HST 071 Final Examination October 26, 2005 Instructions: This is a closed-book exam. Allow yourself up to 3 hours to complete the exam. Please write only one answer per question on the answer sheet. If more than one answer is circled, the question will be marked as incorrect. 1. What is the function of the epididymis? a. To make sperm b. To store sperm c. To make testosterone d. To capacitate sperm e. none of the above 2. What is the normal sperm count for a male? a. 1,500 b. 15,000 c. 150,000 d. 1,500,000 e. 15,000,000 3. What do Cowper’s glands do? a. Increase the volume of the ejaculate significantly b. Secrete alkaline fluid to neutralize the acidic urethra and acidic vagina c. Secrete fructose into the ejaculate d. Secrete citric acid into the ejaculate e. Secrete proteases that help penetrate the female cervical mucus into the ejaculate 4. All of the following apply to Sildenafil except: a. Inhibition of PDE5 b. Reduction of smooth muscle vasoconstriction c. Increase in cAMP levels d. Inhibition of PDE6 e. Contraindicated in patients taking nitroglycerin 5. What is the most common presenting complaint of a woman with endometriosis? a. Dyspareunia b. Vaginal bleeding c. Pelvic pain, especially during menses d. Fever e. Irregular menses 1 Harvard-MIT Division of Health Sciences and TechnologyHST.071: Human Reproductive BiologyCourse Director: Professor Henry Klapholz6. Order the following, with respect to the normal menstrual cycle: i. LH surge ii. Increase in progesterone levels iii. Ovulation iv. Selection of a dominant follicle v. hyperplasia of endometrial layer a. iv, ii, i, iii, v b. iii, iv, i, ii, v c. i, iv, ii, iii, v d. iv, v, i, iii, ii 7. All of the following are stromal cell tumors of the ovary except: a. Sertoli cell tumor b. Leydig cell tumor c. Granulosa cell tumor d. Brenner-transitional cell e. Sex cord tumor 8. A 37 yo woman presents with right lower quadrant abdominal pain and an elevated CA-125. On ultrasound imaging, she is found to have a large right adnexal mass, with solid and cystic areas, within the tumor. Biopsy reveals ovarian cancer. Pathology shows extension of the mass into the uterus, but without evidence of rupture or extension into any other pelvic organs. The left ovary was uninvolved, peritoneal fluid cytology was negative, and lymph node biopsy was normal. What is the staging of this tumor? a. Stage IA b. Stage IIA c. Stage IIIB d. Stage IV 9. Which of the following organisms can cause Toxic Shock Syndrome? a. Staph aureus b. Group A strep c. Clostridium Perfringens d. a + b e. All of the above 210. Of the following, which woman is the best candidate for the female condom? a. 16 year old high school student who has never had sex, but wishes to start with her new 18-year-old boyfriend b. 29 year old secretary who has been married for 7 years, and is in a monogamous relationship with her husband. c. 40 year old obese smoker whose partner refuses to wear condoms d. 34 year old woman who has three children and had a post-partum tubal ligation 11. Which of the following is true about the spermicide, nonoxynol-9: a. Reduces the risk of HIV transmission b. Reduces the risk of Gonorrhea transmission c. Reduces the risk of C. trachomatis transmission d. Some contraceptives containing this may increase the risk of HIV transmission e. b + c 12. All of the following can be indications for oral contraceptive therapy except: a. Polycystic Ovarian Syndrome b. Catamenial migraine headaches c. Endometriosis d. Ovarian failure e. Pre-menstrual syndrome 13. Which of the following mechanisms best explains the contraceptive effect of birth control pills that contain both synthetic estrogen and progestin? a. Direct inhibition of oocyte maturation b. Inhibition of ovulation c. Production of uterine secretions that are toxic to the developing embryo d. Impairment of implantation e. Impairment of sperm transport due to uterotubal obstruction 14. Which of the following is NOT considered to have phytoestrogen-like properties? a. Black Cohosh b. Soy c. Ginger d. Ginseng e. Bugbane 315. Which of the following in NOT a cell type present in the mature human placenta? a. Macrophages b. Fibrocytes c. Cytotrophoblast d. Epiblastic cells e. Endothelial cells 16. Which of the following placental characteristics has poor prognostic implications for the baby? a. 3-vessel umbilical cord present b. Meconium stained placenta at 41 wks gestation, with no grossly visible meconium during delivery c. Velamentous cord insertion d. Thrombosis of placental vessels e. Maternal Floor infarct 17. A 19 year old primigravida is expecting her first-child; She is 12 weeks pregnant by last menstrual period dating. She has vaginal bleeding and an enlarged-for-dates uterus. In addition, no fetal heart sounds are heard. An ultrasound is obtained that shows a hydatidiform mole. The uterus is evacuated and no clinical or radiographic evidence is found of metastatic disease. How should this woman now be managed? a. Weekly hCG titers b. Hysterectomy c. Single-agent chemotherapy d. Combination chemotherapy e. Radiation combined with chemotherapy 18. Indications for instituting single-agent chemotherapy following evacuation of a hydatidiform mole usually include: a. A rise in hCG titers b. A plateau of hCG titers for 1 week c. Return of hCG titer to normal 6 weeks after evacuation d. Appearance of liver metastases e. Appearance of brain metastases 419-20. A 20-year-old G3P0 (3 pregnancies, 0 full-term births) comes to your office for a routine gynecological exam. She is single and sexually active. She has a history of 5 sexual partners in the past, and started having sex at age 15. She has had three first-trimester voluntary pregnancy terminations, uses Depo-Provera (Medroxyprogesterone acetate) for birth control, and occasionally condoms. She was treated for Chlamydia last year but denies any prior history of abnormal pap smears. She denies use of illicit drugs, but smokes 1 pack per day. Her physical exam is normal. Her pap smear returns showing a high-grade squamous intraepithelial lesion. 19. All of the following are risk factors for cervical dysplasia in this patient’s history except: a. Young age at initiation of sexual activity b. Multiple sexual partners c. Previous history of Chlamydia d. Use of Depo-Provera e. Smoking 20. What is the next most appropriate step in the management of this