Reproductive System Questions PDF

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ME215 SEMESTER 4 REPRODUCTIVE SYSTEM CONTINUOUS ASSESMENT 1. A 50 year-old man notices gradual enlargement of his breasts which are now approaching in size to those of his wife. He has been under medical treatment for cirrhosis of the liver for the past 2 years. Which event is the most likely to be ...

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ME215 SEMESTER 4 REPRODUCTIVE SYSTEM CONTINUOUS ASSESMENT 1. A 50 year-old man notices gradual enlargement of his breasts which are now approaching in size to those of his wife. He has been under medical treatment for cirrhosis of the liver for the past 2 years. Which event is the most likely to be primarily responsible for his breast change? A. B. C. D.

Decreased degradation of oestrogen Decreased degradation of testosterone Decreased faecal excretion of sex steroids Decreased urinary excretion of sex steroids

Comments: Gynecomastia, defined as benign proliferation of male breast glandular tissue, is usually caused by a decrease in testosterone : oestrogen. The cause of this decrease can be due to reduction of testosterone or increment of oestrogen.

2. A couple has unprotected sex over a period of time and fails to conceive. What is the duration of failure to conceive by this couple to be diagnosed as infertile? A. B. C. D.

6 months 12 months 18 months 24 months

3. An 8 year-old shows early signs of thelarche but there is absence of axillary hair and pubic hair. The plasma level of which of the following would most likely be elevated in this girl? A. B. C. D.

Dehydroepiandrosterone Gonadotrophin releasing hormone Progesterone Testosterone

Comments: Premature thelarche is suggestive of precocious puberty. High-amplitude pulses of GnRH cause pulsatile increases in the pituitary gonadotropin-luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

4. Intrauterine trophoblastic tissue was removed from a woman who was 2 months pregnant. The tissue shower some oedematous villi and a foetal heart. What is the most likely karyotype of this hyatidiform mole? A. B. C. D.

46 XX 46 XY 46 YY 69 XXY

5. A 24 year-old primigravida visited an antenatal clinic for a routine check-up at 22 weeks of pregnancy. The attending physician noticed slight puffiness of her eyes. The pulse was 90/min and BP 148/94mmHg. Investigations revealed proteinuria and raised liver enzyme levels. Despite careful management, patient developed complications and delivered a premature baby at 32 weeks. On careful laboratory examination of placenta, what will be noted? A. B. C. D.

Abnormal shaped villi Abnormal spiral arteries Fused cotyledons Presence of lymphocytes

Comments: Incomplete remodelling of spiral arteries lead to pre-eclampsia.

6. A woman in the 8th month of gestation found that her shoes were not fitting as her feet seemed swollen. What is the best explanation for her phenomenon? A. B. C. D.

Increased heart rate Increased systolic pressure Reduced haematocrit Reduced plasma albumin level

Comments: Hypoalbuminemia may cause generalized edema via a decrease in oncotic pressure.

7. A healthy pregnant woman in her 7th month gestation came for an antenatal visit and glycosuria was reported. What is the most likely reason for her glycosuria? A. B. C. D.

Decreased tubular threshold for glucose transport Decreased renal plasma flow Increased glomerular filtration rate Increased insulin secretion

8. A 47 year-old woman found her period to be irregular and blood test showed high level of follicle stimulating hormone and normal luteinising hormone level. Which statement regarding ovarian follicles best describes her condition? A. B. C. D.

Some follicles were resistant to gonadotropin The follicular phase was lengthened The follicles produced high levels of inhibin There was no follicle left in the ovary

Comments: In perimenopause period, estrogen levels decrease. A reduction in estrogen levels exerts a positive feedback on FSH to bring up the estrogen levels.

9. A 35 year-old man undergoes an infertility workup. On scrotal examination, he has descended testes that appear decreased in size. Semen analysis showed aspermia. A testicular biopsy is performed and on microscopic examination only sertoli cells are present in the seminiferous tubules. Which laboratory test findings is he most likely to have? A. B. C. D.

Decreased LH Decreased testosterone Increased alfa-fetoprotein Increased FSH

Comments: In Sertoli-Cell-Only syndrome, the serum FSH level is typically (90%) elevated. Elevations of greater than 2.5-3 times the reference range are diagnostic for spermatogenic failure.

10. A 29 year-old woma had an abnormal pap smear. Biopsy of the cervix on microscopic examination shows atypical squamous epithelium along with koilocytosis. Upon microscopic examination, which pathological feature suggests cervical malignancy? A. B. C. D.

Basement membrane infiltration Dysplastic cells Inflammatory cell background Peri-nuclear halo

11. A 40 year-old woman had pelvic discomfort for over a month, along with a 4kg weight loss, nervousness, and excessive sweating, An ultrasound examination showed a 10 cm cystic and solid ovarian mass. The mass was removed and on gross pathologic examination, there was hair, sebum and prominent tooth-like structure. Which microscopic finding is most likely to be seen in this biopsy sample? A. B. C. D.

Neuroendocrine cells Thyroid follicles Trophoblastic cells Yolk sac remnants

12. A 38 year-old healthy woman has ha a white vaginal discharge for the past week. There was no bleeding. A pap smear demonstrates normal appearing squamous epithelial cells along with scattered neutrophils and budding cells with pseudo-hyphae. Which infection agent is most likely to be present? A. B. C. D.

Candida albicans Escherichia coli Neisseria gonorrhoeae Trichomonas vaginalis

13. A 22 year-old woman gave birth to a healthy male infant at term following an uncomplicated pregnancy. She now has been breast feeding the baby for a montj, but notes that her breast has gradually become swollen and painful over the past week. On examination, she is febrile. What is the most likely diagnosis? A. B. C. D.

Acute mastitis Fibroadenoma Intraductal papilloma Traumatic fat necrosis

14. A 39 year-old woman has noted a breast lesion for 3 months. There is an eczematous 1cm diameter area on the skin of the right breast areola but there is no palpable lump. Biopsy of the skin shows large cells at the dermal-epidermal junction that stain positively for mucin. What is the most likely diagnosis? A. B. C. D.

Acute mastitis Fat necrosis Metastatic carcinoma Paget disease of the breast

15. A 35 year-old woman is seen in the emergency room with abdominal pain and vaginal spotting of 3 hour duration. Her vital signs are stable. Her las menstrual period was 8 weeks ago. Ultrasound scan of the abdomen reveals extra-uterine gestation. What is the most likely site of implantation? A. B. C. D.

Cervix Fallopian tube Ovary Pouch of douglas

16. A 38 year-old has irregular scantly menstruation for the past 8 months. She is unable to conceive. She is obese and has prominent coarse haor over the face and breast areola. She has recently been diagnosed as a diabetic. Her serum testosterone level is high. What is the most likely abnormality identified on her abdominal ultrasound scan? A. B. C. D.

Follicular cyst in ovary Large cystic ovarian mass Multiple ovarian cysts Solid ovarian tumor

Comments: PCOS.

17. A 33 year-old woman has been unable to conceive for the past 10 years. She has mild pelvic pain, but regular menstrual cycles. Past history shows few visits to gynaecologists for vaginal discharge. Her pap smear is normal. Her husband’s sperm count is normal. What is the most likely diagnosis?

A. B. C. D.

Adenomyosis Chronic cervicitis Ovarian teratoma Pelvic inflammatory disease

18. What drug causes teratogenicity by anti-angiogenesis action? A. B. C. D.

Alorvastatin Diethylstilboestrol Retinoid Thalidomide

19. A 28 year-old pregnancy woman developed a swollen painful left leg at 12th week of gestation. Doppler ultrasound of her left leg showed popliteal vein thrombosis. Which drug treatment is associated with greatest risk to the fetus? A. B. C. D.

Aspirin Heparin Paracetamol Warfarin

20. A 20 year-old male notices gradual increase in the size of his right testis since 2 months, investigations revealed the presense of testicular Germ Cell Tumor (GCT). MRI shows spread to the lymph nodes. Which group of lymph nodes show early metastatic deposits? A. B. C. D.

Iliac Inguinal Mediastinal Retroperitoneal

The retroperitoneal lymph nodes receive lymph from the lower limbs, genitals, pelvic viscera and retroperitoneal structures. Tumor metastasis to these nodes from the afore-mentioned sites is not uncommon. In some cases of testicular carcinoma, renal cell carcinoma and upper urinary tract urothelial carcinoma and other urologic malignancies, a procedure known as retroperitoneal lymph node dissection can be conducted as both a diagnostic and therapeutic procedure.

21. A 30 year-old woman felt sharp pain at her vaginal region. She also notices that there was a small ulcer on the external surface of her left labia. This was not the first time that’s she had an ulcer around her vaginal region. This recurrent ulcer took more than a week to heal. What is the most likely causative organism for her ulcer? A. B. C. D.

Human immunodeficiency virus (HIV) Herpes simplex virus Hepatitis B virus Trichomonas vaginalis

22. The picture below is a photomicrograph at high power of the seminiferous tubule. What is the most likely cell indicated by the arrow?

A. B. C. D.

Primary spermatocyte Secondary spermatocyte Sertoli cell Spermatogonium

23. A 22 year-old pregnant woman attends the antenatal clinics for her first pregnancy regularly. Clinical pelvimetry is done to assess the adequacy of her pelvis to allow for a vaginal delivery. Which distance should be adequare at the mid-cavity of the pelvis, or her to allow a vaginal delivery? A. B. C. D.

From one ischial spine to opposite ischial spine From one ischial tuberosity to the opposite ischial tuberosity From sacral promotory to the lower border of the pubic symphysis From sacral promotory to the upper border of the pubic symphysis

Comments: Pelvimetry includes assessing pelvic inlet (sacral promontory and inner pubic arch), mid pelvis (between 2 ischial spines) and pelvic outlet (between 2 ischial tuberosities)

24. A 35-year old man sustained a pelvic bone fracture following a car accident. An ultrasound scan reveals accumulation of urine in the deep perineal pouch and the lesser pelvis. Which site of his lower urinary tract is most likely to be ruptured? A. B. C. D.

Membranous urethra Neck of the urinary bladder Penile urethra Prostatic urethra

Comments:

25. A 60 year-old man comes to a surgical clinic with difficulty in passing urine and incomplete sensation of emptying his bladder at the end of urination. Ultrasonography shows an enlarged prostate gland and a post-prostatic pouch in the urinary bladder. What anatomical factor of the prostate gland contributes to the formation of this pouch? A. B. C. D.

Base of the gland lying in contact with the base of the urinary bladder? Presence of a median groove separating lateral lobes of the gland Presence of more prostatic tissue posterior to the prostatic urethra The median lobe of the gland lying between prostatic urethra and ejaculatory ducts

26. A 25 year-old woman gets admitted for a hysterectomy for her prolapsed uterus. She has given birth to 7 children within a period of 8 years. Weakness of which muscle leads to her prolapsed uterus? A. Coccygeus B. Deep transverse perinei C. Levator ani

D. Superficial transverse perinei

27. A 55 year-old woman notices a lump in her right breast which is rapidly increasing in size. The lump is located in the upper medial quadrant and hard in consistency. To which lymph node group does the lymph from this particular region initially drains into? A. B. C. D.

Inferior phrenic Parasternal Pectoral Supraclavicular Comments:

28. In the 36th week of pregnancy, which change is expected to occur in the mammary glands? A. B. C. D.

Distension of secretory alveoli with colostrum Increased fat deposition Increased thickness in interlobular connective tissue Proliferation of secretory alveoli

29. External urethral orifice of a male new-born was found to be on the ventral surface of the glans penis. What is the embryological basis for this infant’s condition? A. B. C. D.

Defect in urogenital sinus Incomplete fusion of genital swellings Incomplete fusion of urethral folds Ventral body defect

30. An ultrasound scan of a 25 year-old pregnancy shows a foetus with anencephaly. She had a history of severe pneumonia with high fever during the first trimester of her pregnancy. Which gestational week did she suffer from hyperthermia that could have affected the foetus? A. B. C. D.

3rd to 4th week 5th to 6th week 7th to 8th week 8th to 10th week

Comments:

31. What is the best approach to prevent intrauterine infections? A. Chemoprophylactic use of tetracycline to prevent chlamydial infection in pregnant women B. Immunisation of pregnant women using hepatitis B vaccine C. Immunisation with hepatitis A vaccine D. Use of condom during sexual intercourse

32. An 18 year-old girl attends the gynaecology clinic with a history of excessive vaginal bleeding associated with clots during menstruation for the past 6 months. There is a history of easy bruising. There is significant pallor. The abdomen examination is unremarkable.

A. B. C. D.

Adenomyosis Bleeding disorders Endometrial carcinoma Fibroid uterus

33. A 48 year-old woman attends the gynaecology clinic complaining of heavy menstrual bleeding and intermenstrual spotting of 8 months duration. The haemoglobin is 11.2g/dl. An ultrasound scan demonstrates no obvious abnormality. What other investigations is required to arrive at a diagnosis? A. B. C. D.

Coagulation screening Diagnostic hysteroscope Endometrial biopsy Serum FSH levels

34. An 18 year-old primigravida presents at 34 week gestation with blood pressure of 150/100mmHg and proteinuria of 3+ using dipstick. She is sure of her dates. Her weight is 56 kg. her blood pressure at 12 weeks gestation was 100/60mmHg and urinalysis was normal. The symphysiofundal height mesures 30cm and foetal parts are easily palpable. What is the most likely explanation for the discrepancy in symphysiofundal height measurement and the gestational age? A. B. C. D.

Constitutionally small foetus Chromosomally abnormal foetus Maternal habitus Placental insufficiency

35. What is the average age at which a child can build a tower of 3 cubes? A. B. C. D.

6 months 9 months 12 months 18 months

36. A 39 year-old woman who has been on birth control methods and attending your family planning clinic was recently diagnosed with early stage cervical cancer. She seeks your advice on the risk factors for cervical cancer. What is the most likely risk factor for her cervical cancer? A. B. C. D.

History of Epstein-Barr virus infection Late onset sexual intercourse Monogamous sex Use of oral contraceptives

37. A 30 year-old man presents with a painless penile ulcer on the glans penis associated with whitish urethral discharge. In the prevention and control of sexually transmited diseases, early detection is important. What is the most likely diagnosis? A. B. C. D.

Chlamydia infection Genital herpes Gonorrhoea Syphilis

38. What is the most likely demonnator in the formula General Fertility Rate (GFR)? A. B. C. D.

Total live births Total live births and stillbirths Total mid-year population Total mid-year population of women of reproductive age group

39. According to Piaget, which term describes the process that children create new schemes or adjust old ones? A. B. C. D.

Accommodation Assimilation Disequilibrium Organization

40. A successful business man is not happy with his personal life. He had a life-long belief that he was a female born in the body of a male. He found it easier to make friends with girls than boys. The primary component of his gender identity is that he often displayed dissatisfaction with his male genitals, and showed signs of distress and anxiety over believing that something in his life was wrong. What condition best describes his behaviour? A. B. C. D.

Bisexual orientation Gender aversion Gender dysphoria Homosexual orientation...