Gyne 2 Exam Recall

GYNECOLOGY 2nd EXAM RECALL

CONGENITAL ABNORMALITIES 1. Organogenesis begins in the a. 3rd embryonic week b. 5th embryonic week c. 10th embryonic week d. 15th embryonic week •

Organogenesis begins in the 3rd embryonic week and is essentially complete in the 10th week (5-12th week in terms of gestational pregnancy)

2. What is 1 to 1.5 cm long and 0.5 cm wide ; enlargement of which is caused by androgen stimulation? a. Vagina b. Clitoris c. Penile urethra 3. Which of the following statements is true regarding congenital Adrenal hyperplasia?  It may cause salt-wasting adrenal crisis Congenital adrenal hyperplasia  It may cause salt-wasting adrenal crisis  It is autosomal recessive (NOT autosomal dominant)  Short stature ( NOT tall) 4. Which of the following is true regarding CAH a. It is caused by deficiency of 11-hydroxylase b. Autosomal recessive gene coded on chromosome 8 c. Elevated 17-hydroxyprogesterone 5. Hymen represents the junction of the o ANSWER: SINOVAGINAL BULBS AND UROGENITAL SINUS 6. Female, 16 y.o with Rokitansky-Kuster-Hauser syndrome may present with the following except: a. Normal vagina and uterus b. Normal ovaries c. 46 xy karyotype 7. 50% of patient with Rokitansky-Kuster-Hause have: a. Urologic abnormalities 8. Transverse Vaginal septum o Failure of junction between mullerian duct and the sinovaginal bulb at the mullerian tubercle

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Main treatment for labial agglutination a. Estrogen ointment

PELVIC SUPPORT 10. Why prolapsed more common in female than male a. 3 openings? b. Hormones c. Multiparity d. ALL 11. The following are risk factors for pelvic relatxation a. Multiparity b. Carrying heavy loads c. Menopause d. All of the above      

Multiparity Squating Carrying heavy loads Chronic cough Menopause Obesity

12. Abnormality of this structure leads to tipped uterus a. Round ligament 13. Descent of the uterus is due to the following except a. Round ligament b. Uterosacral ligament c. Cardinal ligament d. Pelvic diaphragm 14. Open introitus : essential for diagnosis a. Long perineum (should be short) b. Labia majora and minora cover the introitus c. Middle third of vagina exposed d. Cervix shown on straining 15. Cystocoele except a. Complete bladder emptying b. Feeling of falling out c. Reducible mass bulging into the anterior vaginal wall d. Increase bulging during straining 16. Women, 75 years old...post hysterectomy a. Cystocoele b. Rectocoele c. Enterocoele d. Ovary prolapsed 17. Falling out ; difficult evacuation of feces Page 1 of 3

a. Rectocoele 18. Uterine prolapse a. Expectant b. Surgery c. Pessary d. All of the above 19. Reproductive age with uterine prolapse a. Vaginal hysterectomy b. Abdominal hysterectomy c. Ligamentopexy d. ___

ENDOMETRIOSIS AND ADENOMYOSIS 20. Endometriosis a. Presence and growth of the glands and stroma of the lining of the uterus in an aberrant or heterotropic location 21. Which is true regarding endometriosis  Many large endometriomas – asymptomatic patients  Cyclic hormones causes growth, continuous hormones reverses the growth pattern (memorize this statement, minsan nakakalito! ) 22. Etiology of endometriosis except: a. Metaplasia b. Retrograde menstruation c. Immunologic d. Infection 23. Cardinal histologic features of endometriosis except a. Ectopic endometrial glands b. Ectopic endometrial stroma c. Hemorrhage into the adjacent tissue d. Hemorrhage into the distant tissue 24. 25. 26. 27.

Danazol – Hypoestrogenic, hyperandrogenic GnRH agonist – medical menopause OCP – pseudopregnancy Progestin –Hypogonadotropic, hypogonadal

28. Adenomyosis  Derived from aberrant glands of the basalis layer of the endometrium; associated with disruption of the barrier between the endometrium and myometrium as an initiating step ldmf2012

29. Risk factor of adenomyosis  Increased parity (NOTE: NULLIPARITY IS NOT A RISK FACTOR)  History of uterine surgery  Trauma 30. Pelvic examination of adenomyosis EXCEPT: a. Usually more than 14-16 weeks size ( NOTE: this is unusual)

PEDIATRIC AND ADOLESCENT GYNECOLOGY 31. Most common cause of vulvar symptoms in the prepubertal age group o Vulvovaginitis 32. Which is not usually done for patient in complete gynaecologic exam a. History b. Inspection and visulaization of cervix c. Culture of vagina d. Rectovaginal exam 33. Lithotomy position for a. 6 mos. b. 1-2 yrs c. 2-3 yrs d. 4-5 yrs. Young children may be examined in the frog leg position, and children as young as 2 to 3 years of age may be examined in lithotomy with use of stirrups. Lithotomy is generally used for girls 4 to 5 years of age and older. 34. Which is not helpful in examining pedia ( HARM THAN GOOD) a. Restraint o

35. A “tell-tale” somewhat translucent vertical midline line is visible on physical exam at the site agglutination a. Labial Adhesion 36. Universal management for vulvovaginitis a. Good perineal hygiene 37. Most common foreign body – tissue paper 38. Most common cause of vaginal bleeding in child a. Foreign body b. Infection c. Trauma Page 2 of 3

39. Most common cause of vaginal bleeding in prepubertal a. Foreign body b. Infection c. Trauma 40. Labial agglutination main cause ---decrease circulating estrogen

43. Cramping, cyclic, no bleeding a. Imperforate hymen 44. What etiologic agent, for suspected sexual abuse a. Neisseria gonorrhoea b. Enterobius c. Trachomatis chlamydia

41. Main treatment of labial agglutination a. Externally applied estrogen 42. Malignant-like lesion a. Lichen Sclerosus

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