IMS Quiz Committee

Choose only one best answer

Q1.Pregnane derivatives are 21 carbon, Androstane are 19 -Carbon and Estrane derivatives are

a) 17 carbon
b)18 carbon
c) 20 carbon
d) 27 carbon

Q2.Choose the wrong answer

a) The main circulating hormone of Menopause is Estradiol (E2) and that of reproductive years is Estrone(E1)
b) ER alpha and ER beta receptors are present in many organs of the body.
c) Estrogen Receptors Alpha are present mainly in liver.
d) Estetrol(E4) ,a low potency Estrogen, present during pregnancy is mainly produced from fetal liver.

Q3.Choose the wrong answer

a) Progesterone is not measurable in menopausal women.
b) Estrogens increase HDL and decrease LDL and Lipoproteins.
c) During Menopause the E2 level drops to 2,000pg/ml.
d) Ethinyl Estradiol is 40,000 times more potent than 17beta Estradiol (if it's value is taken as 100).

Q4.Choose the wrong answer

a) Among the testosterone derivatives Levonorgestrel(LNG) is 10-20 times and Norgestrel is 5-10 times more potent than Norethindrone.
b)If the potency of NETA -Norethisterone Acetate is taken as 1,then MPA -Medroxy Progesterone Acetate was 10 times ,dydrogesterone 50 times and Progesterone 500times less potent than NETA.
c) Estradiol is 10 times more potent than Estrone and 80 times more potent than estriol.
d) All of the above.

Q5. Testosterone levels are ____ than Estradiol concentrations in post menopausal women.

a) higher
b) lower
c) negligible
d) same

State True or False

Q6. Progestogens are routinely included in Hormone Therapy in hysterectomised women

Q7. Androgenic Progestins like Medroxy Progesterone Acetate or NETA have not been implicated in increasing the risk of breast cancer and coronary heart disease.

Q8. In the Adrenals,Ovary and peripheral target cells, DHEA is converted to Androstenedione and Testosterone, and both can be aromatised to Estrogens.

Q9. Estrogen deficiency causes breast and uterine cancer, fibroids, endometriosis and venous thromboembolism.

Q10. Natural micronized Progesterone and the non androgenic forms of Progesterone like dydrogesterone, or Drospirenone have a less favourable metabolic profile and should not be preferred in obese, post menopausal women with Insulin resistance or DM.

Quiz Answers

Q1. b
Q2. a
Q3. c
Q4. d
Q5. a
Q6. False
Q7. False
Q8. True
Q9. False
Q10. False

Dr Neelam Jain
Chairperson Quiz Committee IMS 2022-2024

Next topic for Quiz on 31/07/2022 would be Basics of Menopause

Choose only one best answer

Q1. An epileptic woman on COC's may face a higher failure rate due to interaction with anti epileptic drugs that are 'liver enzyme inducing ' drugs except

a) Sodium Valproate
b) Phenytoin
c) Carbamazepine
d) Primidone

Q2) Saheli (Centchroman) is a non steroidal contraceptive taken as a tablet 30mg twice weekly for a period of ___ weeks and then weekly there after.

a) 4 weeks
b) 8 weeks
c) 12 weeks
d) 16 weeks.

Q 3).In a 35 day menstrual cycle, ovulation will occur on ___ day, so the risk period is from D18 -D 24

a) 18th
b) 19th
c) 21st
d) 24th

Q4.Toxic shock syndrome can occur most commonly with the following contraceptive

a) Diaphragm
b) Seasonale
c) Norplant
d) POP

Q5. The emergency contraceptive pill has the following Progesterone

a) Desogestrel
b) Levonorgestrel
c) Drospirenone
d) Cyproterone Acetate

State True or False

6) Antara (DMPA) cannot be given upto 6weeks postpartum in a breastfeeding woman

7) A Progesterone only pill Drospirenone may decrease Blood Pressure because of it's antimineralocorticoid action.

8)Implanon(etonorgestrel)has 6 rods while Norplant has only rod.

9) If a woman is diabetic, hypertensive and a smoker then she should be advised combined oral contraceptives.

10) If a woman has Cu 375 IUD inserted after the age of 40 years, she may retain the intrauterine device until Menopause.

Quiz Answers

1. a
2. c
3. c
4. a
5. b
6 .True
7. True
8. False
9. False
10.True

Dr Neelam Jain
Chairperson Quiz Committee IMS 2022-2024

Next topic for Quiz on 17/07/2022 would be Estrogens and Progestogens

Choose only one best answer

Q1.__% of Endometrial Cancer in Post Menopausal period present with Post Menopausal bleeding
a)40%
b)60%
c)70%
d)90%

Q.2.In homogeneous and normal morphology, women on hormone therapy and hypertensive medication, the acceptable combined endometrial thickness is-
a) 3 mm
b) 4 mm
c) 5 mm
d)6mm

Q.3 All are correct except
a) FIGO stage llB for endometrial Cancer means -Cervical stromal invasion.
b) Women with PMB with an endometrial thickness of less than or equal to 4mm in TV scan generally do not require sampling.
c) Women on Tamoxifen for treatment and prevention of CA Breast have a decreased risk of endometrial carcinoma.
d) Estrogen or Androgen producing tumor of ovary or suprarenal need surgery.

Q.4 Post Menopausal bleeding is also associated with other non endometrial Cancers.The most common of these is a) Fallopian tube Cancer
b) Breast Cancer
c) Cancer of the cervix
d) Colorectal Cancer

Q.5.____ is considered gold standard for evaluating endometrium
a) Pipelle
b) Hysteroscopy
c) Vibra Aspirator
d) Colposcopy

State True or False

Q6. The common precursor of endometrial Cancer is atrophic endometrium

Q7. Obesity increases endogenous estrogen .

Q8. Multiparity appears to confer a 2 -fold risk of developing endometrial Cancer.

Q9. PET-CT reveals metabolic activity in the tissue and is a gold standard for staging.

Q10. The lifetime risk of endometrial Cancer in HNPCC mutation is as high as 60%.

Quiz Answers

1. d
2 .d
3. c
4. c
5. b
6. False
7. True
8. False
9. True
10.True

Dr Neelam Jain
Chairperson Quiz Committee IMS 2022-2024

Next topic for Quiz on 03/07/2022 would be PERIMENOPAUSAL CONTRACEPTION