REPRO-BIO TEST QUESTIONS-2004-Version K-1
1. Which of the following substances or neurotransmitters has a positive stimulatory effect on gonadotropinreleasing hormone production?
A. Marijuana
B. Beta-endorphin
C. Leptin
D. Pro-opiomelanocortin
E. Dopamine
2. Gonadotropin releasing hormone (GNRH) receptors are
A. Nuclear receptors
B. Require potassium for action
C. Not regulated by sex steroids
D. Down regulated by constant GNRH exposure
E. Polypeptides with alpha and beta subunits
3. Identify the correct statement concerning the gonadotropins, luteinizing hormone (LH) and follicle
stimulating hormone (FSH).
A. FSH induces LH receptors
B. Synthesis is rate limited by availability of alpha subunit
C. LH stimulates granulosa cell aromatase
D. FSH surge at mid cycle exceeds LH
E. Alpha subunit confers biological specificity
4. The mid-cycle gonadotropin surge:
A. Increases gonadotropin releasing hormone pulsatility
B. Is triggered by estradiol and facilitated by progesterone
C. Arrests meiosis in prophase II
D. Allows release of prostaglandin inhibitors
E. Down regulates vascular endometrial growth factor expression.
5. A 24 year old female with pelvic pain has an ultrasound and blood test. These show a serum progesteroneof 1.0 ng/ml, estradiol of 200 pg/ml, and a follicle measuring 19 by 18 mm in seen in the right ovary.Which cycle day is most representative of the above?
A. 7
B. 14
C. 19
D. 24
E. 28
6. A 49 year old attends the clinic with abnormally prolonged and erratic menstrual bleeding. An endometrialbiopsy is performed and she is informed that while there was no cancer identified, she is exhibitinganovulatory bleeding. Which of the following would be consistent with this diagnosis?
A. Glycogen in lumen of glands
B. Leucocyte infiltration
C. Stromal decidual reaction
D. Stromal edema
E. Increased coiling of glands
7. Which of the following genetic disorders would be associated with high follicle stimulating hormone (FSH)concentrations?
A. FSHj mutation
B. Septo-optic dysplasia (HESX1)
C. Leptin deficiency
D. Luteinizing hormone (LHβ) mutation
E. 17 hydroxylase deficiency (CYP17)
8. All of the following are minor side effects of combination birth control pills EXCEPT:
A. Breast pain
B. Decreased libido
C. Amenorrhea
D. Nausea
E. Anemia
9. One advantage of the progestin only pill includes:
A. No increased risk of deep vein thrombosis
B. Better cycle control
C. Less ovarian cyst development
D. Protects against sexually transmitted infections
E. More effective than combination oral contraceptive pills
10. Depo-Provera provides its contraceptive effect by which of the following mechanisms:
A. Blocks fallopian tube with thickened mucus
B. Inhibits follicle formation
C. Blocks luteinizing hormone surge and ovulation
D. Makes endometrium unfavorable for implantation
E. Bothcandd
11. When using a diaphragm for contraception all of the following are true EXCEPT:
A. It acts as a shield to protect the cervix from sperm
B. It must be fitted by a physician
C. Urinary tract infections are less common among users
D. Oil based lubricants may affect its integrity
E. Spermicide must be re-added for repeat acts of intercourse
12. Which of the following is the most common reversible contraceptive method used in the United States?
A. Oral combination pills
B. Sterilization
C. Depo-Provera
D. Diaphragm
E. Intrauterine device
13. All of the following are true regarding lactational amenorrhea as a method of contraception, EXCEPT?
A. Nipple stimulation suppresses ovulation via feedback inhibitions of gonadotropin releasing
hormone and gonadotropins
B. Most effective in 6 months after delivery
C. 98% effective
D. Supplemental feeds should exceed 20% of total intake
E. To be effective the woman should remain amenorrheic
14. P. S. is a 36 year old female who presents for her well-woman exam. She has a new partner and is
interested in taking the pill. All of the following would prevent her from using a combination oral
contraceptive EXCEPT:
A. History of lower extremity deep venous thrombus after a car accident
B. Family history of hepatitis C
C. Smoking a pack of cigarettes each day
D. Blood pressure 160/110
E. History of liver adenoma
15. As a physician examining a patient, which of the following findings do you think would most strongly
support the diagnosis of lymphogranuloma venereum?
A. A painful blister on the foreskin of the penis
B. A foul smelling discharge from the urethral meatus
C. Large painful inguinal lymph nodes
D. A shallow painless genital ulcer
E. A swollen Bartholin's gland at the vaginal opening
16. Which of the following reproductive tract infections can be easily diagnosed with a simple wet mount
smear of the vagina?
A. Syphilis
B. Vaginal Trichomoniasis
C. Gonorrheal cervicitis
D. Chlamydial salpingitis
E. Lymphogranuloma venereum
17. Which of the following does NOT requires notification of the Texas Health Department?
A. Lymphogranuloma venereurn
B. Chlamydia
C. Gonorrhea
D. HIV
E. Chancroid
18. A 22 year old female patient presents to the emergency room with the following findings: Two days ofworsening pelvic pain; Foul smelling vaginal discharge; Temperature = 101.27; and cervical motiontenderness. If she is found to have Pelvic Inflammatory Disease, what should she be told about her longterm health?
A. The increased chance of infertility is only temporary
B. She is more likely to develop an ectopic pregnancy
C. She is more likely to develop ovarian cancer
D. She has a higher life-time risk of breast cancer
E. Chronic painful intercourse is rare
19. Which of the following infections is NOT known to have a recently increasing rate?
A. Syphilis
B. Chlamydia
C. Gonorrhea
D. Herpes simplex
20. At what stage does the egg complete meiosis I?
A. Onset of puberty
B. Menarche
C. Ovulation
D. Menstruation
E. Fertilization
21. Implantation of embryo normally takes place
A. When embryo is at 8-cell stage
B. 3-5 days after ovulation
C. 5-7 days after ovulation
D. 7-9 days after embryo enters the uterus
22. Sperm undergoes capacitation
A. In the fallopian tube(s)
B. Just before fusion of sperm and egg membranes
C. In the cervical mucus
D. After acrosome reaction is completed
E. Just before zona reaction occurs
23. The egg completes its meiosis II at the time of
A. Puberty
B. Middle cycle luteinizing hormone surge
C. Ovulation
D. Fertilization
E. Implantation
24. Up to how many hours after ovulation does a human egg remain fertilizable?
A. 6 hours
B. 24 hours
C. 48 hours
D. 72 hours
25. Which of the following is correct about the formation and the transport of sperm?
A. Leydig cells lining the seminiferous tubules give rise to spermatid
B. Sperm from the head of the epididymis are not capable of fertilizing eggs
C. The main function of epididymal duct is to serve as a storage site for sperm prior to ejaculation
D. Contraction of posterior urethra prevents entry of sperm into the bladder
E. Sperm occupy 10% of the semen volume
26. About hCG (human chorionic gonadotropin), which of the following is NOT true?
A. hCG is produced by the embryo while it is still in the fallopian tube
B. hCG becomes detectable in maternal circulation only after
implantation of the embryo
C. hCG enhances progesterone production by the corpus luteum
D. hCG is produced by trophoblast cells of placenta
E. Current blood pregnancy test can not detect an early pregnancy in a woman who has regular
periods and is seven days late for her period
27. Normal pregnancy is characterized by:
A. Increased volemia, increased cardiac output, increased urinary output
B. Hemoconcentration, increased cardiac output, decreased renal plasma flow
C. Increased volemia, unchanged cardiac output, low urinary output
D. Increased volemia, increased cardiac output, unchanged glomerular filtration rate
28. Hemodynamic changes normally seen in pregnancy include:
A. Decreased osmolality
B. Decreased pulmonary capillary wedge pressure
C. Decreased colloid-osmotic pressure
D. a, b, and c
E. ac
29. Normal pregnancy is characterized by all, EXCEPT:
A. Increased systemic vascular resistance
B. Decreased pulmonary vascular resistance
C. Decreased blood pressure in the second trimester
D. Insulin resistance
30. The ONLY ONE correct statement is:
A. Maternal hemoglobin has higher affinity for oxygen than fetal hemoglobin
B. Fetal blood has lower affinity for CO2 than maternal blood
C. The fetus needs a higher oxygen saturation man the adult
D. Human placenta is characterized by high efficiency in oxygen transfer
31. The hormone that may be responsible for smooth muscle relaxation is:
A. Estrogen
B. Progesterone
C. Prolactin
D. Cortisol
32. R.S. is a 26-year-old woman who comes into the obstetrics/gynecology clinic because she has missed her/ period for 2 months. After a pregnancy test you inform her that she is 7 weeks pregnant. If RS's bodymass index (BMI) was 17 kg/m2, what is the appropriate amount of weight she should gain during theremainder of this pregnancy?
A. 15-25 lbs
B. 28-40 lbs.
C. 35-45 lbs.
D. 40-50 lbs.
33. During pregnancy, increased amounts of protein are needed to provide for maternal stores, fetal
development, and placental tissue. The Recommended Dietary Allowance (RDA) for protein for adultwomen of child bearing age is 46 g per day. Which of the following would be an appropriate amount ofprotein for a pregnant woman with a BMI (body mass index) of 24.0?
A. 52 g
B. 60 g
C. 72 g
D. 84a
34. Megavitamin therapy is a common practice for many people; however, many do not recognize the potentialfor toxicity. Of the following vitamins, which is most likely to cause teratogenic effects (birth defects inthe developing embryo) if taken during pregnancy in doses exceeding the RDA?
A. Vitamin C
B. Vitamin A
C. Vitamin B 12
D. Folate
35. According to the RDA, how many additional calories from the diet are required on a daily basis during thesecond and third trimester of pregnancy?
A. An additional 100 kcal per day and 300 kcal per day are required from the diet during the secondand third trimester, respectively
B. An additional 300 kcal per day are required during the remainder of the pregnancy
C. An additional 500 kcal per day and 700 kcal per day are required from the diet during the secondand third trimester, respectively
D. No additional calories are required from the diet in either trimester
36. HL is a 30-year-old woman who is planning her second pregnancy. She has already delivered an infantwith a neural tube defect and inquires about any measures that can be taken to prevent a neural tube defectfrom reoccurring. What vitamin supplement has been shown to decrease the likelihood of neural tubedefects when taken preconceptually and during pregnancy?
A. Folic acid
B. Thiamine
C. Vitamin B12
D. All of the above
37. Abnormalities often occur in the eating habits of women during their pregnancy. Pica is an eating practicethat is seen occasionally. Which of the following best describes this eating habit?
A. Laxative or diuretic use
B. Binge eating and purging
C. Eating nonfood items such as chalk or ice
D. Following the newest food fad
38. Of the following listed, which may play a role in sexuality:
A. Medications
B. Chronic medical problems
C. Stress at work
D. Religion
E. All of the above
39. All of the following are important in achieving an erection, EXCEPT
A. Sexual stimulation
B. cGMP (cyclic guanosine monophosphate)
C. Nitric oxide
D. cAMP (cyclic adenosine monophosphate)
E. Phosphodiesterase inhibitor
40. All of the following have been proven to benefit women with sexual difficulties, EXCEPT:
A. Psychological counseling
B. Eros Clitoral Therapy Device
C. Estrogen therapy
D. Sildenafil
E. Androgen therapy
41. Of the following, which statement is MOST accurate?
A. Selective Serotonin Reuptake Inhibitors may aid in disorders of desire and arousal
B. Sexual dysfunction is easy to diagnose and treat
C. Vaginal intercourse is well designed to elicit orgasm in the female
D. The orgasmic platform was initially described by Kaplan
E. Deep dyspareunia requires a pelvic exam
42. Characteristics of the Sexual Response Cycle include all of the following, EXCEPT:
A. It consists of two physiologic responses, vasocongestion and myotonia
B. The plateau phase lasts from 30 seconds to 3 minutes
C. It provides minimal impact when assessing sexual responding in clinical samples
D. Men and women have similar sexual functioning
E. Cultural beliefs are well incorporated
43. The average age of onset of menopause is:
A. 48
B. 49
C. 51
D. 53
E. 55
44. Characteristic laboratory changes indicative of the perimenopause include all but which one of the
following:
A. Elevated follicle stimulating hormone
B. Decreased estradiol
C. Decreased inhibin
D. Normal luteinizing hormone
E. Normal prolactin
45. Identify the correct statement:
A. Perimenopausal women cannot get pregnant
B. After menopause the androgen/estrogen ratio increases
C. The later the age of menarche, the later the age of menopause
D. Inhibin concentrations rise with menopause
E. Menopause is characterized by constant vaginal bleeding
46. Which of the following patient characteristics is NOT a risk factor for the development of osteoporosis?
A. Steroid usage
B. First degree relative with osteoporosis
C. Athletic lifestyle, body building
D. Smoking
E. Caucasian
47. Which of the following is NOT an indication for estrogen/progestin hormone therapy?
A. Prevention of osteoporosis
B. Prevention of heart disease
C. Treatment of atrophic vaginitis
D. Treatment of vasomotor symptoms
E. Treatment of urethral symptoms
48.According to the Women's Health Initiative, estrogen/progestin hormone therapy lowers the risk of
A. Stroke
B. Venous thrombotic events
C. Colon cancer
D. Invasive breast cancer
E. Coronary artery disease
49. HNPCC
A. Involves DNA repair gene mutations
B. Second most common malignancy in females with HNPCC is uterine cancer
C. Is known as Lynch II syndrome
D. Primarily involves MSH2 and MLH1 gene mutations
E. All of the above
50. p53
A. Is commonly mutated in papillary serous ovarian cancer
B. Is over expressed in hyperplasias of the endometrium
C. Is a proto-oncogene
D. Is inactivated by human papilloma virus protein E7
E. Is located on chromosome 2
51. BRCA2 gene (breast cancer gene 2)
A. Is a proto-oncogene
B. Is mutated in patients with HNPCC
C. Is associated with male breast cancer
D. Is mutated in 1/70 American women
E. Is located on chromosome 17
52. Normally, transforming growth factor beta
A. Is a tumor suppressor
B. Is located in the nucleus
C. Causes proliferation of benign ovarian cells
D. Is inhibited by human papilloma virus
E. Activates cyclin dependant kinases
53. Apoptosis
A. Is energy independent
B. Characterized by expansion of chromatin
C. Is inhibited by BAX
D. Involves caspases
E. Involves cellular fragmentation
54. Telomerases
A. Are involved with chromosomal destabilization
B. Senescence is due to lengthening of telomerase
C. Telomerase is a tumor promotor gene
D. Telomerase activity is involved in gynecologic cancers, most commonly uterine
55. The placenta is capable of producing which types of hormones?
A. The placenta does not produce hormones
B. Only steroid hormones
C. Only protein hormones
D. Both steroid and protein hormones
56. Human chorionic gonadotropin (hCG)
A. Is considered the "pregnancy hormone"
B. Is produced almost exclusively in the placenta
C. Is composed of two subunits
D. Can be detected in the maternal serum and urine
E. All of the above
57. Which of the following is/are major functions of human chorionic gonadotropin (hCG)?
A. Induces lipolysis
B. Stimulates the corpus luteum to produce progesterone and relaxin
C. Causes early feminization of the female fetus
D. Stimulates ketosis
E. All of the above
58. Human placental lactogen (hPL)
A. Has a 96% sequence homology with human chorionic gonadotropin
B. Rises early in pregnancy and then decreases in production until term
C. Is detectable in large quantities in the maternal urine and is the basis for the "pregnancy test"
D. Has important metabolic actions to ensure nutrients for the developing fetus
59. The maternal blood concentrations of progesterone and estrogen reach their peak for pregnancy near term.
A. True
B. False
60. The placenta uses C-19 steroids (dehydroepiandrosterone sulfate) as precursors to estradiol biosynthesisrather than using acetate or cholesterol (like the ovary) because it does NOT express which enzyme?
A. Aromatase
B. 17a-hydroxylase/ 17,20 desmolase
C. Sulfatase
D. Pregnenolone
61. Which of the following statements is correct?
A. Gestational changes in the myometrium are progesterone dependent
B. The term pregnant uterus weighs approximately 1000 grams and has a capacity of 5 liters
C. Uterine blood flow decreases from a nonpregnant rate of 500 ml/min to 30 n-/min at term
D. None of the above
62. Oxytocin
A. May be produced in the pituitary and the chorion/decidua
B. Production may be stimulated by estrogen
C. Receptors increase during pregnancy and labor
D. None of the above
E. All of the above
63. Cyclic AMP
A. Increases sequestration of calcium in the sarcoplasmic reticulum
B. Levels increase with activation of adenylate cyclase
C. Increases phosphorylation of myosin light chain kinase
D. None of the above
E. All of the above
64. Estrogen
A. Stimulates an increase in the number of gap junctions
B. Stimulates an increase in the number of open gap junctions
C. Neither of the above
D. Both of the above
65. Which of the following are required to define labor?
A. Uterine activity
B. Cervical change
C. Both
D. Neither
66. Which of the following is NOT one of the cardinal movements made by the fetus in labor?
A. Effacement
B. Engagement
C. Internal rotation
D. External rotation
67. Both external and internal fetal monitors can record the maternal heart rate.
A. True
B. False
68. The period of time between delivery of the fetus and delivery of the placenta describes which stage of
labor?
A. Stage I
B. Stage 2
C. Stage 3
D. Stage 4
69. The minimum progress that separates normal from abnormal labor in Stage I is:
A. 2 cm/hr
B. 1 cm/hr
C. 0.5 cm/hr
D. 5 cm/hr
70. The direction of external rotation of the fetal head indicates to the birth attendant what proper hand
placement should be prior to delivering the anterior shoulder.
A. True
B. False
71. By placing traction on the umbilical cord after the baby is delivered, what serious complication can be
caused?
A. Uterine inversion
B. Placenta accreda
C. Uterine atony
D. Uterine rupture
72. Which of the following is correct?
A. Foramen ovale → Left atrium to right atrium
B. Ductus arteriosus → Aorta to pulmonary artery
C. Crista dividens →Superior vena cava to right ventricle
D. Ductus venosus→ Umbilical vein to inferior vena cava
E. Crista interveniens→ Interior vena cava to left atrium
73. Which of the following has the greatest O2 saturation?
A. Right ventricle
B. Ductus venosum
C. Ascending aorta
D. Coronary sinus
E. Umbilical artery
74. All of the following are responses to "fetal distress" EXCEPT
A. Increase in blood pressure
B. Increase in angiotensin II
C. Decreased catecholamines
D. Activation of chemoreceptors
E. Redistribution of cardiac output to heart and brain
75. The following statements are TRUE.
A. The right ventricular output is shunted through ductus arteriosus to the placenta
B. Left ventricular output is distributed to the brain and myocardium
C. The fetal left ventricular output is 35% of the total cardiac output