Jakvani Quiz

A 31 year old G4P0040 presents to your office after her fourth miscarriage before 10 weeks. The least likely diagnosis to be found in your workup is:

Smoking is associated with all of the following, except:

A 37 year old G1P1001 comes to you for a preconception visit. Her last pregnancy was 9 years ago. Her advanced maternal age increases her risk for all of the following except:

What is the most common fetal karyotypic abnormality?

When is the ideal time to perform a nuchal translucency?

You are quizzing the intern on the different components of the material serum screening. All of the following conditions can be associated with abnormal maternal AFP levels except:

Conjoined twins are the result of division of the conceptus at which of the following stages?

Which of the following complications is the least likely to occur in a pair of monochorionic/diamniotic twins?

A 22 year old G1PO at 19 weeks estimated gestation is concerned about her heavy drinking in the early second trimester. Which of the flowing features are least likely to be associated with fetal alcohol syndrome?

What causes an increase in the erythrocyte sedimentation rate (ESR) during pregnancy?

Umbilical artery Doppler studies provide the most meaningful information for which of the following conditions?

Which of the following would not receive a score of 2 when calculating the biophysical profile performed over 30 minutes?

A 32 year old G2P0101 presents at 12 weeks for her first prenatal visit. Her first pregnancy was complicated by spontaneous preterm labor and subsequent delivery at 33 weeks. She wants to know if there is any other way to prevent another preterm birth. You explain that the current evidence supports the use for what treatment for the prevention of preterm delivery in a patient with a history of previous preterm birth?

A 34 year old G1P0 with a history of a LEEP procedure for CIN III at age 32 presents her anatomy ultrasound at 18 3/7 weeks gestation. She is noted to have a cervical length of 5mm with funneling. The pregnancy is extremely desired and the patient wants “everything done.” Which of the following is the next appropriate course of action?

A 41 year old G2P0010 @ 26 weeks of estimated gestational age notices a 2cm mass in her left breast. What do you recommend for evaluation/treatment?

You are called to evaluate a woman in the emergency department who has been the victim of a sexual assault. You discover that she is 15 weeks pregnant. What is the most likely immediate or long term medical consequence of this assault?

A 31 year old G2P1001 has an uncomplicated prenatal course and vaginal delivery at 39 weeks gestation. Postpartum the neonate is noted to have significant bleeding at venipuncture. The most likely cause is:

You are seeing a 27 year old G1P0 for prenatal care. Her platelet counts have been normal throughout pregnancy, but her third trimester CBC is significant for platelet of 80,000. She denies spontaneous bleeding, petechiae, or easy bleeding. The most likely diagnosis is:

Your patient is a recent immigrant to the United States whose first visit is at 26 weeks. Initial labs demonstrate Rh isoimmunization with an anti D titer of 1:32. You recommend MCA Doppler velocimetry over serial amniocentesis for fetal surveillance because of its:

You are providing prenatal care of a pregnant patient with a Kell antibody titer of 1:132. The paternal Kell antigen status is negative. What is the next best step?

In a pregnant patient, which type of cancer is most likely to metastasize to the placenta and/or fetus?

A 29 year old G1P0 at 18 weeks pregnant with nausea, vomiting, and severe LLQ pain. Urinalysis reveals hypercalciuria and renal ultrasound shows a calculus in the left ureter. Serum parathyroid hormone (PTH) level. What is the most appropriate treatment?

A 39 year old G3P1011 with a history of chronic hypertension treated with diet and exercise presents for her first prenatal visit. You counsel her that if her blood pressure increases during pregnancy, you may need to begin an anti hypertensive agent. Which of the following is most appropriate first line medication?

You have a 37 year old G4P2103 who has developed preeclampsia at 28 weeks estimated gestational age. Which of the following would be the least likely reason for expedited delivery?

25 year old G3P0020 at 10 weeks estimated gestational age with a history of systemic lupus erythematous presents with a flare. What is the most appropriate treatment?

A 29 year old G1P0 at 39 weeks estimated gestational age has a history of Myasthenia Gravis. You advise her that after delivery, her neonate may require treatment with:

A review of a patient’s initial prenatal labs is significant for a positive Hepatitis B surface antigen. Which of the following is least important in the management of this patient’s pregnancy and delivery?

An 18 year old G1P0 at 12 4/7 weeks gestation presents with pain that started peri umbilically and then gradually migrated to the right lower quadrant. She also complains of nausea and vomiting, and is acutely tender on exam. Which of the following will best help to establish your diagnosis?

What is the most likely pregnancy outcome for a patient who contracts Parovirus B19 causing erythema infectiosum (Fifth Disease) in the first trimester?

A 27 year old G2P1001 at 38 weeks gestation with a history of herpes simplex, present to labor and delivery with strong, regular uterine contractions. Her cervical exam is 5/80/ 1. Which of the following would be an indication for cesarean delivery?

Your patient is 3 weeks postpartum and exclusively nursing. She presents with pain in her right breast and a fever of 102.7 F. On exam, the lower outer quadrant of her breast is swollen, erythematous, and tender to palpation. What is the most likely causative organism?

A 31-year-old term pregnant patient with paraplegia presents to obstetrical triage in early labor. What is the most effective medication to prevent autonomic hyperreflexia?

During the second stage of labor, the sensory nerve fibers that transmit pain to S2-4 travel through which nerve?

Your medical student is studying meconium aspiration syndrome, and asks which of the following neonates is least likely to pass meconium in utero?

Your patient is a 38-year-old G3P2002 at 41 0/7 with a history of one prior cesarean delivery who is admitted in early labor. You are called to see her for a new complaint of a sharp, constant abdominal pain.
You plan to evaluate for the possibility of uterine rupture. What is the most common finding in uterine rupture?

Your patient is a 27-year-old G1P0 newly diagnosed at 22 weeks with a fetal demise. What is the safest and most effective management?

Your patient is a 31-year-old G1P0 at 41 6/7 weeks being induced with misoprostol for post-term gestation. Her fetus is noted to be 4300g on ultrasound in occiput posterior position. She has an epidural in place. Which factor is least likely to be implicated in a protracted labor?

A 36-year-old G4P1021 at 36 weeks gestation presents to labor and delivery with vaginal bleeding. Upon evaluation, she has bright red vaginal bleeding and fetal monitoring is significant for contractions every 5 minutes and repetitive variable decelerations. Which of the following is the greatest risk factor for this condition?

After the delivery of a 4100g infant via outlet forceps with a right mediolateral episiotomy, you identify a fourth-degree laceration. Which of the following was likely the greatest contributor to the development of the Obstetrical laceration?

A 35-year-old G2P2 presents 7 days postpartum with perineal pain and foul discharge. Delivery was complicated by a midline episiotomy with a 3rd degree laceration.  Their temp is 100.2, with a red, indurated suture line at the repair site. When you cut the suture, the large wound opens revealing slightly necrotic issue at the wound edges. What is the most appropriate treatment?

You are called to assist a colleague in the delivery of a 42-week infant. Which of the following is least likely to complicate this delivery and the early neonatal period?

Your patient undergoes a vacuum-assisted delivery for a Category 2 tracing ending in a terminal bradycardia. Which of the following is the weakest predictor of a poor long-term prognosis for this neonate?

What is the oxygen pressure (PO2) in the fetal umbilical vein?

A 25-year-old G0 presents to the emergency department having had heavy vaginal bleeding for several days and complains of weakness. Her hemoglobin in 6.5g/dl. Which will control her bleeding the fastest?

Uterine artery embolization is most appropriate for which type of fibroid?

Uterine artery embolization is thought detrimental in women who desire a pregnancy. In the event of a pregnancy following embolization, Which of the following adverse events is not increased by embolization?

Which patient is the best candidate for endometrial ablation?

A 30-year-old G1 presents at 20 weeks gestation with a 4cm unilocular cyst. What is the most appropriate management?

Which of these blood vessels does not originate at the Aorta?

Where  is the ureter found when the broad ligament is opened?

Which artery should be avoided when performing a hypogastric artery ligation?

Which of the following is a direct branch of the aorta?

The left ovarian vein empties into which vein?

All the following ligaments provide support of the uterus, except:

Which of the following is the strongest contradiction to methotrexate?

Methotrexate inhibits which portion of the cell cycle?

An ectopic can implant at any portion along with the fallopian tube. Which site in the fallopian tube is associated with the highest morbidity and mortality?

A 19-year-old G1 has a laparoscopic salpingectomy for an ectopic pregnancy. What is the risk of recurrent ectopic pregnancy?

A patient presents to the ED with first trimester bleeding. An ultrasound does not reveal any evidence of products of conception in the uterus. What quantitative hCG value would strongly predict an ectopic or abnormal pregnancy?

What is the most likely complication of an induced abortion?

Where would you be least likely to injure the ureter during a TAH/BSO?

Which chemotherapeutic agent inadvertently used during pregnancy is most likely to result in a birth defect?

In which cancer is chemotherapy the most effective in the treatment for recurrent disease?

A BRCA carrier is most likely to develop what cancer?

A 38 year old G2P2 is BRCA-1 positive. What is the best way for her to lower her risk of breast cancer?

In a patient with invasive breast cancer, which characteristic below is the best predictor of relapse and survival?

What is the inheritance pattern of BRCA-1 and BRCA-2?

A postmenopausal patient has been placed on anastrozole rather than tamoxifen by her oncologist for the treatment of breast cancer. Which of the following would the patient be most at risk for while on anastrozole?

A woman with postmenopausal invasive breast cancer, treated initially five years ago with surgery and chemotherapy, just completed five years of Tamoxifen. Which medication lowers her risk of recurrence the most?

A 40 year old woman with a 3m breast cyst has a fine needle aspirate of dark green fluid. What is the most likely diagnosis?

A 38 year old woman presents with a serosanguinous left nipple discharge. What is the most likely diagnosis?

A nulliparous woman is at greatest risk for developing which of the following cancers?

What genetic mutation has the highest risk of breast cancer?

The most likely cause of bloody nipple discharge is?

A patient is diagnosed with breast cancer in pregnancy and receives radiation therapy during the late second trimester. If the fetus survives, what is the most likely outcome?

Tamoxifen’s mechanism of action is similar to which of the following?

Which of these histological findings has the least risk for progressing to breast cancer?

Which of the following breast conditions is often confused with carcinoma of the breast?

What is the best predictor of survival from breast carcinoma?

What is the most appropriate management of an atypical glandular cells (AGC) Pap smear in a post-menopausal female?

Which patient is not a candidate for the Gardasil vaccine?

The HPV vaccine protects against which HPV genotypes that cause cancer?

What type of vaccine is Gardasil?

A 35 year old is referred to you with atypical glandular cells on her screening Pap. What is the last appropriate in the initial workup?

Which of the following is not used to describe colposcopic findings of dysplasia?

A 28 year old G0 underwent a cold knife conization (CKC) for adenocarcinoma-in-situ. The pathologist reports positive margins. She wants to preserve her fertility. What is the most appropriate next step?

The most common complication of radical hysterectomy is:

A 30 year old woman who desires full fertility presents with a cervical cancer which is 1.5mm deep. What is the treatment?

Which lymph nodes are the most common site of metastasis for cervical cancer?

What are the first lymph nodes involved with cervical cancer?

What is the most appropriate for patient with cervical cancer staged as a 3B?

A 31 year old G0 is diagnosed with FIGO stage A1 cervical cancer. She desires to have fertility sparing treatment if this would not put her at increased risk of recurrence. What is the most appropriate treatment?

What is the most common fallopian tube cancer?

Which of the following symptoms is pathognomonic for fallopian tube cancer?

Which of the ultrasound characteristics below is most likely associated with an ovarian malignancy?

A 65 year old menopausal female has 6 cm adnexal mass found on ultrasound. Which of the following is the most likely diagnosis?

Which of the following is least likely to decrease a patients risk of ovarian cancer?

Which method below is the best screen for ovarian cancer in woman who has an average risk?

A nulligravida at 19 weeks has a suspected immature teratoma. She is asymptomatic. What is the best management?

Which of the following ovarian cancer subtypes is the most common in post-menopausal women?