CHAPTER 16

Reproductive

381
 382 Section II: Organ Systems • Questions

Q U E ST I O N S

1. A 53-year-old woman experiences hot flashes the image. Which of the following is the most
associated with menopause. She calls her pri- likely infectious organism?
mary care physician to ask for advice about the
risks and benefits of hormone replacement
therapy (HRT). Which of the following is a po-
tential benefit of HRT?
(A) Decreased risk of breast cancer
(B) Decreased risk of deep venous thrombosis
(C) Decreased risk of hip fracture
HIGH-YIELD SYSTEMS

(D) Decreased risk of myocardial infarction

(E) Decreased risk of stroke

2. A 38-year-old nulliparous woman comes to the

physician for an annual check-up. She reports
a 10-pack-year smoking history and a family
history of early mastectomy. Physical examina-
Reproduced, with permission, from Wolff K, Johnson RA,
tion is notable for a scaly patch on her right
Suurmond D. Fitzpatrick’s Color Atlas & Synopsis of Clinical
nipple. On palpation, there is a firm mass and Dermatology, 5th ed. New York: McGraw-Hill, 2005:
a clear discharge from the nipple. Which of Figure 27.15.
the following would most likely be seen on a
histological examination of this mass?
(A) Intralobular clusters of tumor cells (A) Candida albicans
(B) Large cells with clear halos (B) Chlamydia trachomatis
(C) Lymphocytic infiltration (C) Gardnerella vaginalis
(D) Necrosis (D) Neisseria gonorrhoeae
(E) Pools of mucus (E) Trichomonas vaginalis
Reproductive

(F) Proliferation of normal epithelial cells

5. A woman who is 31 weeks’ pregnant comes to
(G) Proliferation of normal glands and ducts
3. During hernia surgeries, it is important to iso-
late important structures in the inguinal canal
so that they do not become damaged and cause
a functional deficit. Which of the following
structures lies inside the inguinal canal but
outside of the spermatic cord?
(A) Ductus deferens
(B) Ilioinguinal nerve
(C) Pampiniform plexus
6. CT imaging of the pelvis performed on a
(D) Testicular artery
(E) Testicular lymphatic vessels
4. A 23-year-old sexually active woman presents
to her physician with a high temperature, pel-
vic pain, purulent cervical discharge, and cer-
vical motion tenderness. A Gram’s stain pre-
pared from a swab of the discharge is shown in
the emergency department with symptoms of
preeclampsia. The presence of which of the
following signs would change this initial diag-
nosis?
(A) Edema
(B) Hyperreflexia
(C) Hypertension
(D) Proteinuria
(E) Seizure
29-year-old African-American woman with dys-
menorrhea reveals uterine masses similar to
those seen in the image. Biopsy shows a
whorled pattern of smooth muscle. These
masses are most commonly associated with
which of the following conditions?

Reproduced, with permission, from PEIR Digital Library
(http://peir.net).
(A) Enlargement with menopause
(B) Enlargement with pregnancy
(C) Formation of chocolate cysts
(D) Malignant transformation
(E) Necrosis and hemorrhage
7. An endocrine research laboratory is investigat-
ing the regulation of the hypothalamic-pitu-
itary axis both through pharmacologic means
and by direct ablation of different regions of
the brains of chimpanzees. They find that ex-
tremely high doses of chlorpromazine as well
as destruction of the hypothalamus causes the
levels of a certain hormone to rise. Levels of
what hormone were found to be elevated?
(A) ADH
(B) Growth hormone
(C) Luteinizing hormone
(D) Oxytocin
(E) Prolactin
(F) Testosterone
(G) Thyroid-releasing hormone
8. A patient with a testicular tumor has blood
work done that shows a serum α-fetoprotein
level of 30 µg/mL (normal: <10 µg/mL).
Which of the following is the most likely age
range of this patient?
(A) 0–3 years
(B) 10–20 years
(C) 20–30 years
Chapter 16: Reproductive • Questions 383
(D) 30–40 years
(E) 40–50 years
9. A 25-year-old woman with a history of recur-
rent upper respiratory infections presents to her
physician with her fifth such infection in the
past year. She mentions that she may be get-
ting sick due to increased stress at home; she
and her husband have been trying to conceive
unsuccessfully for several years. The patient’s
WBC count, immunoglobulin, and platelet
levels are within normal limits. Which organi-
HIGH-YIELD SYSTEMS
zational unit represents the structure most
likely to be defective in this patient?
(A) Central pair with nine peripheral pairs of
microtubules
(B) Collagen α chains in triplets
(C) Multilobular nucleus with enzyme-filled
granules
(D) Numerous adjoining e-cadherin molecules
with actin filaments
(E) Two longer heavy chains and two shorter
light chains linked by disulfide bonds
10. A young couple is having trouble conceiving
and decides to undergo in vitro fertilization.
The woman begins treatment to stimulate ovu-
lation prior to ova collection and fertilization.
Which of the following hormones is most di-
Reproductive
rectly responsible for ovulation?
(A) Estrogen
(B) Follicle-stimulating hormone
(C) Gonadotropin-releasing hormone
(D) Human chorionic gonadotropin
(E) Luteinizing hormone
(F) Progesterone
11. A 57-year-old woman is scheduled for elective
hysterectomy. Severing which of the following
structures during surgery would disrupt the
most blood flow to the ipsilateral ovary?
(A) Cardinal ligament
(B) Fallopian tube
(C) Round ligament
(D) Suspensory ligament
(E) Ureter
 384 Section II: Organ Systems • Questions

12. Which of the following is the function of the
androgen-binding globulin?
(A) Binding of inhibin
(B) Binding of testosterone
(C) Conversion of testosterone into estrogen
(D) Inhibition of androgen secretion
(E) Testosterone transport
13. A 23-year-old woman who works as a prostitute
comes to the clinic for a follow-up appoint-
ment because the results of her Pap smear
showed a high-grade squamous intraepithelial
HIGH-YIELD SYSTEMS
16. A 64-year-old man visits his physician for an
annual examination. He complains of a recent
9.1-kg (20-lb) unintentional weight loss and
pain in his back and pelvis. Otherwise, he has
no complaints. His examination is notable for
point tenderness along his spine and pelvis. He
also had firm prostate nodules palpated on dig-
ital rectal examination. Which of the following
laboratory values would be expected in this pa-
tient?
PROSTATE

lesion. Which of the following strains of the SPECIFIC ALKALINE

human papillomavirus (HPV) is this condition CHOICE ANTIGEN CALCIUM PHOSPHATASE
most often associated with?
A ↓ ↓ ↓
(A) Strain L1-3
(B) Strains 1 and 2
B ↓ ↓ ↑
(C) Strains 6 and 11
(D) Strain 8
C ↑ ↓ ↓
(E) Strains 16 and 18
D ↑ ↓ ↑
14. Following a normal pregnancy and labor, a
baby is born to a young couple. The baby cries E ↑ ↑ ↓
immediately and has Apgar scores of 9 at both
1 and 5 minutes. While examining the baby,
the pediatrician at delivery notes that the baby
has some labial scrotal fusion and a phallus- (A) A
like organ. The baby is also hypotensive and (B) B
Reproductive

hypovolemic. Genotyping reveals a karyotype (C) C

of 46,XX. Which of the following is the most (D) D
likely cause of the patient’s physical findings (E) E
and symptoms?
17. A 57-year-old man with erectile dysfunction
(A) 11α-Hydroxylase deficiency
has cavernosography prior to surgery. Caverno-
(B) 17β-Hydroxylase deficiency
sography demonstrates a leak from the dorsal
(C) 21α-Hydroxylase deficiency
vein to the saphenous vein. Which of the fol-
(D) Mutation in the androgen receptor gene
lowing is the most likely cause of this patient’s
(E) 5α-Reductase deficiency
impotence?
15. A 50-year-old woman tells her physician that (A) Arterial insufficiency
she is concerned about her risk for developing (B) Hormonal impotence
endometrial cancer. Which of the following (C) Psychogenic impotence
factors poses the largest risk for developing en- (D) Somatosensory defect
dometrial cancer? (E) Venous outflow
(A) Alcoholism
18. A 26-year-old primigravida presents to her ob-
(B) Early sexual activity
stetrician for a check-up. One week earlier she
(C) Low-fiber diet
underwent a cesarean section because of fail-
(D) Multiparity
ure to progress. She says that she has been cry-
(E) Prolonged unopposed estrogen use
ing a lot over the past week and is worried that
 Chapter 16: Reproductive • Questions 385

it is not normal to feel like this. Which of the

following symptoms would make one more
suspicious about postpartum depression instead
of postpartum blues?
(A) Anxiety about the infant
(B) Easily fatigued
(C) Easily irritated
(D) Emotional lability
(E) Feeling hopeless

19. A 28-year-old woman presents to her physician

with concerns that she is unable to produce

HIGH-YIELD SYSTEMS
breast milk, despite having given birth approxi-
mately 1 month ago. On further questioning
she indicates she has been exceptionally thirsty
lately, and describes feelings of fatigue and
cold intolerance. Physical examination reveals
no abnormalities except a scarcity of axillary
hair. Laboratory tests reveal a serum sodium
level of 150 mEq/L and urinalysis reveals a Reproduced, with permission, from Chandrasoma P, Taylor
urine osmolality of 220 mOsm/kg. Which of CR. Concise Pathology, 3rd ed. New York: McGraw-Hill,
the following most likely increased the patient’s 1998: Figure 52-16.
risk of developing this condition?
(A) Abnormalities of the placenta (A) Galactorrhea
(B) Alcohol intake during pregnancy (B) Melena
(C) Endometriosis (C) Palpable gallbladder
(D) Gestational diabetes (D) Pearly papules on face
(E) Incorrect use of tampons (E) Supraclavicular lymphadenopathy

(F) Multiple sexual partners
(G) Pelvic inflammatory disease
20. A 46,XY infant is born with a nonsense muta-
tion in the SRY gene. Which of the following
will be the symptomatic manifestation of this
mutation?
(A) Female phenotype
(B) Female pseudohermaphrodite
(C) Male phenotype
(D) Male pseudohermaphrodite
(E) True hermaphrodite
21. Biopsy of a bilateral ovarian mass reveals
round, mucin-secreting cells, as seen in the im-
age. Which of the following other physical
findings might be found in a patient with this
condition?
Reproductive
22. A 25-year-old married woman who has been
trying to become pregnant for the past 5
months presents to the emergency department
with sudden and severe abdominal pain. Ultra-
sonography shows a mass in her left fallopian
tube with free fluid in the cul-de-sac. Previous
infection by which of the following agents most
likely put this patient at a higher risk for devel-
oping this complication?
(A) Chlamydia trachomatis
(B) Escherichia coli
(C) Herpes simplex virus
(D) Human papilloma virus
(E) Streptococcus agalactiae
 386 Section II: Organ Systems • Questions
23. A woman in her seventh month of pregnancy
asks her obstetrician why her breasts are enlarg-
ing. In which of the following locations is the
hormone responsible for breast milk produc-
tion synthesized?
(A) Adenohypophysis
(B) Corpus luteum
(C) Hypothalamus
(D) Placenta
(E) Syncytiotrophoblast
24. A 29-year-old sexually active woman presents
HIGH-YIELD SYSTEMS
to the clinic complaining of a malodorous,
fishy vaginal discharge for the past 2 weeks.
She notices the smell most after sexual activity
and does not complain of any pelvic pain. On
examination there is a thin, homogeneous,
grayish discharge coating her vaginal wall. Vag-
inal pH is 6.0, and urinalysis for β-human cho-
rionic gonadotropin (β-hCG) is negative. A sa-
line wet mount of the vaginal fluid is shown in
the image. What is the mechanism of action of
the antibiotic indicated for this condition?
Reproductive
Image courtesy of the Centers for Disease Control and Pre-
vention’s Public Heath Image Library; content provider M.
Rein.
(A) Binds to the 30S subunit of the ribosome
and prevents attachment of aminoacyl-
tRNA
(B) Inhibits DNA-dependent RNA polymerase
(C) Inhibits ergosterol synthesis
(D) Inhibits topoisomerase II
(E) Interacts with DNA to form toxic metabo-
lites in the bacterial cell
25. A 14-year-old boy is brought to the clinic by
his parents who are concerned because he has
not yet begun puberty. Laboratory results indi-
cate hypogonadism secondary to failure of the
hypothalamic-pituitary-gonadal axis. Which of
the following are possible adverse effects of the
treatment for this patient’s condition?
(A) Decreased serum LDL cholesterol levels
(B) Growth of scalp hair
(C) Increased spermatogenesis
(D) Nausea and vomiting
(E) Premature closing of the epiphyseal plates
26. A 26-year-old woman presents to her gynecolo-
gist with a purulent vaginal discharge, lower
abdominal pain, and fever. She reports having
unprotected sexual intercourse about 1 month
ago. On physical examination, she demon-
strates cervical motion tenderness. What type
of organism is the most likely cause of this pa-
tient’s infection?
(A) Budding yeast with pseudohyphae
(B) Coccobacillus often seen with clue cells
(C) Gram-positive, catalase-negative,
bacitracin-resistant cocci
(D) Obligate intracellular parasite
(E) Trophozoites seen on wet mount
27. A 34-year-old woman is 35 weeks pregnant and
comes to the emergency department because
she is unable to walk secondary to swelling in
her legs. Physical examination shows a tempera-
ture of 36.5° C (97.7° F), a pulse of 95/min, and
a blood pressure of 150/90 mm Hg. The patient
complains of a severe headache but has no other
symptoms. Which of the following tests would
help most in the initial diagnosis of this patient?
(A) Electroencephalogram
(B) 24-hour urine collection
(C) Liver panel
(D) Papanicolaou smear
(E) Peripheral blood smear
 Chapter 16: Reproductive • Questions 387

28. An 80-year-old woman sustains a broken hip sperm motility and normal sperm morphology.
after a minor fall from a chair. The only medi- His past surgical history includes an inguinal
cations she takes are multivitamins. Which of repair. Which of the following is the most
the following is the most likely hormonal pro- likely cause of the patient’s infertility?
file of this woman?
(A) Disordered sperm transport
(B) Primary gonadal deficiency
FOLLICLE- GONADOTROPIN- (C) Secondary hypogonadism
LUTEINIZING STIMULATING RELEASING (D) Sperm dysfunction
CHOICE ESTROGEN HORMONE HORMONE HORMONE (E) Y-chromosome abnormality

A ↓ ↓ ↓ ↑ 31. A 73-year-old patient has been hospitalized for

6 days due to complications from surgery. The

HIGH-YIELD SYSTEMS
B ↓ ↓ ↓ ↓
patient had a urinary catheter in place, which
was removed on the fourth hospital day. Now
C ↓ ↑ ↑ ↑
she is complaining of painful and frequent uri-
D ↑ ↑ ↑ ↑
nation and has a fever of 38.9° C (102° F). Uri-
nalysis results are positive for nitrites and leu-
E ↑ ↑ ↑ ↓ kocyte esterase. A urine culture grows a
gram-negative rod that produces a red pigment.
Which of the following organisms is the most
likely cause of this patient’s symptoms?
(A) A
(A) Candida albicans
(B) B
(B) Escherichia coli
(C) C
(C) Klebsiella pneumoniae
(D) D
(D) Proteus mirabilis
(E) E
(E) Pseudomonas aeruginosa
(F) Serratia marcescens
29. A 23-year-old woman comes to the physician
(G) Staphylococcus saprophyticus
with vaginal candidiasis and is placed on an

Reproductive
antifungal medication. Shortly thereafter, she
32. A 25-year-old woman comes to her physician
experiences amenorrhea. Which of the follow-
complaining of cyclic dysmenorrhea and pain
ing antifungal drugs did this patient most likely
with intercourse. A sonogram reveals bilateral
use?
adnexal masses, and a laparoscopy shows choc-
(A) Amphotericin B olate cysts. This patient at risk for developing
(B) Fluconazole which of the following conditions?
(C) Flucytosine
(A) Carcinoma
(D) Itraconazole
(B) Infertility
(E) Ketoconazole
(C) Masculinization
(D) Obesity
30. A 26-year-old man presents to a urologist after
he and his wife failed to conceive for 14
months. His testosterone levels are normal, and
initial semen analysis shows significantly de-
creased volume and no detectable sperm. Tes-
ticular fine-needle biopsy demonstrates normal
 388 Section II: Organ Systems • Questions

33. A new mother calls her obstetrician to say that
she is having trouble breast-feeding. She is un-
able to produce enough milk to sate her baby
even though her breasts are aching with stored
milk. What is the name of the specialized in-
tracellular organelle where the hormone this
patient is lacking is stored?
(A) Birbeck granules
(B) Ferruginous bodies
(C) Herring bodies
(D) Lewy bodies
(E) Negri bodies
HIGH-YIELD SYSTEMS
oral agents approved for the treatment of erec-
tile dysfunction?
(A) Androgen supplementation
(B) Antiandrogen action via receptor site inter-
ference
(C) Binding to G proteins to stimulate adenylyl
cyclase
(D) Inhibition of cAMP phosphodiesterase
(E) Inhibition of cGMP phosphodiesterase
37. A 35-year-old man comes to the physician
complaining of painful genital vesicles. On

further questioning, he admits to unprotected

34. A previously healthy 25-year-old sexually ac- sex with multiple partners. To confirm the di-
tive man comes to the physician because of a agnosis, the physician performs a Tzanck test;
painful genital rash for the past 5 days. Physi- results are shown in the image. Which of the
cal examination reveals grouped vesicles on an following is the pathognomonic finding on this
erythematous base. Tzanck smear shows multi- patient’s Tzanck smear?
nucleated giant cells. Which of the following
mechanisms is involved in the pathogenesis of
this patient’s infective agent?
(A) Direct invasion into the bloodstream
(B) Invasion of CD4+ cells
(C) Migration to the central nervous system by
retrograde axonal transport
(D) Migration to the peripheral nervous system
by anterograde axonal transport
(E) Migration to the peripheral nervous system
Reproductive

by retrograde axonal transport

35. A 2-month-old boy is brought to the pediatri-

cian by his mother for a well-baby visit for the
first time since his birth. On examination, the
doctor notes that the patient has cryptorchid-
ism, with both testicles remaining unde-
scended. This patient is at increased risk for
developing which of the following conditions?
(A) Hypogonadotropic hypogonadism
(B) Indirect inguinal hernia
(C) Retractile testis
(D) Testicular cancer
(E) Torsion of the spermatic cord
36. A 45-year-old man presents to his physician
complaining of erectile dysfunction. Which of
the following is the mechanism of action of the
Reproduced, with permission, from Wolff K, Johnson RA,
Suurmond D. Fitzpatrick’s Color Atlas & Synopsis of Clinical
Dermatolgy, 5th ed. New York: McGraw-Hill, 2005:
Figure 25-23.
(A) Auer rods
(B) Call-Exner bodies
(C) Lewy bodies
(D) Mallory bodies
(E) Multinucleated giant cell
38. A woman at 32 weeks’ gestation comes to the
emergency department with painless vaginal
bleeding. Her temperature is 37.1° C (98.8°
F), pulse is 76/min, and blood pressure is
126/90 mm Hg. The fetal heart rate is 155/
min. She has no other symptoms. Urinalysis

shows no blood cells or bacteria and a nor-
mally elevated β-hCG level. Which of the fol-
lowing diagnoses should the emergency depart-
ment physician consider before performing a
gynecologic examination?
(A) Abruptio placentae
(B) Eclampsia
(C) Hydatidiform mole
(D) Placenta previa
(E) Preeclampsia
39. Abnormal opening of the urethra on the ven-
tral penis is caused by the failure of a certain
urogenital structure to complete normal devel-
opment in the fetus. This structure is present
in both male and female infants, but has a dif-
ferent fate in each. What structure in the fe-
male infant is derived from the fetal structure
described here?
(A) Glans clitoris
(B) Greater vestibular glands (of Bartholin)
(C) Labia majora
(D) Labia minora
(E) Urethral and paraurethral glands (of
Skene)
(F) Vestibular bulbs
40. A 66-year-old woman visits her primary care
physician because she has been having vaginal
bleeding for several days. Her last menstrual
period was 10 years ago. Her physical examina-
tion and review of systems are otherwise nor-
mal, with the exception of blood seen within
the cervical os. Which of the following is a risk
factor for this condition?
(A) Alcohol consumption
(B) Late onset of menarche
(C) Multiparity
(D) Oral contraceptive pills
(E) Polycystic ovarian syndrome
(F) Smoking
41. A 24-year-old bartender returning from Pan-
ama presents to the clinic because of a painful
penile lesion that appeared about 1 week after
having unprotected sex with a new female part-
ner. On examination the ulcer is 1.5 cm in di-
ameter with an erythematous base and clearly
Chapter 16: Reproductive • Questions 389
demarcated borders. The base of the ulcer is
covered with a yellow purulent exudate and
bleeds when scraped. Gram stain of the exu-
dates shows gram-negative rods in chains in a
school-of-fish appearance. Otherwise, examina-
tion is notable only for tender inguinal lymph-
adenopathy. Which of the following is the most
appropriate treatment at this time?
(A) A 10-day course of oral acyclovir
(B) Highly active retroviral therapy until the
lesion resolves
(C) Nystatin powder to the lesion daily for at
HIGH-YIELD SYSTEMS
least 1 week
(D) One high dose of intramuscular penicillin
G
(E) One high dose of oral azithromycin
42. A 32-year-old woman who is at 30 weeks of ges-
tation presents to the emergency department
with vaginal bleeding and painful abdominal
cramps. Her blood pressure is 125/80 mm Hg.
A urinalysis shows no protein, leukocytes, or
bacteria with few RBCs. A peripheral blood
smear shows a decreased number of normo-
cytic, normochromatic RBCs with many schis-
tocytes. Which of the following is the most
likely diagnosis?
(A) Abruptio placentae
Reproductive
(B) Amniotic fluid embolism
(C) Hydrops fetalis
(D) Placenta previa
(E) Preeclampsia
43. A 30-year-old woman finds a lump in her
breast during a self-examination. A biopsy indi-
cates malignancy, and a lumpectomy is per-
formed. The pathology report states that the
malignant tissue is a primary breast cancer that
is Her-2/neu-positive, but estrogen and proges-
terone receptor-negative. Which of the follow-
ing therapies would fail in treating this patient’s
breast cancer?
(A) Cyclophosphamide
(B) Doxorubicin
(C) Paclitaxel
(D) Tamoxifen
(E) Trastuzumab
 390 Section II: Organ Systems • Questions

44. A 65-year-old man visits his physician because
of increasingly difficult urination. He has trou-
ble initiating a stream and experiences postvoid
dribbling. He wakes from sleep three times per
night to urinate. His baseline creatinine level
was 1.0 mg/dL, and it is now 1.5 mg/dL.
Which treatment is most feasible to immedi-
ately improve this patient’s creatinine level?
(A) Administration of fluid boluses
(B) Dialysis
(C) Placement of a Foley catheter
(D) Treatment with terazosin
HIGH-YIELD SYSTEMS
(A) Decreased estrogen
(B) Decreased testosterone
(C) Excess follicle-stimulating hormone
(D) Excess luteinizing hormone
(E) Excess progesterone
48. A 23-year-old woman is brought to the emer-
gency department with vaginal bleeding. The
patient says that she is in her ninth week of
pregnancy. Laboratory studies show a β-hCG
level of 153 IU/L. The sample shown in the
image is retrieved from the patient’s uterus.

There are no recognizable fetal parts. Which

of the following describes the most likely geno-
45. An infant is born with ambiguous genitalia.
type and parental source of DNA in this mass?
On initial laboratory testing, the infant has a
testosterone level of 482 ng/dL (normal 437–
707 ng/dL), an estrogen level of 12 pg/mL
(normal 10–60 pg/mL) and a LH level of 8 U/L
(normal 7–24 U/L). Testes are present. Suppos-
ing this child’s genitalia masculinize at pu-
berty, which of the following disorders does
this infant most likely have?
(A) Complete androgen insensitivity
(B) Double Y syndrome
(C) Female pseudohermaphroditism
(D) 5α-Reductase deficiency
(E) True hermaphroditism
Reproductive

46. A 27-year-old woman presents to her primary

care physician with breast pain, nonbloody
nipple discharge, and multiple bilateral breast
masses. She denies any history of breast cancer
in her family. Which of the following would
most likely confirm that a breast mass is be-
nign?
(A) Central necrosis
(B) Lymphocytic infiltration
(C) Lymphatic involvement
(D) Overlying eczema
(E) Sclerosis
47. A 22-year-old obese woman presents to her gy-
necologist with amenorrhea and hirsutism. Ul-
trasonography reveals polycystic ovaries. Which
of the following is a likely pathophysiologic
mechanism of this disorder?
Image courtesy of Armed Forces Institute of Pathology.
(A) 46,XX; maternal
(B) 46,XX; maternal and paternal
(C) 46,XX; paternal
(D) 69,XXX; maternal and paternal
(E) 69,XXY; maternal and paternal
49. After fertilization of the ovum, implantation
occurs in the endometrium and the develop-
ing placenta begins to produce a hormone
necessary for embryonic viability. Which of the
following is the action of this hormone?
(A) To initiate parturition
(B) To increase the threshold for uterine con-
traction

(C) To stimulate the corpus luteum to produce
estriol and progesterone
(D) To stimulate the uterus to produce estriol
and progesterone
50. A 38-year-old woman comes to the physician
complaining of vaginal burning and itching.
On physical examination a whitish, curd-like
vaginal discharge and inflammation of the
walls of the vagina and vulva are observed.
Laboratory results indicate the infection is not
bacterial. Which of the following clinically sig-
nificant symptoms could also result from infec-
tion with this organism?
Chapter 16: Reproductive • Questions 391
(A) Blood-tinged sputum, loss of appetite,
weight loss, painful red rash on the legs,
and change in mental status
(B) Chronic lung disease resembling tubercu-
losis
(C) Lung cavity lesions
(D) Meningoencephalitis
(E) Thrush, “diaper rash,” disseminated infec-
tion, chronic mucocutaneous disease
HIGH-YIELD SYSTEMS
Reproductive