woman asks about the use of medications given prior to pregnancy by her other physicians. Which FDA pregnancy risk factor category is characterized by the presence of human studies in which there is no demonstrable fetal risk during pregnancy? a: D b: C c: B d: A 26: Which of the following effects to the fetus is associated with maternal ingestion of tetracyclines? a: Hemolytic anemia b: Irreversible arthropathies c: Discoloration of deciduous teeth d: Hyperbilirubinemia 43 | P a g e27: Fetal abnormal facies, cleft lip or palate, and microcephaly are associated with maternal ingestion ofwhich of the following drugs during pregnancy? a: Heparin b: Thiazide diuretics c: Sulfonamides d: Phenytoin 28: A 23-year-old pregnant woman who complains of constipation should be informed that physiologic constipation in pregnancy is associated with a: increased bulk b: decreased water absorption c: decreased blood flow to the gut d: increased transit time 29: Due to the position of the fetus, round ligament pain is often more pronounced a: in the center b: on the right side c: on the left side d: in the fundus 44 | P a g e30: For which of the following conditions should all pregnant women be tested? a: Tay-Sachs b: Sickle cell disease c: Tuberculosis d: HIV ANS:[d,d,b,b,a,c,c,d,c,c,b,b,c,a,c,c,d,b,b,c,c,b,c,c,d,c,d,d,b,d] Chapter 7: Genetics and Genetic Disorders in Obstetrics andGynecology 1: A DNA replication error that results in one amino acid being substituted for another is termed a(n) a: Missense mutation b: Deletion mutation c: Nonsense mutation d: Insertion mutation 2: During which phase of meiosis is an error most likely? a: Anaphase I b: Meiosis II c: Metahase I d: Prophase I 3: 45 | P a g eWhich of the following is an example of euploidy? a: 47, XXY b: 46, XX c: 45, X d: 69, XXX 4: Trisomy 21 is an example of which type of chromosomal anomaly? a: Ring chromosome b: Aneuploidy c: Euploidy d: Deletion mutation 5: A Robertsonian translocation in the mother increases the risks to her fetus of which of the following conditions? a: Spina bifida b: Anencephaly c: Fragile X syndrome d: Down syndrome 6: Which of the following conditions is inherited through autosomal dominant inheritance? 46 | P a g ea: Tay-Sachs disease b: Huntington disease c: Phenylketonuria d: Cystic fibrosis 7: The parents of a child found to have Marfan syndrome are planning to conceive in the future, and inquire about the inheritance pattern of this condition. They should be informed that the inheritancepattern is a: multifactorial b: autosomal dominant c: X-linked d: autosomal recessive 8: In autosomal dominant inheritance, the affected parent passes the disease to a: twice as many male offspring as females b: one-half of the offspring c: twice as many female offspring as males d: one-half of female offspring 9: First trimester screening tests are performed to determine the risk of what abnormality in addition to trisomy 13 and trisomy18? 47 | P a g ea: Hemophilia b: Klinefelter syndrome c: Turner syndrome d: Down syndrome 10: A woman who has previously had a child with a neural tube defect should take a daily prenatal vitaminin subsequent pregnancies that contains how much folic acid? a: 40 mg b: 0.04 mg c: 0.4 mg d: 4 mg 11: An ultrasound confirms a 7-week intrauterine gestation. If nuchal transparency measurement is to be used to aid in the detection of Down syndrome, the next ultrasound should be performed in how many weeks? a: 8 b: 2 c: 4 d: 12 12: Trisomy 16 is characterized by which of the following clinical scenarios? 48 | P a g ea: Rarely survives to 3 years of age b: Multisystem failure within a year of birth c: Cardiac arrest within 3 days of birth d: No live births 13: Which of the following is more common than trisomy 18 (Edwards syndrome)? a: Turner syndrome b: Trisomy 21 (Down syndrome) c: Trisomy 13 (Patau syndrome) d: Cridu chat syndrome 14: Individuals with which of the following chromosomal abnormalities are most likely to live intoadulthood? a: Trisomy 21 b: Trisomy 16 c: Trisomy 13 d: Trisomy 18 15: First trimester screening reveals that a woman is at increased risk for carrying a fetus with Down syndrome. She elects to undergo amniocentesis. This is typically performed between what weeks of gestation? 49 | P a g ea: 8 and 10 weeks b: 15 and 20 weeks c: 22 and 26 weeks d: 30 and 34 weeks 16: During her initial visit for this pregnancy, a couple inquires about the potential value of chorionic villus sampling. Which of the following conditions cannot be diagnosed by this technique? a: Down syndrome b: Trisomy 13 c: Trisomy 18 d: Neural tube defects 17: A 33-year-old patient comes to you for her annual gynecologic exam. In the course of obtaining her history, she tells you that her aunt was diagnosed with breast cancer at age 49 and that her grandfather had lung cancer. She is not of Ashkenazi Jewish origin. You tell her that you recommend which of the following? a: HPNCC testing b: BRCA 1 and BRCA 2 testing c: Annual clinical breast exams and no further testing at this timed: BRCA 1 testing only 18: The level of alpha-fetoprotein in amniotic fluid is normal in which of the following conditions? 50 | P a g ea: Anencephaly b: Spina bifida c: Omphalocele d: Postmaturity 19: The increased availability of what test has resulted in a declining reliance on PUBS? a: FISH b: Early amniocentesis c: Fetoscopy d: CVS 20: Which of the following is an accurate description of a germ cell? a: Two sets of chromosomes b: Gamete c: 2n d: Diploid 21: Which of the following karyotypes is an example of mosaicism? a: 51 | P a g e46, XX/XY b: 47, XXY c: 47, XXX d: 45, X 22: In autosomal recessive disorders, which parent(s) is/are usually affected? a: Father always b: Both c: Mother usually d: Neither 23: Color blindness has what kind of inheritance pattern? a: Autosomal dominant b: X-linked c: Multifactorial d: Autosomal recessive 24: In counseling a couple about the role of first trimester screening, the difference between the "triplescreen" and the "quadruple screen" should be described as the addition of which marker? a: hCG 52 | P a g eb: Estriol c: MSAFP d: Inhibin A 25: In obtaining informed consent regarding chorionic villlus sampling (CVS), the provider should inform the patient that which of the following is the most common complication? a: Infection b: Bleeding c: Pregnancy loss d: Limb reduction ANS: [a,a,d,b,d,b,b,b,d,d,c,d,b,a,b,d,c,d,a,b,a,d,b,d,b] Chapter 8: Intrapartum Care A 22-year-old primigravid patient at 38 weeks gestation calls the office stating that she has had "bloody show." She should be informed that this is related to which of the following? a: Quickening b: Effacement of the cervix c: Braxton Hicks contractions d: Lightening 2: True labor is associated with contractions that the patient feels in what area? a: Low abdomen 53 | P a g eb: Bilateral round ligaments c: Low back d: Uterine fundus 3: