Gyne 5 Long Exam

Gyne 5th Long Exam 2010 1.

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It is the second most common malignancy of the lower part of the female genital tract: a. Cervix b. …Ovary c. Corpus d. Vulva In the Philippines, this is the second most common cancer in women: a. Breast b. Lung c. Cervix d. …Ovary

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Carcinomas of the cervix is predominantly ________: a. …Squamous cell carcinoma b. Adenocarcinoma c. Adenosquamous d. Glassy cell

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Endometrial cancer occurs in what age group? a. Pre-menarcheal b. …Postmenopausal c. Childbearing age d. Perimenopausal

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The main pathophysiology in endometrial hyperplasia is: a. Hyperestoronism b. Hyperprogesteronism c. Hyperaldosteronism d. …Hyperestrogenism

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The most important factor in the propensity of endometrial hyperplasia to progress to endometrial cancer is: a. Presence of estrogen receptors b. Presence of progesterone receptors c. …Degree of atypia d. Body mass index of patient

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Cervical cancer that involves the posterior lip of the cervix and extends to the posterior fornix would be assessed as: a. Stage IB2 b. …Stage IIA c. Stage IIB d. Stage IIIA Obesity is a risk factor in endometrial cancer patients due to endogenous estrogen. This is due to the conversion of androstendione to: a. …Estrone b. Estriol c. Estradiol d. Ethinyl estradiol The most common presenting symptom in patients with endometrial cancer: a. Abdominal mass b. …Vaginal bleeding c. Abdominal distention d. Anorexia

10. The ff are risk factors for endometrial cancer, except: a. Nulliparity b. Obesity c. Anovulation d. …Multiple sexual partners 11. The most common histopathologic type of endometrial adenocarcinomas a. Clear cell b. Papillary c. Serous d. …Endometroid 12. Rare and most malignant group of uterine tumors of mesodermal origin: a. …Uterine sarcoma b. Endometrial polyp c. Adenocarcinoma of the endometrium d. Adenomyoma 13. Histological differentiation of CIN includes: a. Mitotic activity b. Nuclear abnormality c. Differentiation, maturation, stratification d. …AOTA 14. For an adolescent with endometrial hyperplasia with atypia, the management option of choice is: a. Total hysterectomy b. Total abdominal hysterectomy with bilateral salpingooophorectomy c. …Oral contraceptive pills/cyclic progestins d. Endometrial ablation 15. A 30 year old nulligravid was diagnosed to have CIN 2 involving almost the entire circumference of the cervix with visible upper limit of the lesion. The best management is: a. …Observation with follow-up smears b. Cryotherapy with destruction of the whole transformation zone c. Conization d. Hysterectomy 16. Patients with carcinoma in situ of the cervix are younger than patients with invasive squamous cell carcinoma by an average of: a. 1 – 2 years b. 3 – 5 years c. 6 – 9 years d. …10 – 15 years 17. The definition of cervical transformation zone is: a. The squamous epithelium b. …The endocervix c. The portio vaginalis d. Those parts of the cervical epithelium undergoing or having undergone squamous metaplasia 18. What color would the normal cervical squamous epithelium show in Schiller’s test? a. Yellow

b. c. d.

…Mahogany brown Red Black

19. What is the most common histologic type for malignant tumors of the cervix? a. …Squamous cell carcinoma b. Adenocarcinoma c. Clear cell carcinoma d. Small cell carcinoma 20. The most effective cancer screening procedure of the cervix is: a. CA 125 b. Routine cervical biopsy c. Colposcopic guided biopsy d. …Pap smear 21. Criteria for the diagnosis of Stage I A1 carcinoma of the cervix is: a. …7 mm in width c. Volume of 30 mm square d. Lymphatic or vascular space involvement 22. All of the ff are route of spread in cervical cancer, except: a. Direct extension b. Paracervical lymphatics and pelvic lymph nodes c. The blood stream d. …NOTA 23. The recommended time to start screening with papsmear is: a. Coitarche b. …3 years after coitarche c. If no history of sexual contact at age 30 d. Age 40 24. Which of the ff factors consistently associated with carcinoma of the cervix? a. Use of oral contraceptive pills b. Cigarette smoking c. Women who have frequent sexual contact d. …Human papilloma virus infection 25. The Schiller’s test involves application of: a. Acetic acid b. …Lugol’s iodine c. Normal saline solution d. Distilled water 26. Which of the ff is an inadequate treatment for Stage IB Carcinoma of the cervix? a. …Radical hysterectomy with pelvic lymph node dissection b. Cobalt c. Brachytherapy d. Total hysterectomy 27. What stage is microinvasive cancer of the cervix: a. Stage 0 b. …Stage IA c. Stage IB d. Stage IIA

28. Symptoms of cervical cancer except: a. Postcoital bleeding b. …Epigastric pain c. Back or leg pain d. Vaginal discharge 29. Most common cause of death in cervical cancer is: a. …Uremia b. Malnutrition c. Peritonitis d. Hemorrhage 30. The risk of spread of cervical cancer to the pelvic node in stage III is: a. 17% b. 27% c. 37% d. …47% 31. Which of the ff provides the best clue that a woman is having an orgasm? a. …Face b. Breasts c. External genitalia especially the clitoris and vulva d. Amount of lubrication of the vagina 32. Which of the ff is true about the G-spot? a. Thought to be the cause of female ejaculation b. …A dense size erotically sensitive area at the posterior vaginal wall c. An anatomically proven structure d. The Gutenberg spot 33. Which of the ff sex positions is recommended for elderly couples? a. Rear entry position b. Man on top, face to face c. Woman on top, face to face d. …Missionary position 34. Which of the ff researches is now the basis of our current understanding of the human sexual response? a. Kuisey Reports b. …Masters & Johnsons c. Grafenberg report d. William Masters 35. Which phase/phases of the sexual response is caused by stimulation of the parasympathetic fibers of the autonomic nervous system? a. …Excitement phase b. Plateau phase c. Orgasm phase d. A & B 36. Which phase/phases of the sexual response is caused by stimulation of the sympathetic fibers of the autonomic nervous system? a. Excitement phase b. Plateau phase c. …Orgasm phase d. Resolution phase

37. Which sexual position is comfortable during pregnancy? a. ….Rear entry b. Woman on top, face to face c. Missionary position D Side by side, face to face 38. Which sexual position is advised for the obese and elderly? a. Rear entry b. Woman on top, face to face c. …Missionary position d. Side by side, face to face 39. Which of the ff physiologic changes in the menopause decrease the ability to demonstrate normal sexual response? a. Vaginal atrophy b. Decrease secretion c. Poor circulation to vagina and uterus d. …AOTA 40. Which of the ff sexual dysfunction is the most common? a. Inhibited sexual desire b. Vaginismus c. Orgasmic dysfunction d. Dyspareunia 41. Which of the theories on the cause of homosexuality is the most widely accepted? a. Genetic theory b. Hormonal theory c. Psychoanalytical theory d. …NOTA 42. The purpose of the operation is to remove the uterus via the vagina a. Total abdominal hysterectomy b. Myomectomy c. Laparoscopic hysterectomy d. …Vaginal hysterectomy 43. A.M., is 23 years old and a nulligravid. Upon internal examination, the uterus is enlarged to 10 weeks AOG with a palpable nodular mass on the fundal area measuring approximately 6 x 6 cm. What is the best procedure to do on AM? a. …Myomectomy b. Total abdominal hysterectomy c. Laparoscopic hysterectomy d. Vaginal hysterectomy 44. K.D. 48 years old G3P3 (3003) came in due to profuse vaginal bleeding. She had her menopause at the age of 45. What is the best procedure to do on KD? a. …Fractional dilatation and curettage b. Completion curettage c. Total abdominal hysterectomy d. Myomectomy 45. JM 24 years old came in due to profuse vaginal bleeding and passage of meaty substance. On internal examination the cervix was 2 cm dilated, soft and the uterus was

enlarged to 8 weeks AOG. What is the best procedure to do on JM? a. Fractional dilatation and curettage b. …Completion curettage c. Total abdominal hysterectomy d. Myomectomy 46. LM 40 years old G2P2 (2002) came in due to an enlarging abdomen. After ultrasound was done there was a note of multiple myoma uteri, intramural with subserous components. Her last menstrual period was on January 21, 2010. Her previous menstrual period was on December 20, 2009. What is the best procedure to perform on LM? a. Total abdominal hysterectomy with bilateral salpingo-oophorectomy b. …Total abdominal hysterectomy c. Vaginal hysterectomy d. Myomectomy 47. The purpose of the operation is to remove a segment of the fallopian tube: a. …Salpingectomy b. Salpingostomy c. Salpingo-oophorectomy d. Salpingoscopy 48. M.M. 30 years old G2P2 (2002) came in due to severe abdominal pain. On sonography there was a note of ovarian torsion. What procedure would you perform on MM? a. Ovarian cystectomy b. Oophorectomy c. …Salpingooophorectomy d. Salpingectomy 49. When performing a total abdominal hysterectomy the ff structures are ligated EXCEPT: a. Cardinal ligament b. Round ligament c. …Infundibulopelvic ligament d. Suspensory ligament 50. KD 56 years old was diagnosed with a submucous myoma. She is G4P4 (4004). She had her menopause at the age of 50. What is the best procedure to perform on KD? a. Total abdominal hysterectomy with bilateral salpingo-oophorectomy b. …Total abdominal hysterectomy c. Vaginal hysterectomy d. Myomectomy