1. Which of the following may be involved in the pathophysiology of twin-twin transfusion?

2. The majority of pregnancies with upper GI bleeding have which of the following?

3. Which of the following has the most influence on iron stores in the infant?

4. What is the fetal or neonatal risk of maternal ITP?

5. What is the most common form of cancer encountered in pregnancy?

6. On examination, a 12-year-old female demonstrates the following sexual characteristics: a secondary mound of areola and papilla above the breasts bilaterally and abundant, adult-type hair limited to the mons pubis. What is her Tanner stage of Development?

7. A 35-year-old Caucasian female presents to your office for amenorrhea for the last 6 months. Lab results reveal a negative pregnancy test, a normal TSH, and a normal prolactin. Her LH is normal at 6 mIU/ml. Her FSH is 50 mIU/ml and estradiol is 30 pg/ml. A 12 day regimen of Provera fails to cause vaginal bleeding. Her diagnosis is:

8. Your patient is a 26 year old caucasian, nulliparous female with complaints of depressed mood, lack of energy, insomnia, irritability, anxiety, and breast tenderness to such a degree that it has affected her performance at work. She states that these symptoms are only associated with the days prior to menses. You recommend the following treatment

9. During your patient's annual gynecology physical exam she complains of an odd discharge. On exam you note a white vaginal discharge and collect a specimen to view under the microscope. While performing the KOH and Wet Prep you note an odd foul odor and numerous squamous cells laden with bacteria. You also note a vaginal pH of 5.0. What are the best treatment options for this patient?

10. This describes multiple anomalies due to a single malformation.

11. This describes an abnormal form, shape, or position of a part of the body due to mechanical force.

12. This describes a defect that results from a developmental process which has been abnormal from the beginning of conception at very early in the life of the embryo.

13. This describes a developmental defect that results from an intrinsic or extrinsic factor that interferes with the normal development process.

14. This describes multiple anomalies resulting from a single known or presumed malformation, deformation, or disruption.

15. Occurrence of multiple anomalies associated with a known or unknown malformation in two or more persons.

16. The major source of lubrication during sexual arousal is

17. A 22-year-old primigravid woman is in labor at term. X-ray pelvimetry is obtained after failure of labor to progress with the cervix dilated 6 cm and the fetal vertex at -2 station. Clinical pelvimetry shows a diagonal conjugate of 11 cm, convergent pelvic sidewalls, prominent ischial spines, a narrow sacrosciatic notch, and forward inclination of the sacrum. The pelvis is

18. A 22-year-old woman has a biopsy-proven carcinoma-in-situ of a single warty lesion in the posterior fourchette. The best treatment is

19. In performing an omentectomy, which of the following should be ligated?

20. Ten hours after a rapid vaginal delivery, a patient has lower abdominal and pelvic pain. She appears pale, her pulse is 125/min, and her blood pressure is 80/40 mm Hg. A right adnexal mass is palpable on both pelvic and abdominal examinations. The most likely diagnosis is

21. You are called to labor and delivery to see a patient who has a sinusoidal tracing pattern


Which of the following is the most likely etiology of the fetal tracing?

22. The most intense sensory mode of erotic stimulation is

23. A 21-year-old nulliparous woman has a history of regular menses occurring every 30 days. It is now 16 days after the date of her expected period and she is having light vaginal spotting. A quantitative beta-HCG assay showed 140,000 mIU/ml. Which of the following is the most likely diagnosis?

24. Of the following, which is the most common cause of immediate postpartum hemorrhage?

25. A 24-year-old American woman, gravida 2, para 1, previously delivered an anencephalic infant. She now is 8 weeks\' gestation and seeks your advice concerning the possibility of having a second affected infant. You should inform her that the risk of a neural tube defect in the next pregnancy is

26. A 20-year-old, gravida 1, is bearing down uncontrollably with painful contractions in the second stage of labor. Lidocaine 35mg is administered for spinal block. Three minutes after being turned from the lateral recumbent position onto her back, she has numbness and tingling of both hands followed by respiratory depression. The most likely explanation is

27. A 78-year-old woman has biopsy-confirmed squamous cell carcinoma of the clitoris. The lesion is 3 x 2 cm, ulcerated and infiltrating the left labium majus. The urethra, vagina, and rectum are clinically uninvolved. The groin nodes are palpable, small (less than 0.5 cm), soft, and freely movable. Findings on a roentgenogram of the chest are unremarkable. This carcinoma is stage

28. An 18-year-old primigravid woman is at 26 weeks\' gestation. Culture of a mucopurulent endocervical discharge is positive for Chlamydia trachomatis. Which of the following antibiotics would be most appropriate for treatment of this infection?

29. A 22-year-old girl is being evaluated for primary amenorrhea. She is 155 cm (61 in) tall and sexually infantile. The cervix is visualized and the uterus palpated. She does not have phenotypic features of Turner's syndrome. The most appropriate next step in the management of this patient is to

30. The wolffian duct empties into the

31. In living tissue the biologic (therapeutic) effects of irradiation depend on the presence of

32. You are called to the ED to evaluate a patient. She is a 32yo G0 who has been taking gonadotropins for infertility. She is experiencing severe abdominal pain and SOB. Physical examination reveals ascites. Ultrasound reveals ovaries >6cm in size bilaterally. Laboratory findings suggest renal failure. Which of the following medications should she receive?

33. Dihydrotestosterone (DHT) is the major androgen working at the hair follicle. Testosterone is converted to DHT by which of the following enzymes?

34. Which of the following is considered to be a benefit of subtotal hysterectomy?

35. A patient with hemoglobin AS is NOT at increased risk for which of the following?

36. Two days post op from an unscheduled cesarean section, secondary to presumed abruption, a patient develops a fever of 101.1 F. Which of the following is the greatest risk factor for this condition?

37. Which of the following regarding prediction of preterm delivery is true?

38. A patient comes to you complaining of a chronic, relapsing pattern of abdominopelvic pain and bowel dysfunction with constipation and/or diarrhea. Which of the following is true?

39. Which of the following is correct regarding cystic fibrosis screening?

40. The fetus of which mother has the highest risk of developing a hemolytic disease:

41. The maternal mortality rate for patients with Marfan's syndrome is:

42. ACOG recommends first visit to the OB/GYN for screening and provision of preventative health care services and guidance occurs between ages:

43. A 26yo AFrican American female with documetned sickle cell disease presents to your office with severe chest and joing pain with fevers. Patient denies productive cough however reports difficulty breating. An office CXR is completed which reveals pulmonary infiltrate SaO2 is 87 on RA revealing oeidosis. What disease process is being completed

44. The human placenta is

45. Angiotensin converting enzyme converts:

46. An invasive squamous cell carcinoma of the vulva measuring 2.8 cm in a patient with no suspicious groin nodes is FIGO stage:

47. The recommended intravenous dose of epinephrine in patients with cardiovascular collapse is

48. A patient has recently undergone a third spontaneous abortion, and the 8-week fetus is found to have a chromosomal anomaly. Which of the following would be the most likely karyotype of the fetus?

49. The proportion of first-trimester abortions attributable to chromosomal abnormalities is approximately

50. A 22-year-old woman who delivered her first infant 17 days ago has a six-hour history of malaise, fever to 38.9C (102F) and pain in the right breast and axilla. Physical examination shows a 4-cm erythematous, tender area in the upper outer quadrant of the right breast and enlarge axillary lymph nodes. Which of the following antibiotics is most appropriate for treatment of this condition?