Test bank for beckmann and ling s obstetrics and gynecology 8th edition by robert casanova.pdf

TEST BANK for Beckmann and Ling’s Obstetrics and
Gynecology
9th Edition by Dr. Robert Casanova
(Complete). All Chapters 1- 50

TABLE OF CONTENTS
Chapter 1: Women’s Health Examination and Women’s Health Care Management p1-13
o Chapter 2: The Obstetrician–Gynecologist’s Role in Screening and Preventive Care p14-21
o Chapter 3: Ethics, Liability, and Patient Safety in Obstetrics and Gynecology p22-28
o Chapter 4: Embryology and Anatomy
p29-42
o Chapter 5: Maternal–Fetal Physiology p43-
55
o Chapter 6: Preconception and Antepartum Care p56-
71
o Chapter 7: Genetics and Genetic Disorders in Obstetrics and Gynecology p72-85
o Chapter 8: Intrapartum Care
p86-97
o Chapter 9: Abnormal Labor and Intrapartum Fetal Surveillance p98-
111
o Chapter 10: Immediate Care of the Newborn
p112-119
o Chapter 11: Postpartum Care
p120-126
o Chapter 12: Postpartum Hemorrhage
p127-133
o Chapter 13: Multifetal Gestation
p134-139
o Chapter 14: Fetal Growth Abnormalities: Intrauterine Growth Restriction and Macrosomia p140-146
o Chapter 15: Preterm Labor
p147-151
o Chapter 16: Third-Trimester Bleeding
p152-157
o Chapter 17: Premature Rupture of Membranes p158-
162
o Chapter 18: Post-term Pregnancy
p163-166
o Chapter 19: Ectopic Pregnancy and Abortion
p167-176
o Chapter 20: Endocrine Disorders
p177-183
o Chapter 21: Gastrointestinal, Renal, and Surgical Complications p184-190
o Chapter 22: Cardiovascular and Respiratory Disorders p191-
200
o Chapter 23: Hematologic and Immunologic Complications p201-
208
o Chapter 24: Infectious Diseases
p209-218
o Chapter 25: Neurologic and Psychiatric Disorders p219-
224
o Chapter 26: Contraception
p225-238
o Chapter 27: Sterilization

p239-244
o Chapter 28: Vulvovaginitis
p245-249
o Chapter 29: Sexually Transmitted Infections p250-
261
o Chapter 30: Pelvic Support Defects, Urinary Incontinence, and Urinary Tract Infection p262-270
o Chapter 31: Endometriosis
p271-278
o Chapter 32: Dysmenorrhea and Chronic Pelvic Pain p279-
284
o Chapter 33: Disorders of the Breast
p285-294
o Chapter 34: Gynecologic Procedures
p295-303
o Chapter 35: Human Sexuality
p304-311
o Chapter 36: Sexual Assault and Domestic Violence p312-
320
o Chapter 37: Reproductive Cycles
p321-326
o Chapter 38: Puberty
p327-331
o Chapter 39: Amenorrhea and Abnormal Uterine Bleeding p332-
336
o Chapter 40: Hirsutism and Virilization
p337-344
o Chapter 41: Menopause
p345-352
o Chapter 42: Infertility
p353-362
o Chapter 43: Premenstrual Syndrome and Premenstrual Dysphoric Disorder p363-368
o Chapter 44: Cell Biology and Principles of Cancer Therapy p369-
373
o Chapter 45: Gestational Trophoblastic Neoplasia p374-
378
o Chapter 46: Vulvar and Vaginal Disease and Neoplasia p379-
388
o Chapter 47: Cervical Neoplasia and Carcinoma p389-
401
o Chapter 48: Uterine Leiomyoma and Neoplasia p402-
405
o Chapter 49: Cancer of the Uterine Corpus
p406-414
o Chapter 50: Ovarian and Adnexal Disease p415-
426
Chapter 1: Women’s Health Examination and Women’s Health Care
Management

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 examination c:
the contraction of the abdominal wall muscle groups, making the examination easier d:
comfortable blood pressure measurement e:
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:
Anteverted, 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 otherwise c:
in visitswhere sufficient time is allotted d:
in all new patientvisits
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:
toovigorous breastfeeding d:
overly tight undergarments e:
galactorrhea
5:
Which kind of speculum is often most suitable for examination of the nulliparous patient?
a:
Morgan'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 indifficulty
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:
Menopause is defined as the cessation of menses for greater than
a:
9 months
b:
36 months
c:
12 months
d:
18 months

e:
24 months
9:
In a woman describing sufficiently frequent sexual encounters, infertility typically is described as a failure to
conceive after
a:
3 months
b:
9 months
c:
12months
d:
18months
e:
6 months
10:
During bimanual examination of theadnexa in normal premenopausal women, the ovaries are palpable
a:
all the time
b:
almost never
c:
about one-halfof the time d:
about thee-quarters/most of the time

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 manner b:
discontinue discussion of the topic to avoid further patient discomfort c:
discontinue discussion toavoid damage to the patient-physician relationship d:
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?
a:
Palpation is done first
b:
Palpation and inspection are done simultaneously c:
Palpation is only done if inspection is abnormal d:
Palpation may be done with detailed inspection if a woman is especially modest

e:
Inspection 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
a:
first day of the last normal period
b:
last day of the last normal period c:
first day of the last bleeding episode
d:
last day of the last bleeding episode

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:
termpregnancies
d:
preterm pregnancies
e:
abortions
17:

a:
living children
b: pregnancies
c:
termpregnancies
d:
preterm pregnancies
e:
abortions
18:
a:
living children
b: pregnancies
c:
termpregnancies
d:
preterm pregnancies
e:
abortions
19:

a:
living children
b: pregnancies
c:
termpregnancies
d:
preterm pregnancies
e:
abortions
20:
a:
living children
b: pregnancies
c:
termpregnancies
d:
preterm pregnancies
e:
abortions
21:
Tanner's classification with respect to the breast relates to changes in the breast
a:

before andafter 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:
after 52 years of age b:
at the initial patientvisit c:
only for the evaluation of chronic pelvic pain d:
only when there are symptoms ofpelvic 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
a:

theduration of the pain
b:
the symptoms present (fever/chills, itching) c:
the timing of pain in relation to menses d:
the associationof pain with body position e:
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 warmed e:
use of the wrong speculum
25:
Prehypertension is defined as a blood pressure range of
a:
80-90/120-139

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 and
Preventive 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
3:

Counseling an obese patient to lose weight is an example of
a:
secondaryprevention b:
primary prevention
c:
empathy
d:
engagement
4:
In women, the thyroid-stimulating hormone screening test should be performed at whatinterval?
a:
Every 1-2 years from age 40 years, then yearly after age 50 years b:
Every 5 years after age 50 years
c:
Annually from puberty or from the onset of sexual activity d:
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 negative
b:

Every 5 years from age 19 years, then every 3-5 years after age 65 years c:
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 atwhat interval?
a:
Every other year from age 40 years, then yearly after age 50 years b:
Every 5 years after age 45 years
c:
Every 3-5 years after age 65 years
d:
7:
A mammography to detect breast cancer should be performed at what interval inwomen at average risk?
a:
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:

8:
A colonoscopy to detect colorectal cancer should be performed at what interval for women at average risk?
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:
9:
Which of the following is the most appropriate screening mechanism for cervical dysplasia?
a:
Pap smear
b:
Serum HPV titer
c:
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 examinationof 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 physicianexamination d:
Thyroid-binding globulin
12:
What is the appropriate interval for Pap testing in women who have had a total hysterectomy for reasons
other than cervical dysplasia?
a:
Every 2 years following the hysterectomy b:

Every 5 years following the hysterectomy c:
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 forwomen without risk factors for osteoporosis beginning at
what age?
a:
40 years
b:
65 years
c:
50 years
d:

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:
TSH 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 in
Obstetrics 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 beliefs and
values best matches the principle of
a:
beneficence
b:
nonmaleficence c:
justice
d:

autonomy
3:
The principle that there is a duty not to inflict harm or injury best matches the principle of
a:
nonmaleficence
b:
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 following?
a:
Cost of theproposed treatment b:
The legal risk to the physician and hospital c:
Patient's ability to consider information d:
Physician's concurrencewith the patient's wishes e:
Standardsof care

7:
A 62-year-old woman with newly diagnosed stage III ovariancancer refuses chemotherapy. She wants to "go
home to die." The next step in evaluating this patient is to
a:
determine insurance coverage for thisaction b:
call the family for a conference c:
accept the patient's wishes and discharge her from the hospital d:
call the state medical licensing board and hospital attorney e:
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 be an
example of
a:
principle-basedethics b:
virtue-based ethics c:
feminist ethics
d:
communication-based ethics e:
case-based ethics

9:
The concept of informed consent best relates to the principle of
a:
autonomy
b:
justice
c:
beneficence
d:
nonmaleficence
10:
Paternalismviolates 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 d:
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]

Chapter 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 fetuses through
the
a:
stimulationof cortisol production
b:
stimulationof cortisone production c:
stimulationof androgen production
d:
inhibition of the SRY gene
e:
inhibition of the WNT4 gene
4:
Primary oocytes first appear at what stageof 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?
a:
Mesonephric (wolffian) ducts
b:
Prmary sex cords
c:
Paramesonephric (Mullerian) ducts d:
Gubernaculum

7:
Gartnercysts result from remnants of the
a:
tunicaalbuginea
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:
15weeks
b:
5 weeks
c:
10weeks
d:
20weeks
e:
25 weeks
9:

Which of the following results in the absence of the uterus?
a:
Degeneration of the Mullerianducts
b:
Degeneration of the mesonephricducts c:
Lack of fusion of the inferior parts of the paramesonephric ducts d:
Failure of migration of the primordial germ cells
10:
Which of the following results in the formation of a double uterus (uterusdidelphys)?
a:
Lack of fusion of the inferior parts of the Mullerian ducts b:
Failure of migration of the primordial germ cells c:
Degeneration of the mesonephricducts 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:
b:
urogenital sinus
c:
genital tubercle
d:
urogenital folds
13:
The clitoris develops from the
a:
urogenital folds
b:
genital tubercle
c:
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
c:
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 spines c:
between the upper border of the pubis anteriorly and the lower sacrum at the level of the ischial spines d:
measured at the greatest width of the superior aperture e:
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:
infundibulopelvic 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
a:
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:
b:
simple diffusion
c:
active transport
d:
phagocytosis
e:
pinocytosis

3:
Amino acids cross the placenta by
a:
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 haswhat effect on gastric reflux?

a:
The effect on gastric reflux is unpredictable b:
Gastric reflux is typically unaffected c:
Gastric reflux typically decreases d:
Gastric reflux typically increases
6:
"Morning sickness" typically begins during which weeksof pregnancy?
a:
1-3weeks
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
a:
thyrotropin-releasing factor
b:

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 third trimesters of
pregnancy?
a:
60%-70%
b:
1%-15%
c:
45%-60%
d:
30%-45%
e:
15%-30%
9:
Epulis is a pregnancy-related vascular swelling of the
a:
larynx
b:

pharynx
c:
nares
d:
gums
e:
epiglottis
10:
Which of the following pulmonary measurements is decreased in pregnancy?
a:
Carbondioxide pressure
b:
Tidal volume
c:
Oxygen pressure
d:
Oxygen requirement
e:
Residualvolume
11:
During pregnancy, total body oxygen consumption
a:
decreases by 50% from nonpregnant levels
b:
increases by 20% from nonpregnant levels

c:
increases by50% from nonpregnant levels
d:
decreases by 20% from nonpregnant levels e:
increases by70% from nonpregnant levels
12:
By term in a normal pregnancy, maternal blood volume
a:
increases by 15%
b:
increases by 50%
c:
decreasesby 15% d:
decreasesby 35% e:
increases by 35%
13:
Iron supplementation in pregnancy is mainly used to
a:
maintain fetal hemoglobin concentration b:
prevent iron deficiency in the mother c:

maintain maternal hemoglobin concentration d:
prevent iron deficiency in both the mother and the fetus e:
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:
The increased nasal stuffiness and perception of increased nasal secretions during prenancy are associated
with
a:
increased immunoglobulin production
b:
increased interluminal production of mastcell toxins c:

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
b:
is increased during pregnancy and in the puerperium c:
is decreased during prengnancy and in the puerperium

d:
is increased during pregnancy and decreased in the puerperium e:
is decreased during pregnancy and increased in the puerperium
18:
Displacement of the maternal heart during pregnancy is caused by
a:
constriction of theanteroposterior diameter of the thorax b:
enlargementof the liver
c:
elevation of thediaphragm 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?
a:
Displaced downward and to the right into a more vertical position b:
Displaced upward and to the left into a more horizontal position c:
Displaced upward and to the right into a more horizontal position d:

Displaced downward and to the left into a more vertical position e:
Displaced further into the thoracic cavity
20:
Whendo changes inmaternal 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 during pregnancy is
approximately
a:
30%-50%
b:
10%-20%
c:
5%-10%
d:
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