Reproductive Biology Test



Reproductive Biology Test

Version 1

1. Which of the following has a positive stimulatory effect on gonadotropin releasing

hormone production?

A. Prolactin

B. Morphine

C. Leptin

D. Corticotropin releasing hormone

E. Cytokines

2. Identify the correct statement regarding gonadotropin releasing hormone (GNRH)

A. Calcium is not a requirement for its action

B. Pulsatility is more frequent in the luteal phase

C. Regulated by sex steroids

D. Constant GNRH exposure maintains cellular luteinizing hormone pools

E. A polypeptide with alpha and beta subunits

3. Identify the correct statement concerning the gonadotropins, luteinizing hormone (LH)

and follicle stimulating hormone (FSH).

A. Activin releases LH

B. Higher FSH concentrations occur in androgen excess disorders

C. Both LH and FSH stimulate theca cell aromatase

D. The mid-cycle LH surge occurs through estrogen negative feedback

E. Beta subunit confers biological specificity

4. A 33 year old woman attends for evaluation of infertility. Blood tests reveal a serum LH

(luteinizing hormone) and FSH (follicle stimulating hormone) of 24 and 15 international

units per liter respectively (normal follicular phase 3-10 international units). Which of

the following possibilities are these results consistent with?

A. Polycystic ovary syndrome

B. The mid-cycle surge

C. Anorexia nervosa

D. Pregnancy

E. Prolactinoma

5. A 14 year old female with a history of pelvic pain a few weeks prior has a pelvic

ultrasound performed on the day of her visit. The ultrasound showed a midline mass.

Blood tests, performed the same day, showed serum progesterone of 9.0 ng/ml,

estradiol of 100 pg/ml consistent with ovulation. Which of the following would you

consider as a diagnostic possibility?

A. Mullerian agenesis

B. Testicular feminization syndrome

C. Transverse vaginal septum

D. 46XY gonadal dysgenesis (Swyer Syndrome)

E. Partial uterine septum

6. A 29 year old attends the clinic with abnormally prolonged and erratic menstrual

bleeding. Blood tests and an endometrial biopsy are performed and she is

informed that she is exhibiting anovulatory bleeding. Which of the following

would be consistent with this statement?

A. Glycogen in lumen of glands

B. Luteinizing hormone level of 15, follicle stimulating hormone level of 4

international units /liter respectively

C. Stromal decidual reaction

D. Stromal edema

E. Serum progesterone of 6 ng/ml [Follicular phase 6 months

D. Excessive alcohol intake

E. Obesity

50. A factor that appears to affect the age of a woman's menopause is:

A. Number of term pregnancies

B. Use of oral contraceptives

C. Race

D. Smoking

E. Age of menarche

51. Which are the changes in hormone production in the late post-menopausal years.?

FSH = Follicle stimulating hormone

LH = Luteinizing hormone

A. FSH - ↑, LH -↓, testosterone -↑, estrogen - ↑

B. FSH - ↑, LH - ↑, testosterone - ↓, estrogen -↓

C. FSH - ↑, LH -↓, testosterone - ↓, estrogen -↓

D. FSH - ↓, LH - ↑, testosterone -↓, estrogen -↓

E. FSH - ↓, LH -↓, testosterone -↓, estrogen -↓

52. According to the Women's Health Initiative study of hormone therapy,

estrogen/progestin therapy does not

A. Reduce vasomotor symptoms

B. Reduce bone loss at the spine and femur

C. Increase the risk of breast cancer

D. Decrease the risk of cardiovascular disease

E. Increase the risk of thromboembolic disease

53. Which one is not an alternative treatment for menopausal symptoms?

A. Botanical phytoestrogens

B. Selective estrogen receptor modulators

C. Clonidine

D. Yoga

E. Selective serotonin reuptake inhibitor

54. A 55 year old comes to see you in your office for her annual exam. She is taking

small dose hormone therapy for relief of menopausal symptoms. Along with a

complete history and physical, mammogram, pap smear, routine lab work, and stool

hemoccult, you also need to schedule a screening

A. Dual energy x-ray absorptiometry scan

B. Full body computerized tomography scan

C. Pelvic ultrasound,

D. Colonoscopy

E. Echocardiogram

55. Which one is not a common symptom of menopause attributed to the decrease in

estrogen?

A. Dyspareunia

B. Psychological distress

C. Vasomotor symptoms

D. Osteoporosis

E. Vaginal dryness

56. Which of the following is false concerning undescended testes?

A. Undescended testes have an increase risk of torsion

B. Undescended testes have an increase risk for blunt injury

C. Undescended testes have poor sperm production

D. Surgery to correct undescended_testes reduces the risk of cancer formation

E. None of the above

57. Which of the following is false concerning male reproductive genetic defects?

A. Cystic fibrosis gene mutations can be passed along to offspring.

B. Y chromosome gene deletions can be passed along to offspring.

C. The chromosome defect 46XXY is associated with decrease male fertility.

D. Unilateral absence of the vas deferens results from a defined genetic abnormality

and hereditary.

E. The etiology (cause) of varicoceles is multi factorial.

58. The most common testicular tumor in men with a history of undescended testes is?

A. Yolk sac tumor

B. Seminoma tumor

C. Embryonal tumor

D. Leydig cell tumor

E. Sertoli cell tumor

59. In Utero testosterone release in the fetus is stimulated by?

A. Mullerian Inhibiting substance

B. Sertoli cell development

C. Human chorionic gonadotropin

D. Expression of 5 alpha reductase in the fetus

E. Development of spermatogonia

60. Which is/are the consequences of varicoceles on the testes?

A. Decreased testes volume

B. Impaired sperm quality

C. Poor Leydig cell function

D. Increased testes temperature

E. All of the above

61. In which stage of labor does cervical dilation take place?

A. Stage 1

B. Stage 2

C. Stage 3

D. Stage 4

62. The process by which the fetal biparietal diameter passes through the pelvic inlet is

called:

A. Effacement

B. Engagement

C. Extension

D. External rotation

63. In graphical assessment of labor, which of the following is the independent variable

(graphed on the x-axis)?

A. Dilation

B. Descent

C. Time

D. Velocity

64. Which of the following events is best avoided through proper management by the

third year medical student?

A. Uterine rupture

B. Abruption of the placenta

C. Uterine inverstion

D. Cord prolapse

65. Which of the following must be present to satisfy the definition of labor?

A. Uterine contractions

B. Cervical change (dilation, effacement)

C. Both a+b

D. Neither

66. When preparing for a vaginal delivery, it is a mistake to take your eyes off the vaginal

introitus.

A. True

B. False

67. What pelvic landmark is used to define station?

A. Pubic arch

B. Sacral promontory

C. Ischial spines

D. Ischial tuberosities

68. In the course of normal labor

A. Dilation of the cervix begins before descent of the fetal head

B. Dilation occurs after descent of the head

C. Nulliparous (no prior children) women labor faster than multiparous women

D. Effacement is something that happens to the fetus

69. During which phase of labor does what we call active labor occur?

A. Phase 0

B. Phase 1

C. Phase 2

D. Phase 3

70. Of the following listed, which may play a role in Sexual Dysfunction:

A. Medications

B. Chronic Medical Problems

C. Stress at work

D. Religion

E. All of the above

71. All of the following are important in achieving an section, except:

A. Sexual stimulation

B. Contraction of the smooth muscle

C. Nitric Oxice, which increases with stimulation

D. Cyclic guanosine monophosphate induced relaxation of the smooth muscle

E. Adequate vascular supply to the penis

72. Which of the following may benefit those with sexual difficulties?

A. Psychological counseling

B. Eros Clitoral Therapy Device

C. Hormone replacement therapy in women

D. Sildenafil

E. All of the above are beneficial

73. All of the following are differences in sexuality between men and women except:

A. The Orgasmic phase is the shortest

B. Puberty is the time when sexual behavior reaches its peak

C. Androgens are necessary for normal sexual arousal and excitability

D. Orgasm is biologically essential for reproduction

E. Conventional vaginal intercourse is the best way to elicit orgasm

74. Which phase of the sexual response cycle is MOST likely to be adversely affected by

medications taken to help with urinary incontinence (parasympathetic antagonist)?

A. Desire

B. Excitement

C. Plateau

D. Resolution

E. Orgasm

75. A 32 yr. old woman with three children presents to your office for an annual health

maintenance examination. She states that she is having difficulties with intimacy with

her husband. On further questioning, she admits that she has no interest in sexual

relations with her husband or anyone else.

The MOST likely diagnosis is:

A. Vaginismus disorder

B. Hypoactive sexual desire disorder

C. Female sexual arousal disorder

D. Female orgasmic disorder

E. Dyspareunia disorder

76. A 21 yr. old woman presents with the complaint of inability to insert a tampon or

undergo a pelvic examination. She becomes sexually aroused easily and is orgasmic.

However, when she and her partner attempt intercourse, she has involuntary

spasmodic contractions of her pelvic floor muscles.

You diagnose the condition as:

A. Dyspareunia

B. Hypoactive sexual desire disorder

C. Hypoactive arousal

D. Vaginismus

E. Phobic avoidance of sex

77. During pregnancy intragastric pressure is:

A. Increased

B. Decreased

C. Unchanged

78. During pregnancy lower esophageal sphincter tone is:

A. Increased

B. Decreased

C. Unchanged

79. During pregnancy intraesophageal pressures are:

A. Increased

B. Decreased

C. Unchanged

80. During pregnancy systemic vascular resistance is:

A. Increased

B. Decreased

C. Unchanged

81. During pregnancy cardiac output is:

A. Increased

B. Decreased

C. Unchanged

82. During pregnancy maternal heart rate is:

A. Increased

B. Decreased

C. Unchanged

83. During pregnancy blood pressure is:

A. Increased

B. Decreased

C. Unchanged

84. During pregnancy maternal tidal volume is:

A. Increased

B. Decreased

C. Unchanged

85. During pregnancy central venous pressure is:

A. Increased

B. Decreased

C. Unchanged

86. Which of the following hemodynamic values remain unchanged in pregnancy?

A. Systemic vascular resistance

B. Pulmonary vascular resistance

C. Colloid osmotic pressure

D. Pulmonary capillary wedge pressure

87. Insulin resistance occurs in normal (non-diabetic) pregnancies and is in part caused by

the effects of human placental lactogen (hPL), cortisol, progesterone, and estrogen.

Insulin secretion increases and all of the following maternal physiologic changes occur

EXCEPT

A. Hyperplasia of pancreatic beta cells

B. A decrease in lipids and free fatty acids

C. Mild fasting hypoglycemia

D. Posprandial hyperglycemia

88. The following hormone is used to assess gestational trophoblastic disease:

A. hCG (human chorionic gonadotropin)

B. Estriol (E3)

C. Estradiol - 17ß (E2)

D. hPL (human placental lactogen)

E. Progesterone

89. The metabolic actions of this placental protein hormone include lipolysis and

anti-insulin effect by favoring protein synthesis (diabetogenic):

A. hCG (human chorionic gonadotropin)

B. Estriol (E3)

C. Estradiol - 17ß (E2)

D. hPL (human placental lactogen)

E. Progesterone

90. Uses of this placental protein hormone include confirmation of pregnancy, monitoring

the outcome of a threatened abortion, and in the evaluation of an ectopic pregnancy:

A. hCG (human chorionic gonadotropin)

B. Estrol (E3)

C. Estradiol - 17ß (E2)

D. hPL (human placental lactogen)

E. Progesterone

91. Which steroid hormone is the main estrogen of pregnancy and has 18 carbon atoms:

A. hCG (human chorionic gonadotropin)

B. Estriol (E3)

C. Estradiol - 17ß (E2)

D. hPL (human placental lactogen)

E. Progesterone

92. What is the average increase in maternal blood volume during pregnancy?

A. 10%

B. 25%

C. 40%

D. 75%

93. The maximum levels of hCG (human chorionic gonadotropin) in maternal serum occur

at what week of pregnancy?

A. 4th

B. 10th

C. 16th

D. 20th

94. Which of the following not true of hPL (human placental lactogen)?

A. Structurally similar to growth hormone

B. Levels peak early in gestation, then decline

C. Metabolic role not completely understood

D. Produced mostly by trophoblasts

95. Which of the following is characteristic of human milk composition:

A. Lacks DHA (docosahexaenoic acid)

B. Acellular composition

C. Fat content constant over time

D. Primary protein lactalbumin

E. High levels of Vitamin K

96. The component of the breast which is responsive to oxytocin resulting inmilk ejection is

the:

A. Lactiferous sinus

B. Montgomery's gland

C. Cooper's ligament

D. Myoepithelial cell

E. Paraventricular nuclei

97. Which of the following is NOT a contraindication for breastfeeding in the United States:

A. Untreated active maternal tuberculosis

B. Maternal Hepatitis B

C. Infant galactosemia

D. Maternal Human Immunodeficiency Virus

E. Maternal active Herpes Simplex Virus involving the areola

98. Which of the following hospital policies is supportive of breastfeeding:

A. Early initiation of breastfeeding in the first hour after birth

B. Routine use of formula supplementation until mother's milk comes in

C. Early introduction of pacifiers to avoid excessive nursing until the milk "comes-in"

D. Scheduled feeding patterns

E. Separation of infants and mothers in the initial 24 hours to allow mother to recover

from routine delivery.

99. Reported effects of breastfeeding include all of the following EXCEPT:

A. Decreased maternal risk of breast cancer

B. Earlier return to ovulation

C. Reduced risk of infant respiratory infections

D. Decreased risk of necrotizing enterocolitis in premature infants

E. Decreased risk and severity of infant diarrheal illness

100. Which of the following is true about supplementation of breastfed infants:

A. Vitamin K is present in sufficient quantities in the milk until the infant is 4 months old

when oral vitamin K drops should be added.

B. Nutritional supplementation should be started when infants fail to gain weight by

day of life 3.

C. Fluoride supplementation should be started at birth.

D. Vitamin D supplementation should be considered in the 2nd month of life for

breastfed infants

E. Breastfed infants should begin iron supplementation at hospital discharge.

Reproductive Biology Version 1 Answers

| | | |

|1. C |43. D |85. A |

|2. C |44. A |86. D |

|3. E |45. B |87. B |

|4. C |46. D |88. A |

|5. E |47. B |89. D |

|6. B |48. D |90. A |

|7. C |49. E |91. B |

|8. E |50. D |92. C |

|9. E |51. B |93. D |

|10. E |52. D |94. B |

|11. A |53. B |95. D |

|12. E |54. D |96. D |

|13. E |55. B |97. B |

|14. C |56. D |98. A |

|15. B |57. D |99. B |

|16. D |58. B |100. B |

|17. D |59. C | |

|18. E |60. E | |

|19. D |61. A | |

|20. E |62. B | |

|21. C |63. C | |

|22. B |64. C | |

|23. A |65. C | |

|24. A |66. A | |

|25. B |67. B | |

|26. D |68. A | |

|27. E |69. C | |

|28. A |70. E | |

|29. A |71. B | |

|30. A |72. E | |

|31. E |73. A | |

|32. E |74. B | |

|33. B |75. B | |

|34. B |76. D | |

|35. D |77. A | |

|36. A |78. B | |

|37. B |79. A | |

|38. E |80. B | |

|39. D |81. A | |

|40. D |82. A | |

|41. C |83. A | |

|42. A |84. A | |

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