| 1. | The quadrivalent Human Papilloma Virus (HPV) recombinant vaccine is for girls and women ages 9 to 26. It is indicated for prevention of infection with several HPV Types. Although not all HPV infections can be prevented, the most common types of sexually transmitted genotype virus-like particles are included in the vaccine. The vaccine is used to treat all of the following conditions EXCEPT: | |
| A | Cervical cancer | |
| B | Cervical intraepithelial neoplasia (CIN), grade 2 and 3 | |
| C | Condyloma acuminata 2 and 3 | |
| => | D | Laryngeal papilloma |
| E | Vulvar intraepithelial neoplasia (VIN), grade 2 and 3 | |
| Your answer:
C GARDASIL is not indicated for prevention of laryngeal papilloma, which is usually acquired by the fetus via vertical transmission. Although GARDASIL is a Category B drug, it is currently not recommended for use in pregnant women. References: Merck & Co. package insert GARDASIL ACOG Committee Opinion #344, September 2006, HPV Vaccination |
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| 2. | A 26-year-old presents to your office for preconception counseling. What is the highest probability of pregnancy relative to ovulation? | |
| A | 5 days before ovulation | |
| => | B | 2 days before ovulation |
| C | 1 day before ovulation | |
| D | Day of ovulation | |
| E | 1 day after ovulation | |
| Your answer:
B A woman is fertile up to six days during each cycle: five days before ovulation, plus 24 hours after ovulation. There is approximately a 4% probability of pregnancy five days before ovulation. The highest probability (between 25-30%) occur on the two days preceding ovulation. The probability of conception drops to 8-10% during the 24 hours after ovulation. Reference: Explaining ovulation awareness-based family planning methods Victoria Jennings, PhD and Helain Landy, MD. Contemporary OB/GYN July, 2006 |
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| 3. | A patient undergoes hysterectomy and bilateral salpingo-oophorectomy for a pelvic mass. The pelvic mass is composed of a 7 cm lesion within the right ovary. Frozen section examination of the tumor demonstrates Call-Exner bodies. It is quite possible that the pathology specimen also demonstrates which of the following? | |
| A | A Brenner cell tumor of the ovary | |
| B | A fallopian tube cancer | |
| C | An ovarian epithelial carcinoma | |
| D | Clear cell carcinoma of the cervix | |
| => | E | Endometrial carcinoma |
| Your answer:
No Answer Call-Exner bodies are found in adult granulosa cell tumors. Such tumors often produce unopposed estrogens which may cause endometrial hyperplasia or an endometrial adenocarcinoma. Ioffe OB, Simsir A, Silverberg SG. Pathology. In: Practical Gynecologic Oncology, Berek JS, Hacker NF (eds), Lippincott, Williams and Wilkins, Philadelphia, 2005. [Page 221] |
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| 4. | All of the following typically may result in prescribing errors EXCEPT: | |
| => | A | 0.1 mg |
| B | 1.0 mg | |
| C | .1 mg | |
| D | 10.0 mg | |
| E | 01 mg | |
| Your answer:
A A leading zero should always precede a decimal expression of less than one. A terminal or trailing zero should never be used after a decimal. Reference: Mag Mutual Healthcare Risk Manager, Vol 12, #31, 2006 Overcoming Prescribing Errors |
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