1. Exam : gym
Time: 50m
Name:
1. What is the cumulative li etime risk o a woman
undergoing surgery or pelvic organ prolapse?
a. 0.1 to 0.15 percent
b. 1 to 5 percent
c. 10 to 15 percent
d. > 30 percen
2. Based on physical examination, what percentage o
adult women presenting or routine gynecologic care
demonstrate prolapse coming to within 1 cm o the
plane o the hymen?
a. 0.1 percent
b. 1 percent
c. 10 percent
d. ≥ 30 percent
3. Compared with selective use, elective episiotomy at
the second stage o labor has been associated with all
o the ollowing EXCEPT:
a. Periurethral tears
b. Anal sphincter laceration
c. Increased postpartum pain
d. Postpartum anal incontinence
4. Risk actors or the development o pelvic organ prolapse include which o the
ollowing?
a. Black race
b. Elective cesarean delivery
2. c. Increased ratio o collagen types III and IV to type I
d. All o the above
5. levator ani muscle. Which is not a component o this
muscle?
a. Puborectalis muscle
b. Iliococcygeus muscle
c. Pubococcygeus muscle
d. Obturator internus muscle
6. A 62-year-old woman complains o eeling as i she
were “sitting on a ball.” During examination, her
anterior vaginal wall prolapses to the level o her
hymen. T e lateral vaginal sulcus sags but rugae
are still seen. T is suggests which type o anatomic
de ect?
a. Central
b. Midline
c. ransverse
d. Paravaginal
7. Which symptom is most reliably associated with
prolapse and usually worsens as prolapse progresses?
a. Pelvic painWhich o the ollowing hormones “rescues” the
corpus luteum rom luteolysis?
a. Luteinizing hormone
b. Human placental lactogen
c. Follicle-stimulating hormone (FSH)
d. Human chorionic gonadotropin (hCG)
b. Constipation
c. Pelvic pressure
d. Anal incontinence
3. 8. Compared with reconstructive procedures or prolapse correction, colpocleisis
generally has which o
the ollowing characteristics?
a. Is technically more di cult
b. Requires longer operating time
c. Has a less-success ul, long-term anatomic outcome
9. E ective procedures or addressing prolapse at the
vaginal apex include all o the ollowing EXCEPT:
a. Simple hysterectomy
b. Abdominal sacrocolpopexy
c. Sacrospinous ligament xation
d. Uterosacral ligament vault suspension
10. In those without menses, which o the ollowing clinical scenarios meets the de
nition o amenorrhea?
a. A 12-year-old woman with anner stage I breast
development
b. A 16-year-old woman with anner stage II breast
development
c. A14-year-old woman with anner stage III breast
development
d. An 18-year-old woman with anner stage V breast
development and cessation o menses or the last
two cycles
11. A rapid rise in which hormone is necessary to trigger
ovulation?
a. Estrogen
b. Progesterone
c. Follicle-stimulating hormone (FSH)
d. Human chorionic gonadotropin (hCG)
12. Which o the ollowing hormones “rescues” the
4. corpus luteum rom luteolysis?
a. Luteinizing hormone
b. Human placental lactogen
c. Follicle-stimulating hormone (FSH)
d. Human chorionic gonadotropin (hCG)
13. An 18-year-old nulligravida presents with primary
amenorrhea. Her examination is notable or anner
stage IV breasts and the absence o pubic and axillary
hair. Also, a blind ending vagina is identi ed. What is
the likely diagnosis in this patient?
a. Müllerian agenesis
b. Premature ovarian ailure
c. Androgen insensitivity syndrome
d. Congenital adrenal hyperplasia
14. What is the expected testosterone level in a patient
with müllerian agenesis?
a. Male level
b. Female level
c. Not measurable
d. Signi cantly elevated (> 1000 ng/dL)
15. In a women younger than 40 years, what ollicle-stimulating hormone (FSH) level,
persistent or 1 month
or more, is diagnostic o premature ovarian ailure?
a. 5 mIU/mL
b. 15 mIU/mL
c. 25 mIU/mL
d. 40 mIU/mL
16. Which o the ollowing conditions is considered the
most requent cause o primary ovarian ailure?
5. a. Gonadal dysgenesis
b. Fragile X syndrome
c. Androgen insensitivity syndrome
d. Mayer-Rokitansky-Kuster-Hauser syndrome
17. An 18-year-old woman with primary amenorrhea
presents or evaluation. Her blood pressure is elevated
and her examination is notable or a lack o breast
development and sexual hair. Pelvic ultrasound con-
rms the presence o a uterus but gonads could not
be visualized. Laboratory evaluation is signi cant or
hypokalemia. Which o the ollowing conditions is
likely to be her diagnosis?
a. 17-hydroxylase de ciency
b. 21-hydroxylase de ciency
c. 5α-reductase de ciency
d. 3β-hydroxysteroid dehydrogenase de ciency
18. most damaging to the ovaries?
a. Antimetabolites
b. Alkylating agents
c. Antibiotic agents
d. Gonadotropin-releasing hormone (GnRH)
19. An increase in which o the ollowing alters gonadotropin-releasing hormone
(GnRH) pulsatility in
exercise-induced amenorrhea?
a. estosterone
b. β-endorphins
c. Nocturnal growth hormone
d. Growth-stimulating hormone
20. Which o the ollowing tumors o ten associated with
6. amenorrhea is the most common?
a. Glioma
b. Germinoma
c. Craniopharyngioma
d. Endodermal sinus tumor
21. A 22-year-old G1P0 presents for a follow-up visit
after receiving care for a spontaneous abortion at
8 weeks’ gestation. She has many questions regarding
the possible cause of her miscarriage, and the risk of
recurrence. You counsel her that approximately what
percentage of pregnancies end in miscarriage?
a. 3–5%
b. 5–10%
c. 10–25%
d. 40%
22. Consumption of which of the following legal
substances in large quantities is most clearly
associated with an increased risk of miscarriage?
a. Alcohol
b. Tobacco
c. Caffeine
d. Phthalates
23. Which of the following chromosomal abnormalities
is most common in the setting of first-trimester
spontaneous abortion?
a. Trisomy 18
b. Trisomy 21
c. Tetraploidy
d. Monosomy X (Turner syndrome)
7. 24. A woman presents with her partner to the emergency
department complaining of abdominal pain and fever.
She has a temperature of 41ºC, a blood pressure of
78/42 mmHg, no rebound or guarding, but exquisite
cervical motion tenderness and generalized malaise. After
asking her partner to leave the room, she discloses
that she underwent an illegal abortion at approximately 8 weeks’ gestation last night.
You diagnose
her with a septic abortion and begin broad-spectrum
antibiotic therapy. Which pathogenic organism do
you suspect given the severity of her illness?
a. Escherichia coli
b. Mycoplasma hominis
c. Group A streptococcus
d. Group B streptococcus
25. What percentage of recurrent pregnancy loss is due
to parental chromosomal abnormalities?
a. 2–4%
b. 6–8%
c. 10%
d. 15%
26. A 24-year-old woman with missed abortion at
6 weeks’ gestation elects for outpatient medical
treatment. You prescribe 800 μg of misoprostol to
be taken up to 3 times 3 hours apart. What of the
following are side effects of misoprostol?
a. Diarrhea
b. Vomiting
b. Fever and chills
8. c. All of the above
27. Which of the following is a relative contraindication
to outpatient medical termination of pregnancy?
a. IUD in situ
b. Use of anticoagulation
c. Severe renal, liver, or cardiovascular disease
d. All of the above
28. A 32-year-old multigravida is diagnosed with an
embryonic demise at 7 weeks’ gestation. When
counseling her regarding options other than expectant
management, you explain that as compared to
suction curettage, which has an efficacy rate of
96–100%, medical abortion is associated with what
risk of failure?
a. 2–17%
b. 4–9%
c. 5–26%
d. 10–20%
29. The patient in Question 28 elects to undergo
dilation and curettage. Misoprostol is chosen for
cervical ripening prior to the procedure. Which route
of administration is thought to be least effective?
a. Oral
b. Vaginal
c. Sublingual
d. All are equivalent
30. Which of the following is an indication for
transabdominal cerclage?
a. Twin gestation
9. b. History of cervical insufficiency
c. History of failed transvaginal cerclage
d. Prior preterm birth at 26 weeks’ gestation.
