Gyne 1st Long Exam 2009 ANS

Gyne 1st Long Exam 2009 (35-50 samplex) 1.

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Which of the following statements is true of Cul-de-Sac? a. Located anterior to the rectum separating the uterus from the large intestines b. The parietal peritoneum of the Culde-Sac covers the lower part of the anterior vaginal wall c. Bounded laterally by the peritoneal folds covering the round ligaments d. A deep pouch formed by the most caudal extent of the visceral peritoneum True of the blood supply of the uterus a. The uterine arteries originate directly from the aorta b. The ovarian arteries are branches of the hypogastric arteries c. The uterine artery arises from the anterior branch of the hypogastric artery d. None of the above e. All of the above The uterus… a. Is separated from the bladder anteriorly by the vesicouterine pouch b. Has an endometrial cavity which is lined by squamous epithelium that undergoes cyclic changes c. Has a muscular layer called myometrium which consists of interlacing skeletal muscle fibers d. Is separated from the rectum anteriorly by the rectouterine pouch e. A and B Which of the following statements are true? a. The uterosacral ligament is also referred to as the Mackenrodt ligament b. The round ligament extends from the lateral portion of the uterus below and anterior to the origin of the oviduct terminating in the upper portion of the labium majus c. The broad ligament is made up of two winglike structures that covers the anterior part of the uterus d. All of the above e. A and C The narrowest portion/s of the fallopian tube is/are? a. Ampulla b. Infundibulum c. Isthmus d. A and B e. None of the above The fallopian tubes… a. And the ovaries are collectively referred to as the adnexa b. Is supplied by the ovarian and uterine arteries

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Is lined by pseudostratified columnar epithelium A and B All of the above

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Parts of the vulva EXCEPT a. Clitoris b. Perineum c. Labia majora d. Paraurethral glands e. None of the above

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Which of the following female genital structures are INCORRECT matched with its male homologue? a. Bartholin’s gland – Cowper’s gland b. Labia majora – Scrotum c. Labia minora – Penile urethra d. Skene’s gland – Corpora cavernosa e. None of the above

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Which of the following structures DOES NOT derive at least partial blood supply from the uterine artery? a. Oviduct b. Ovary c. Cervix d. All of the above e. None of the above

10. Which of the following statement/s about the ovarian vessels is/are true? a. The left ovarian artery originates from the descending aorta b. The right ovarian vein drains into the inferior vena cava c. The left ovarian vein drains into the left renal vein d. A and C e. All of the above 11. The following provide support for the vagina a. Infundibulopelvic ligament b. Pelvic diaphragm c. Cardinal ligament d. A and C e. All of the above 12. The perineum… a. Is supported by the pelvic and urogenital diaphragms b. Is supplied by the internal pudendal artery c. Is divided by an imaginary line from the pubic symphysis to the coccyx to form the anterior and posterior triangle d. A and B e. All of the above 13. The vagina… a. Is composed of an inner longitudinal and outer circular arrangement of smooth muscles b. Is lined by nonkeratinized stratified squamous epithelium c. Has an abundant vascular supply d. B and C e. All of the above

d. 14. Which of the following statement/s is/are true? a. Sensory nerve fibers from the upper part of the vagina are in pudendal nerve b. Sensory nerve fibers from the uterus are in T11 – T12 c. Sensory nerve fibers from the lower part of the vagina are in S2 – S4 d. A and B e. All of the above 15. Muscles of the levator ani a. Coccygeus b. Pubococcygeus c. Deep transverse perineal d. A and B e. All of the above 16. The cyst primarily of mesonephric origin found laterally in the vagina a. Nabothian cyst b. Gartner’s duct cyst c. Dysontogenetic cyst d. Bartholin’s cyst 17. The most common cystic structure of the vagina is the a. Nabothian cyst b. Hydatid cyst of Morgagni c. Inclusion cyst d. Hydatid cyst of Morgagni 18. All of the following are histologic subtypes of endocervical polyp EXCEPT a. Adenomatous b. Cystic c. Solid d. Inflammatory 19. The optimal management of endometrial polyp is a. Medical management b. Fractional dilatation and curettage c. Hysteroscopy dilatation and curettage d. All of the above 20. A 45 y/o G3P3 (2103) consulted at your clinic with complains of prolonged and profuse menses for almost 6 months. The patient eventually underwent Total Abdominal Hysterectomy with Bilateral Salpingoophorectomy. On cut section, the tumor has a glistening, pearl white appearance w/ the smooth muscles arranged in a trabeculated or whorled configuration. Your diagnosis is: a. Adenomyosis b. Leiomyoma c. Endometriosis d. Dermoid cyst 21. The mildest form of degeneration of a myoma is a. Myxomatous b. Calcific c. Hyaline

Cystic

22. This is usually lined by stratified squamous epithelium which is usually a result from birth trauma or gynecologic surgery. a. Nabothian cyst b. Hidradenoma c. Inclusion cyst d. Gartner duct cyst 23. A 28 y/o nulligravid came in to the OPD with complains of menstrual cramps on the 1st day of her period for 2 years. An ultrasound was done and revealed an adnexal mass on the right approximately 12 x 8 x 8 cm. Exploratory laparatomy was done and revealed a cystic mass with chocolate like fluid. Your diagnosis then will be a. Dermoid cyst b. Corpus luteum cyst c. Endometrial cyst d. Theca lutein cyst 24. If a vulvo-vaginal hematoma continues to enlarge despite conservative measures, the treatment is a. Evacuation of clots and colpoclesis b. Evacuation of clots and insertion of vaginal pack c. Evacuation of clots by marsupialization d. Evacuation of clots and ligation of bleeders 25. Contact dermatitis of the vulva is treated by a. Hot sitz bath b. Anti-fungal cream c. Oral antibiotics d. Withdrawal of the offending substance 26. Symptoms of hematometra include the following EXCEPT a. Primary amenorrhea b. Cystic lower abdominal pain c. Dysuria d. None of the above 27. A 48 y/o multiparous patient complains of hypogastric pain. Pelvic ultrasound shows a 7 cm large myoma uteri. Treatment is: a. Myomectomy b. Hysterectomy c. GnRH agonist d. Dilatation and curettage 28. A theca lutein cyst may be found together with which of the following conditions a. Pregnancy in a diabetic patient b. Pelvic endometriosis c. Pelvic inflammatory disease d. Trophoblastic disease 29. This is not a component of Meigs Syndrome a. Thecoma b. Ascites c. Fibroma d. Pleural effusion

30. The diagnosis of cervical stenosis is established by a. Pelvic ultrasound b. Hysteroscopy c. Inability to pass a 1 to 2 mm cervical dilator d. Amenorrhea in an adolescent 31. Cervical polyps are often secondary to a. Cervical cancer b. Use of IUD* c. Chronic irritation d. Douching 32. The most frequent cystic structures in normal ovaries are a. Theca lutein cyst b. Serous cystadenoma c. Follicular cyst d. Dermoid cyst 33. True of the uterine fibroid a. May remain asymptomatic throughout life b. May undergo torsion and rupture c. Symptoms may be explained by size and location d. Has a true capsule 34. Histologic components of endometrial polyp a. Columnar epithelium b. Central vascular channel c. Endometrial stroma d. A and B e. All of the above