38 Questions
What is the next step in managing ectopic pregnancy after initial diagnosis?
Laparotomy and salpingectomy
Which of the following is NOT an indication for hormone therapy?
Hot flashes
What is the definition of heterotrophic pregnancy?
Extrauterine and intrauterine pregnancy
What is the most probable cause of postmenopausal bleeding in a woman who is obese, hypertensive, and diabetic?
Endometrial cancer
Nanovalent vaccine offers protection against which types of HPV viruses?
Types 6, 11, 16, 18, 31, 35, 45, 52, 58
What is the correct sequence of sperm formation?
ABCD
Which type of thyroid carcinoma always spreads to the cervical lymph nodes?
Papillary carcinoma
What is the least malignant type of thyroid cancer?
Papillary carcinoma
What is the best treatment for cervical lymph node involvement in papillary carcinoma thyroid?
Radical neck dissection
What is not a characteristic of papillary carcinoma of thyroid?
Always unifocal
What is the treatment of papillary carcinoma of thyroid with bony metastasis?
Near total thyroidectomy with radioiodine and radiotherapy
What is the term for metastatic foci from primary in thyroid?
Lateral aberrant thyroid
Which of the following is used in the treatment of differentiated thyroid cancer?
Radioiodine
What type of thyroid carcinoma is often associated with occult thyroid malignancy with nodal metastasis?
Papillary carcinoma
What is the preferred treatment for thyroid cancer?
Total thyroidectomy and modified neck dissection on the side of the enlarged lymph node
Which type of thyroid carcinoma is associated with amyloid stroma?
Medullary carcinoma
A patient with a pituitary tumor and pheochromocytoma is most likely to develop which type of thyroid carcinoma?
Medullary carcinoma
What is the primary effect of local anesthetics on the body?
Blocking pain sensation without loss of consciousness
What is an undesirable property of a local anesthetic agent?
Local irritation and tissue damage
What are the typical components of a local anesthetic agent?
All of the above
What determines the duration of local anesthetic action?
Intermediate chain
Which of the following is a characteristic of a good local anesthetic agent?
Fast onset and long duration of action
What is the primary course of treatment for a child presenting with a swelling over the mastoid, pain in the ear with pulsatile ear discharge, and fever?
Analgesics and IV antibiotics
A patient with a negative Rinne's test and a louder tone in the opposite ear on Weber's test is likely to have which type of hearing loss?
Conductive hearing loss on the same side
What is the operation of choice for a patient with attic cholesteatoma of the left ear and lateral sinus thrombophlebitis?
Canal wall down mastoidectomy
A patient with bilateral hearing loss that becomes profound with pregnancy is likely to have which type of tympanogram curve?
AS
A patient with bleeding from the ear, pain, tinnitus, and progressive deafness is likely to have which condition?
Glomus jugulare tumor
What is the primary management option for a patient with glomus jugulare tumor?
Surgery
A patient with a postero-superior retraction pocket with cholesteotoma is at risk of developing which complication?
Lateral sinus thrombophlebitis
What is the primary goal of cortical mastoidectomy in a patient with acute mastoiditis?
To drain the infected mastoid air cells
What is the chemical nature of local anesthetics?
Weak bases
Why are local anesthetics usually made available as salts?
More stability and greater water solubility
Which statement is not correct about local anesthetics?
A charged cationic form penetrates biologic membranes less readily than an uncharged form
What is incorrect about the metabolism of local anesthetics?
Metabolism of local anesthetics occurs at the site of administration
Which anesthetic agent is the agent of choice in a patient with liver disease?
Procaine
Which local anesthetic is preferable in a patient with pseudocholinesterase deficiency?
Procaine
What is the reason for the decreased effectiveness of local anesthetics in inflamed tissues?
Low pH in inflamed tissues
How are ester group of anesthetics like procaine metabolized?
Systemically by pseudocholinesterase
Study Notes
HCG and Pregnancy
- HCG should be repeated after 2 weeks
- Medical management and laparotomy with salpingectomy are possible treatments
Hormone Therapy
- Hormone therapy is not indicated for hot flashes
- It can be used to prevent coronary artery disease, osteoporosis, and vaginal atrophy
Heterotrophic Pregnancy
- Heterotrophic pregnancy occurs in both tubes, with both extrauterine and intrauterine pregnancy
- It can also occur in the ovaries and tubes, or in the cervix
Postmenopausal Bleeding
- A postmenopausal woman with obesity, hypertension, and diabetes who presents with bleeding may have endometrial cancer
- Other possible causes include malignant ovarian tumor, cervical cancer, and Brenner tumor
Human Papillomavirus (HPV) Vaccine
- The nanovalent vaccine offers protection against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58
Sperm Formation
- The sequential order of sperm formation is: spermatogonia, spermatocyte, spermatids, and spermatozoa
Birth Control Pills and Fertility
- A 39-year-old woman who stops taking birth control pills to conceive may experience a delay in fertility
- The return of menses can be anticipated after stopping the pills
Thyroid Cancer
- Papillary carcinoma of the thyroid can be reliably diagnosed using fine needle aspiration cytology
- It typically spreads to the cervical lymph nodes
- Total thyroidectomy with radiotherapy is a treatment option for papillary carcinoma with bony metastasis
- Radioactive iodine can be used to treat cervical lymph node involvement in papillary carcinoma
- Medullary carcinoma is the least malignant type of thyroid cancer
- Lateral aberrant thyroid refers to metastatic foci from primary thyroid cancer
- Occult thyroid malignancy with nodal metastasis is commonly seen in papillary carcinoma
Ear Disorders
- Attic cholesteatoma of the ear with lateral sinus thrombophlebitis is treated with canal wall down mastoidectomy
- A patient with bilateral hearing loss, which becomes profound with pregnancy, may have a tympanogram showing a type B curve
Anesthesia
- Local anesthetics produce analgesia by blocking pain sensation without loss of consciousness
- A good local anesthetic agent should not cause local irritation and tissue damage
- Local anesthetics are weak bases and are usually made available as salts for therapeutic application because of more stability and greater water solubility
- Ester group of anesthetics like procaine are metabolized systemically by pseudocholinesterase
- Amides such as lidocaine are metabolized in the liver by microsomal mixed function oxidases
This quiz covers various topics in obstetrics and gynecology, including pregnancy complications, hormone therapy, and women's health issues.
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