Gyne-LE-4

Gyne. LE 4 1. Puberty described as all of the following except a. biological change after which sexual reproduction becomes possibleTRUE b. Type of accelerated linear growth and secondary sexual characteristicsTRUE c. Menarche occurs before axillary or pubic hair- FALSE d. Normal puberty occurs in a wide range of ages- TRUE 2. Precocious puberty describes all of the following except a. A relatively common d/o b. Appearance of any kind of sexual maturation at an early age c. Diminished ultimate height due to premature closure of epiphyseal closing centre d. Majority develop GNRH dependent 3. Most common cause of GnRH dependent precocious puberty a. unknown 4. Most common cause of GNRH independent precocious puberty a. Functioning ovarian tumor b. MCCune Albright syndrome c. Exposure to external hormones d. Tumour in adrenal or pituitary 5. Primary emphasis in a child w/ precocious puberty would be a. To rule out life threatening neoplasm of ovary, adrenal or CNS 6. Secondary emphasis would be a. To delineate the spread of tumor 7. Role of chemotherapy in precocious puberty is to a. Reduce gonadotrophin secretion b. Counteract the peripheral action of steroids c. Decrease the growth..... d. All of the above 8. Most important in the medical management of GNRH dependent precocious puberty is to a. Change the growth pattern 9. Classic definition of Polycystic ovarian syndrome is a. Women w/ b. Women who have irregular period c. Hyperandrogenism d. All of the above 10.Ultrasound finding of PCOS include all except a. Abnormal follicles measuring 17mm b. 11.Central Pathophysiology of PCOS a. Insulin resistance 12.35y/o... BMI 32, ovarian follicles... diagnostic tests except a. OGTT b. Serum testosterone c. LDL, HDL, Cholesterol d. Urinalysis 13.First step in mgmt of this pt a. Loose weight 14.Long term consequence of PCOS a. Risk of Ovarian cancer 15.Idiopathic hirsuitism...best treatment

Spironolactone 16.Major androgen provided by ovary Testosterone 17.Source of androgen production in foll organs except Pituitary 18.Symptoms of PCOS except a. Hirsuitism b. Alopecia c. Dysmenorrhea d. Glucose intolerance 19.Ovarian new growth secreting excessiveamt of testosterone a. Brenners Tumor b. Theca leutin cyst- prog c. Fibroma d. CL cyst –prog 20.Treatment for hyperandrogenism except a. Ocp b. Surgery c. Diet and exercise d. Testosterone 21.Natural menopause a. Cessation of menstrual flow due to change in secondary to change in reproductive physiology. 22.Mean age for menopause a. 35- 55 23.Factors that speed up menopause a. Underweight b. Deseases that damage ovary c. Overweight d. smoking 24.Premature ov falure causes premature menopause because a. It depletes the ovarian follicles before age of 40 25.Perimenopause characterized by except a. Decreased estradiol 26.Pathgnomonic symptom of menopause a. Hot flushes 27.Initial endocrinologic change in menopause Decresed inhibin production and inc pit. Fsh 28.Treatment for menopause except a. Hysterectomy b. OCP c. Hormonal therapy d. Fractional D and C 29.If menopause is due to organ failure which organ is involved a. Ovary 30.Which organ is deficient in menopausal women 17 Beta progesterone 31.Anatomical changes in menopausal women except Cervix does not atrophy 32.Female in menopause are prone to dysparunia coz of a. Decreased estrogen production 33.All are true about HRT for menopausal women except a. For urogenital atrophy b. Primary and secondary prevention of CV disease

c. Decrease the risk of osteoporosis and colorectal cancer d. Does not increase risk of Endometrial cancer 34.Recommendation for care of menopausal women except a. CT scan every year 35.Most effective treatment for urogenital and vasomotor symptom a. Highest dose b. All women c. ....... is the most effective treatment 36.Major cause of infertility are a. Male factor..... b. ALLL 37.Assessment of ovulation includes all of the foll except a. b. Semen analysis c. ultrasound 38.Conditions for semen collection All of the above 39.Initial screening in evaluation of tubal pathology would be Hysterosalpingogram 40.Qualities of a post coital test except a. Poor predictor of infertility b. In vivo evaluation of sperm mucous interaction c. Tests the male factor of infertility d. 5-10 progressive motility 41.Components of a basic infertility work up a. Post coital test b. Hysterosalpingogram c. Laparoscopy 42.A value greater than 30nm/L is a predictor of ovulation a. LH testing b. Serum progesterone c. Semen analysis 43.Accurate way to do document ovulation a. Ultrasound 44.Normal semen parameters except Concentration of Less than 20M (40-60M) 45.Parameters for semen analysis- liquifactive time, leukocyte count, .... All CASES 46.25y/o women G2P2...hx of ruptures appendicitis- surgery; regular periods; Husband normal- TUBAL FACTOR 47.29y/o women G5P4...bimanual examination- enlarged uterus- UTERINE FACTOR(MYOMA) 48. 31y/o women. Secondary infertility... regular menses. Decreased follicle count- OOCYTE QUANTITY 49.Could not get preg after reversal of husbands vasectomy- MALE FACTOR 50.Irregular periods, ROS- hair growth on her abdomen- OVULATION FACTOR.