Gyne Reviewer

Gyne 1.

The most common pathophysiologic mechanism in perimenopausal bleeding is: (Compre Gyne, 1082) A. cervical ancer B. endometrial cancer C. anovulation D. abnormal pregnancy states

2.

A 34 yo G3P3 (3-0-0-3) presents with episodes of missed period for 2 cycles then irregular and profuse bleeding for the past two weeks. Her pregnancy test is negative with unremarkable pelvic exam findings except for the moderate bleeding. What is the most likely diagnosis: (Compre Gyne, p. 1082-1083) A. threatened abortion B. hydatidiform mole C. dysfunctional uterine bleeding D. endometrial cancer

3.

A 60 yo G5P5 (5-0-0-5) has been menopausal for the past 12 years presents with minimal vaginal bleeding. What diagnostic exam will you recommend? (Compre Gyne, p. 1082-1083) A. colposcopy B. laparoscopy C. diagnostic Dilatation and Curettage D. Transvaginal Ultrasound

4.

An adnexal cystic mass was seen appreciated on TVS, 6 cm in diameter, in a 24 yo patient who presents with abnormal vaginal bleeding. What is the most likely diagnosis? (Compre Gyne, p. 506-507) A. follicular cyst B. dermoid cyst C. serous cyst D. corpus luteum cyst

5.

A 5 year old child was initially treated with antibiotics for purulent vaginal discharge for a week. On follow up, the discharge was noted to be foul smelling and bloody. The most probable cause is: (Comprehensive Gynecology, 4 th ed, page 274-277) A. monilial infection B. child molestation C. foreign body in the vagina D. precocious puberty

6.

A mother is concerned with the appearance of whitish, non puritic vaginal discharge on her 11 year old child noted since 8 month preceding menarche. It is best to; (Comprehensive Gynecology, 4th ed, page 276) A. do gram stain on the discharge B. advise vaginal douche C. prescribe oral antibiotics D. reassure the mother and the child that the discharge is normal

7.

The most frequent symptoms of endometrial hyperplasia is: (Compre Gyne, p. 870) A. foul smelling vaginal discharge

B. abnormal vaginal bleeding C. pelvic pain D. alternating constipation and diarrhea 8.

A 46 yo G4P4 (4-0-0-4) with a nodular uterus, enlarged to 20 weeks AOG presents with menorrhagia. What is the most likely diagnosis? (Comprehensive Gynecology Chapter 18 Page 502) A. Subserous myoma B. Submucous myoma C. Adenomyosis D. Abnormal pregnancy

9.

A 65 year old nulligravida consulted at the emergency room due to postmenopausal bleeding for 3 yrs. She’s obese and known to be hypertensive for 10 years. Her menstrual history revealed irregularly irregular cycles. She was treated for breast cancer 6 years ago and has been taking tamoxifen for the past 5 years. The most probable cause of her bleeding is a pathology in the: (Compre Gyne, p. 860-867) A. Cervix B. Endometrium C. Ovary D. Vagina

10.

A 35 year old, G6P6 (6006) wife of a seaman, consulted due to postcoital bleeding. Speculum exam revealed a flat warty lesion along the posterior cervical lip. Histopathology of cervical punch biopsy done revealed dysplastic cells involving nearly the whole thickness of the epithelium. The most probable diagnosis is CIN? (Compre Gyne, 802-803) A. I B. II C. III D. IV A 65 year old nulligravida consulted at the emergency room due to postmenopause bleeding x 3 yrs. She’s obese and known to be hypertensive for 10 years. Her menstrual history revealed irregularly irregular cycles. She was treated for breast cancer 6 years ago and has been taking tamoxifen for the past 5 years. The most appropriate diagnostic test is: (Compre Gyne, 870-871) A. Pap smear B. Cervical punch biopsy C. Fractional curettage D. Transvaginal ultrasound

11.

12.

A 25 year old, G6P0 (0060) consulted at the emergency room due to postcoital bleeding x 3 months duration. She’s a victim of child prostitution. On pelvic exam, there was a 2 cm cauliflower – like lesion on the anterior lip of the cervix. The vagina and parametria are smooth. What is the most appropriate diagnostic test? (Compre Gyne, p. 844) A. pap smear B. colposcopy with biopsy C. direct punch biopsy D. cone biopsy

13.

A 20 year old commercial sex worker presented at the clinic due to painful shallow ulcers in the vulva associated with burning sensation during urination. She also has multiple oral ulcers at the time of consultation. The most likely diagnosis is: (Compre Gyne, , Chapter 22, page 656) A. Herpes simplex infection B. granuloma inguinale C. Lymphogranuloma venereum D. Syphilis

14.

A 38 year old diabeteic patient presented at the clinic due to vaginal pruritus and whitish vaginal discharge. On examination, the vulva is beefy red in appearance with whitish curdled discharge. The most likely diagnosis is: (Compre Gyne, Chapter 22, page 669) A. Trichomoniasis B. Candidiasis C. Bacterial vaginosis D. Mucopuruloent Cervicitis

15.

The presence of heavy concentration of coccobacilli surrounding vaginal epithelial cells with loss of distinct cell margins is the appearance of; (Compre Gyne, Chapter 22, page 671) A. Donovan bodies B. Clue cells C. chancre D. inclusion cells

16.

A patient with chronic ulcers in the vulva had smears done taken from the ulcers. Findings shows presence of dark staining bacteria with a bipolar appearance found in the cytoplasm of large mononuclear cells .These are diagnostic of ; (Compre Gyne, Chapter 22, page 660 A. Granuloma inguinale B. Lymphogranuloma venereum C. Chancroid D. Syphilis

17.

A patient with painless vulvar ulcers came with a positive screening test for syphilis. Confirmatory test that should be done can either be any of the following except: (Compre Gyne, Chapter 22, page 664) A. RPR B. TPI C. FTA-ABS D. MHA-TP

18.

According to CDC, treatment of patients diagnosed with HIV includes the following except: (Compre Gyne Chapter 22, page 686) A. behavioral B. psychosocial C. emotional D. medical

19.

A patient diagnosed with gonorrhea should: (Compre Gyne, Chapter 22, page 692) A. be treated with Chloramphenicol B. also be treated for Chlamydia infection C. have follow-up cultures done for asymptomatic women D. not have serologic test for syphilis if cultures for gonorrhea are positive

20.

Linda, 65 year old, G7P7 came to your clinic complaining of vaginal itching with burning discomfort. This condition may be due to a decrease in what hormone? (Compre Gyne, p.1223) A. LH B. progesterone C. estrogen D. FSH

21.

Linda, 18 year old, delivered an 8 lbs baby. There was note of laceration on the lateral wall off the vaginal vault with profuse vaginal bleeding. There was a sudden drop of BP. Post partum there was note of amenorrhea. Lab examination shows destruction of the pituitary gland. Linda has what syndrome? (Compre Gyne p. 1116) A. Simmonds syndrome B. Sheehan’s syndrome C. Edward’s syndrome D. Asherman’s syndrome

22.

The patient with abnormal uterine bleeding is a: A. 18 y.o. whose interval of menses is 24 to 30 days B. 41 y.o. whose menses last 8 to 10 days C. 29 y.o. on DMPA with occasional vaginal spotting D. 22 y.o. leukemic patient with menstrual blood loss of 80 ml

23.

Compre Gyne 4th ed, p. 1079-80 A 55 y.o. G5P5 (5005) consulted for fish-wash like vaginal discharge and on-and-off vaginal bleeding. Pelvic exam showed the cervix to be converted to a 6 x 5 cm nodular, fungating mass extending to the R lateral fornix, the right parametria nodular and fixed while the left was free. Based on the information given, this patient can be clinically staged as A. IIB B. IIIA C. IIIB D. IVA Compre Gyne 4th ed, p. 897

24.

A 53 y.o. G1P1 (1001) underwent exploratory laparotomy for an ovarian new growth. Intraoperative findings showed the right ovary to be converted to a 10 cm predominantly cystic mass with excrescences on its outer capsule. The left ovary was grossly normal. All other abdominopelvic organs were grossly normal. Based on the information given, the Intraoperative stage of this patient is A. IA B. IB C. IC D. IIA Compre Gyne 4th ed, p. 966

25.

Speculum exam of a 27 y.o. complaining of leucorrhea showed copious frothy greenish vaginal discharge with strawberry-like mucosa. This is most likely due to: A. candidiasis

B. trichomoniasis C. gonococcal infection D. bacterial vaginosis 26.

Compre Gyne 4th ed, p. 672-73 A woman using the oral contraceptive pills for the first time should be advised to start taking it : A. on day 1 of menses B. on day 5 of menses C. on day 7 of menses D. anytime as long as she is not pregnant

27.

Management of choice for procidentia uteri in a 60 year old multiparous patient with marked cystorectocoele: A. observation and close follow up B. vaginal hysterectomy C. vaginal hysterectomy with anterior-posterior repair D. total abdominal hysterectomy with anterior-posterior repair

28.

The following are characteristics of Rokitansky syndrome EXCEPT: A. phenotypically female B. normal ovaries C. normal uterus D. absent vagina

29.

The following are congenital anomalies of the mullerian duct EXCEPT: A. imperforate hymen B. transverse vaginal septum C. unicornuate uterus D. uterus didelphys

30.

The so called psammoma bodies are found in: A. serous cystadenoma B. mucinous cysadenoma C. clear cell carcinoma D. mucinous cystadenoma

31.

Abnormal uterine bleeding during the pubertal and perimenarcheal period is due to: A. polycystic ovaries B. failing ovarian function C. delayed,aynchronous hypothalamic maturation D. exogenous estrogen stimulation

32.

Most common cause of vaginal bleeding among postmenopausal women: A. endometrial carcinoma B. endometrial hyperplasia C. endometrial polyp D. atrophic endometrium

33.

A woman with postmenopausal bleeding warrants: A. an endometrial biopsy

B. observation and Pap’s smear yearly C. total hysterectomy D. total hysterectomy with bilateral salpingooophorectomy 34.

In Meig’s syndrome, the ovarian newgrowth is a: A. Fibroma B. mature teratoma C. immature teratoma D. cystadenoma

35.

Drug of choice for pregnant patients with Chlamydia infection: A. Doxycycline B. azythromicin C. erythromycin D. ampicilin

36.

The so called tobacco pouch appearance of the fallopian tube is seen in: A. gonorrhea infection with tubo ovarian abscess B. Chlamydia infenction with tubo ovarian abscess C. Pelvic tuberculos D. Old tubal ectopic gestation

37.

Type of endometrial hyperplasis which is mot likely to progress to endometrial carcinoma: A. simple hyperplasis with atypia B. cystic hyperplasia with atypia C. complex hyperplasia without atypia D. complex hyperplasia with atypia

38.

A post coital test is best done: A. pre menstrual B. right after menses C. periovulatory period D. anytime during the cycle

39.

Hysterosalpingography is best done: A. periovulatory period B. before menses C. after menses D. anytime during the cycle

40.

Which of the following Pap’s smear will definitely require colposcopic examination of the cervix: A. AGUS B. ASCUS C. LSIL D. HSIL

41.

Which of the following is considered a precursor of cervical carcinoma: A. Metaplasia B. dysplasia C. eversion D. severe eroisions

42.

Endometrial carcinoma is LEAST likely if endometrial thickness is: A. 5 mm B.