Imtiaz- Gynaecology – Flashcards
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The lining epithelium of the vagina is: A. Stratified squamous epithelium B. Simple columnar epithelium C. Tall columnar epithelium D. Transitional epithelium E. Ciliated columnar epithelium
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A* Stratified squamous epithelium 6
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All of the following effects occur on the vagina by estrogen, except: A. The vagina becomes more vascular B. The vaginal epithelium grows C. The vaginal glands start to secret D. The epithelium cells become filled with glycogen E. The glycogen is broken by Doderlein's bacilli which cause lowering of vaginal pH
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C* The vaginal glands start to secret 7
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The uterine artery is a branch of one of the following: A. External iliac artery B. Internal iliac artery C. Common iliac artery D. Middle sacral artery E. Obturator artery
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B* Internal iliac artery 8
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The best support to the uterus is by: A. The broad ligaments B. Infundibulopelvic ligaments C. Round ligament D. Utero-ovarian ligament E. Cardinal ligament
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E* Cardinal ligament 9
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The round ligament of the uterus terminates in one of the following: A. Symphysis pubis B. Iliac crest C. Upper portion of labium majus D. Upper portion of labium minus E. Upper portion of inguinal canal
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C* Upper portion of labium majus 10
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Regarding lower uterine segment, all the following are true except: A. It represents isthmus in non pregnant uterus B. It lies between the anatomical and histological internal os C. It is a passive segment compared to the upper segment which is active D. In obstructed labor it can form Bandl's ring E. It is the least site of rupture in obstructed labor with no previous CS scar
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E* It is the least site of uterus in obstructed labor with no previous CS scar 11
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The left ovarian vein empties in one of the following: A. Vena cava inferior B. Left common iliac vein C. Left internal iliac vein D. Left renal vein E. Left external iliac vein
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D* Left renal vein 12
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The most inner part of a mature Graafian follicle is: A. Theca interna B. Theca externa C. Granular cell layer D. Zona pellucida E. Ovarian stroma
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D* Zona pellucida 13
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Maximal number of germ cells in the ovary occurs at: A. 22 weeks of intrauterine life B. 30 weeks of intrauterine life C. Birth D. Menarche E. Age of 25 years
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A*22 weeks of intrauterine life 14
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Ovarian failure causes atrophic changes in all of the following, except: A. Uterus B. Vagina C. Urethra D. Bone E. Rectum
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C* Urethra . 15#
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Regarding menstrual cycle, all the following are true except: A. Increasing levels of FSH from anterior pituitary gland B. FSH release is influenced by gonadotropin releasing hormone from hypothalamus C. FSH promotes follicular development in the ovary D. Ovulation occurs 14 days from 1st day of the cycle E. The endometrium undergoes proliferation during 1st half of the cycle
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B* FSH release is influenced by GnRH from hypothalamus 16
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In a normal menstrual cycle of 35 days duration, ovulation occurs: A. Two weeks before menstrual flow B. Mid cycle C. Time of maximum progesterone production D. Two weeks after the onset of the menstrual flow E. Time of maximum prolactin production
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A* Two weeks before menstrual flow 17
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Severe hyperstimulation syndrome associated with gonadotropin therapy may be manifested clinically by the following, except: A. Abdominal pain B. Ascites C. Follicular cysts D. Hypovolemic shock E. Thrombo-embolic episodes
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A* Abdominal pain 18
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Physiologic processes that are estrogen dependent in women include all the following except: A. Menses B. Vaginal cornification C. Hirsutism D. Appearance of axillary hair E. Production of cervical mucus
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C* Hirsutism 19
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In a 38 years old woman complaining of irregular and heavy periods, the first line of management is: A. Vitamin K injections B. Dilatation and curettage (D&C C. Hormone therapy D. Immediate hysterectomy E. Radiotherapy
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B* Dilatation and curettage (D&C 20
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Complication of Dilation and Curettage D&C include all of the following, except: A. Uterine perforation B. Injury of the urethra C. Cervical laceration D. Cervical stenosis E. Asherman's syndrome
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B* Injury of the urethra 21
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Laparoscopy is a useful investigation to diagnose one of the following conditions: A. Adenomyosis B. Congenital uterine abnormalities C. Premature ovarian failure D. Endometriosis E. Vaginal atresia
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D* Endometriosis 3. Hysteroscopy. 22
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The following are contraindications for Hysterosalpingography, except: A. Uterine bleeding B. Active pelvic infection C. Suspected pregnancy D. Bicornuate uterus E. Active cervicitis
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D* Bicornuate uterus 23
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Concerning primary amenorrhea, all the following are true except: A. Investigations include serum FSH B. Is associated with karyotype 45 XO C. May be due to congenital adrenal virilism (hyperplasia D. May be due to Mullerian duct fusion failure E. May be due to granulous cell tumors of the ovary
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E* May be due to granulous cell tumors of the ovary 24
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All of the following may cause primary amenorrhea, except: A. Cryptomenorrhea (imperforate hymen B. Testicular feminization syndrome C. Turner's syndrome D. Gonadal agenesis E. Dermoid cyst of the ovary
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E* Dermoid cyst of the ovary 25
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Amenorrhea in a 16 years old girl may result from all of the following conditions, except: A. Imperforate hymen B. Androgen insensitivity syndrome (testicular feminization syndrome C. Turner's syndrome D. Bicornuate uterus E. Pituitary tumor
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D* Bicornuate uterus 26
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Absence of vagina is common in: A. Congenital adrenal hyperplasia B. Turner's syndrome C. In Mullerian atresia with absent uterus D. With absent uterus in testicular feminization syndrome E. Drug induced masculinization
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C* In Mullerian atresia with absent uterus 27
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The following statements are true regarding hematocolpos, except: A. It causes primary amenorrhea B. The patient may present with urine retention C. The patient may present with abdominal mass D. The treatment is incision of hymen E. Breasts atrophy may occur
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E* Breasts atrophy may occur 28
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An imperforate hymen in a girl may be associated with all of the following, except: A. Retention of urine B. Hematocolpos C. Periodical abdominal pain D. Amenorrhea E. Absent uterus
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E* Absent uterus 29
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Concerning secondary amenorrhea, all the following are true except: A. May be due to thyrotoxicosis B. May be due to anorexia nervosa C. Investigations include prolactin levels D. Oral contraceptives can be used in treatment E. Clomiphene can be given as treatment
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E* Clomiphene can be given as treatment 30
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All of the following may cause secondary amenorrhea, except: A. Lactation (breast feeding B. Endometriosis C. Pituitary failure D. Early menopause E. Pregnancy
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B* Endometriosis 31
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One of the following investigations is necessary in patients with primary amenorrhea: A. Serum TSH B. Serum prolactin C. Dilation and Curettage D. Chromosomal analysis E. Hysteroscopy
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D* Chromosomal analysis 32
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In secondary amenorrhea, elevated FSH over 40 nmol/u, indicates: A. Polycystic ovary syndrome B. Ovarian failure or resistance C. Pituitary failure D. Anorexia nervosa E. Hypothalamic amenorrhea
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B* Ovarian failure or resistance 33
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Raised FSH levels are found in all of the following, except: A. Post menopausal woman B. Turner's syndrome C. Prepubertal girls D. Gonadal dysgenesis E. Kleinfelter's syndrome
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C* Prepubertal girls 34
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All of the following are true about effect of androgens on the external genitalia of a female fetus, except: A. Clitoral hypertrophy B. Labia fusion to form scrotum C. May give varying degrees of hypospadia D. It may cause adrenogenital syndrome E. It may cause closure of the Bartholin gland duct
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E* It may cause closure of the Bartholin gland duct 35
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Signs of virilism include all of the following, except: A. Excessive body hair B. Muscle development C. Deepening of the voice D. Clitoromegaly E. Occipital balding
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E* Occipital balding 36
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The most common pelvic mass associated with amenorrhea in a reproductive age woman is: A. Follicular cyst B. Corpus luteum cyst C. Benign cystic teratoma D. Leiomyoma E. Pregnancy
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E* Pregnancy 2. Abnormal Uterine Bleeding. 37
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The most likely cause of abnormal genital bleeding in a 13 year old girl is: A. Uterine cancer B. Ectopic pregnancy C. Threatened abortion D. Cervical cancer E. Anovulation
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E* Anovulation 38
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Regarding dysfunctional uterine bleeding all of following are true, except: A. It is an abnormal menstrual pattern B. There is no organic disease in the uterus C. It may cause menorrhagia D. It may cause prolonged period E. It is a pre-malignant condition of the endometrium
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E* It is a pre-malignant condition of the endometrium 39
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All of the following are true for hemorrhagic metropathia, except: A. It is a condition of variable periods of amenorrhea B. It occurs more common with fibroid in the uterus C. Periods are heavy, continuous and painless D. It is found more common nearer the menopause E. It is a feature of anovular cycles in which estrogen levels are high
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B* It occurs more common with fibroid in the uterus 40
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The most common cause of heavy bleeding in adolescent girls is: A. Uterine fibroid B. Endometriosis C. Dysfunctional uterine bleeding D. Cervical erosion E. Hypothyroidism
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C* Dysfunctional uterine bleeding 41
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Vaginal bleeding in the newborn female infant is most commonly due to: A. Trauma B. Estrogen withdrawal C. Infections D. Neoplasms E. Hemorrhagic disease of the newborn
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B* Estrogen withdrawal 42
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A 4 days old female healthy baby presented to your clinic with vaginal bleeding, the most appropriate action to do is: A. Refer to gynecologist B. Do PT and PTT C. Reassure the parents D. Do pelvic US E. Give vitamins and iron
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C* Reassure the parents 43
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One of the following drugs is commonly used for dysfunctional uterine bleeding DUB: A. Progesterone B. Testosterone C. Estrogen D. Epsilon aminocaproic acid E. Prostaglandin
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A* Progesterone 44
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One of the following is associated with dysfunctional uterine bleeding: A. Uterine infection B. Placental polyp C. Cervical polyp D. Polycystic ovary E. Endometrial carcinoma
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D* Polycystic ovary 3. Dysmenorrhea. 45
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Regarding dysmenorrhea all of the following are true, except: A. It is a painful menstruation B. The spasmodic type is the primary C. The congestive type is the secondary D. Membranous dysmenorrhea is most uncommon E. D&C is the treatment of choice
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E* D&C is the treatment of choice 46
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All of the following are true about spasmodic dysmenorrhea (primary, except: A. The pain occurs with the onset of menstruation B. The pain in colicky in nature C. It may associate with nausea and vomiting D. It is more common in multi parous women E. The pain may radiate from lower abdomen to the inner aspects of the thighs
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D* It is more common in multi parous women 47
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Primary dysmenorrhea at the time of menstruation is caused by: A. Uterine atony B. Uterine ischemia C. Ovulation D. High level of estrogen E. Uterine hyper contractility due to prostaglandins release
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E* Uterine hyper contractility due to prostaglandins release 4. Postmenopausal bleeding. 48
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Regarding post menopausal bleeding, all the following are true except: A. May be caused by estrogen therapy B. Can only occur six months after the cessation of menses C. May occur due to atrophic vaginitis D. Dilatation and curettage are mandatory E. Rarely is due to malignant changes in the endometrium
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E* Rarely is due to malignant changes in the endometrium 49
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All of the following may cause postmenopausal bleeding, except: A. Estrogen therapy B. Atrophic changes of the vagina C. Testosterone therapy D. Cervical malignancy E. Endometrial malignancy
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C* Testosterone therapy 50
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The following are causes of post menopausal bleeding, except: A. May be caused by estrogen therapy B. Atrophic vaginitis C. Endometrial malignancy D. Cervical carcinoma E. May be caused by non hormone-producing ovarian tumors
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E* May be caused by non hormone-producing ovarian tumors 51
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Causes of post menopausal bleeding are the following, except: A. Endometrial cancer B. Cervical cancer C. Urethral carbuncle D. Ovarian tumor E. Prolapse of the uterus
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C*Urethral carbuncle 52
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Post menopausal bleeding is managed primarily by: A. Hormonal replacement B. Papanicolau smear C. Dilatation and curettage (D&C D. Cervical biopsy E. Contraceptive pills
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C* Dilatation and curettage (D&C 53
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Postmenopausal bleeding is usually caused by all the following except one: A. Cervical lesions B. Vaginal lesions C. Hematologic disease D. Gastroenterological lesions E. Urinary lesions
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C* Hematologic disease 54
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Regarding endometriosis all of the following are true, except: A. The endometrium is found in situation other than the uterine cavity B. It may be found in myometrium C. The principle feature is menorrhagia D. It may cause infertility E. The treatment of choice in young age is hysterectomy
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E* The treatment of choice in young age is hysterectomy 55
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Concerning endometriosis, all the following are true except: A. Causes deep dyspareunia B. Is often asymptomatic C. Is frequently pre-malignant D. Often present as secondary dysmenorrhea E. Rare outside the pelvis
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C* Is frequently pre-malignant 56
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The following are characteristics of endometriosis, except: A. Period pain is congestive type B. Periods may be heavy C. There is intermenstrual bleeding D. May cause infertility E. May cause ovarian cysts
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C* There is intermenstrual bleeding 57
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All of the following symptoms are associated with endometriosis, except: A. Dyspareunia B. Dysmenorrhea C. Menorrhagia D. Back pains E. Amenorrhea
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E* Amenorrhea 58
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The most common site of endometriosis externum is: A. The uterus B. The pouch of Douglas C. The ovaries D. The fallopian tubes E. The cervix
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C* The ovaries 59
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All of the following are theories for causation of endometriosis except: A. Coelomic metaplasia B. Endometrial hyperplasia C. Retrograde menstruation D. Immunologic deficiency E. lymphatic spread of endometrial fragment
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B* Endometrial hyperplasia 60
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Endometriosis is often associated with all the following except: Dysmenorrhea Dyspareunia Infertility Amenorrhea Pelvic pain
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D* Amenorrhea 61
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In adenomyosis the endometrial glands are localized at: A. Pelvic cavity B. Ovaries C. Fallopian tubes D. Bowels E. Uterine muscle
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E* Uterine muscle 62
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Concerning uterine fibroids the following are true, except: A. Rarely cause infertility B. They are not a cause of post menopausal bleeding C. May be asymptomatic during pregnancy D. May undergo red degeneration during pregnancy E. May cause antepartum hemorrhage
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B* They are not a cause of post menopausal bleeding 63
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The most common tumor of the uterine corpus is: A. Adenocarcinoma B. Squamous carcinoma C. Leiomyoma D. Sarcoma E. Lymphoma
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C* Leiomyoma 64
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All of the following complications are associated with intramural fibroid, except: A. Excessive uterine bleeding B. Red degeneration during pregnancy C. Fatty degeneration D. Hyaline degeneration E. Sarcomatous changes in 20% of cases
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E* Sarcomatous changes in 20% of cases 65
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The following changes may occur in a fibroid, except: A. Cystic changes B. Sarcomatous changes C. Calcified called "womb stone" D. Acute fatty degeneration E. Hyaline degeneration
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D* Acute fatty degeneration 66
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The commonest type of bleeding encountered with uterine leiomyoma (fibroids is: A. Post coital bleeding B. Menorrhagia C. Metrorrhagia D. Postmenopausal bleeding E. Intra-abdominal bleeding
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B* Menorrhagia 67
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Uterine fibroid may be associated with all of the following, except: A. Amenorrhea B. Menorrhagia C. Frequency of micturition D. Infertility E. Abdominal enlargement
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A* Amenorrhea 68
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In a 42 years old female who has menorrhagia due to a uterine fibroid, the best treatment is: A. Radiotherapy B. Myomectomy C. Total abdominal hysterectomy D. Hormonal therapy E. Repeated D&C operations
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B* Myomectomy 69
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The most common pelvic mass in postmenopausal women is: A. Follicular cyst B. Corpus luteum cyst C. Germ cell tumor D. Leiomyoma E. Endometrioma
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D* Leiomyoma 70
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The most common uterine neoplasm is: A. Sarcoma B. Adenocarcinoma C. Choriocarcinoma D. Adenomyosis E. Leiomyoma
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E* Leiomyoma 71
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The ideal method of contraception for a cardiac patient with mitral valve disease who desires no more children is by: A. Birth control pills B. IUCD (Intra Uterine Contraceptive Device C. Laparoscopic tubal ligation D. Immediate post partum tubal ligation E. Tubal ligation 40 days after delivery by laparotomy
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E* Tubal ligation 40 days after delivery by laparotomy 2. Hormonal Methods. 72
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The most effective contraceptive known is: A. Diaphragm B. Condom (Sheath C. Synthetic progestin D. Combined contraceptive pills (estrogen + progesterone E. Intrauterine device
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D* Combined contraceptive pills (estrogen + progesterone 73
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About combined oral contraceptive pills one is true: A. Predispose to pelvic inflammatory disease (PID B. Predispose to breast tumors C. Predispose to ovarian cyst D. May be used in patient with heart lesion E. Less effective in patient with epilepsy on treatment
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E* Less effective in patient with epilepsy on treatment 74
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One of the following is contraindicated in combined oral contraceptive pills: A. Multiparity B. Chronic liver disease C. Primary dysmenorrhea D. Bronchial asthma E. Endometriosis
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B* Chronic liver disease 75
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All of the following are contraindications for the use of combined oral contraceptive pills, except: A. Liver disease B. Secondary amenorrhea C. Thrombo-embolic disease D. Sickle cell disease E. Endometriosis
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E* Endometriosis 76
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Absolute contraindication for oral contraceptive pills are the following, except: A. Carcinoma of the breast B. Heart disease C. Lactating mother D. Liver diseases E. Thrombo-embolic disease
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C* Lactating mother 77
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Contraindications to birth control pills include all of the following, except: A. Migraine headache B. Deep vein thrombosis C. Hypertension D. Liver adenoma E. Hirsutism
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E* Hirsutism 78
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All of the following are side effects of oral contraceptives, except: A. Weight gain B. Hypertension C. Deep vein thrombosis D. Strike E. Hypoglycemia
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E* Hypoglycemia 79
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The effectiveness of oral contraceptives is reduced following interaction with the following drugs, except: A. Ampicillin B. Phenobarbitone C. Phenytoin D. Thyroxine E. Carbamazepine
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D* Thyroxine 80
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Regarding oral contraceptive pills, one is true: A. Inhibit release of gonadotropic hormones B. May lead lo thinning of cervical mucus C. Lead to reduced platelet aggregation D. Lead lo increased antithrombin III E. Increase fallopian tube smooth muscle activity
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A* Inhibit release of gonadotropic hormones 81
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The use of combined oral contraceptive pills may increase the risk of one of the following conditions: A. Fibrocystic breast disease B. Hepatic adenoma C. Salpingitis D. Ovarian cancer E. Endometrial cancer
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B* Hepatic adenoma 82
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The most common side effect of low-dose oral contraceptive pills is: A. Breakthrough bleeding B. Dysmenorrhea C. Nausea D. Hypertension E. Breast pain
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A* Breakthrough bleeding 83
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Concerning Intrauterine Contraceptive Device IUCD, choose the correct answer: A. Failure rate 2-3 % women every year B. Increases the incidence of cervical erosion C. Increases the incidence of Candida infection D. Contraindicated in patients with cervical polyp E. Cryocautery to the cervix can be done while IUCD is in situ
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A* Failure rate 2-3 % women every year 84
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Intrauterine contraceptive devices (inert type prevent pregnancy by all of the possible mechanisms, except: A. Increase the motility of fallopian tubes B. Increase the contractility of the uterus C. Causing aseptic inflammatory reaction in the endometrium D. Increasing the potential space of uterine cavity E. Increasing the hostility of the cervical mucus to the spermatozoid
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A* Increase the motility of fallopian tubes 85
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One of the following is an absolute contraindication to Intrauterine Contraceptive Device IUCD: A. Uterine fibroids B. Bicornuate uterus C. Grand multi-parous woman D. Previous caesarian section E. Lactation
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B* Bicornuate uterus 86
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Contraindications of IUCD are the following, except: A. Pregnancy B. Pelvic infection C. Multigravida D. Dysfunctional uterine bleeding E. Patient with heart disease
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C* Multigravida 87
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Intrauterine contraceptive device may be associated with following complications, except: A. Pelvic infection B. Uterine perforation C. Ectopic pregnancy D. Cervical erosion E. Menorrhagia
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D* Cervical erosion 88
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The most common method of contraception in Jordan is: A. Intrauterine device (IUCD B. Long acting progesterone injection (Depo-Provera C. Diaphragm D. Spermicidal cream E. Lactation
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A* Intrauterine device (IUCD 89
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A 27 years old woman has tried unsuccessfully for 5 months to become pregnant, The recommended investigation in this case would be: A. Hormonal assay B. Hysterosalpingogram (HSG C. Endometrial biopsy D. Laparoscopy E. None of the above
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E* None of the above 90
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All the following are complications of ovulatory inducers, except: A. Multiple pregnancy B. Ectopic pregnancy C. Hypotension D. Ascites E. Hypoproteinemia
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E* Hypoproteinemia 91
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What percentage of couples in the reproductive age is unable to conceive after one year of coitus without contraception: A. 1-2% B. 15% C. 30% D. 50% E. 75%
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B* 15% 92
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All of the following are possible indications of ovulation, except: A. Increased plasma levels of progesterone in the second half of the cycle B. Increased basal temperature in the second half of the cycle C. Follicular stimulating hormone surge at the mid cycle D. Change in the cervical mucus E. Mid cycle abdominal pain
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C* Follicular stimulating hormone surge at the mid cycle 93#
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Ovulation can be diagnosed by the following, except: A. Measuring day 14 serum progesterone B. Observing a rise in basal body temperature in the second half of the menstrual cycle C. Study of cervical mucus D. Endometrial biopsy E. Day 20 serum prolactin
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E* Day 20 serum prolactin 94#
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Ovulation can be diagnosed by all the following except one: Measuring day 14 serum progesterone Observing a rise in basal body temperature in the second half of the menstrual cycle Study of the cervical mucus Endometrial histology Mittle schmerz (midcyclic pain
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1* Measuring day 14 serum progesterone 95
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Tests to detect ovulation include all of the following, except: A. Basal body temperature B. Endometrial biopsy C. Estrogen level D. Progesterone level E. Vaginal wall cytology
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C* Estrogen level 96
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Induction of ovulation may be achieved by giving: A. Clomiphene citrate B. Cyproterone acetate C. Letrozole D. FSH and LH E. Tamoxifen
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A* Clomiphene citrate 97
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Clomiphene citrate is contraindicated in one of the following: A. Endometrial hyperplasia B. Post pill amenorrhea C. Polycystic ovary (Stein-Leventhal syndrome D. Ovarian tumors E. Infrequent ovulation
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D* Ovarian tumors 98
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Normal semen should have the following characteristics, except: A. Volume 2.5-5 cc B. Liquefaction in 30 minutes C. Motility 60-70% after 3 hours D. After 6 hours only 30% remain motile E. Sperm count the average normal specimen is 10-20 million per 1 cc
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E* Sperm count the average normal specimen is 10-20 million per 1 cc 98
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All of the following may cause azoospermia, except: A. Blockage of the ducts B. Klinefelter syndrome C. Orchitis due to mumps D. Varicoceles E. Surgical trauma to the spermatic artery
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D* Varicoceles 99
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Male sterilization (vasectomy causes: A. Azoospermia B. Loss of libido C. A decrease in the volume of the ejaculat D. Impotence E. Infection
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A* Azoospermia 100
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All of the following are causes of abnormal spermatogenesis except: A. Cryptorchidism B. Genetic abnormality C. Varicoceles D. Cold environment E. Drugs
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D* Cold environment 101
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All the following environmental factors might adversely affect spermatogenesis except: A. Prolonged sitting B. Febrile illness C. Hot bath D. Swimming E. Frequent saunas
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D* Swimming 102
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Regarding polycystic ovary syndrome all are true, except: A. Is best treated by clomiphene B. Wedge resection is the treatment of choice C. Absence of LH surge D. Low or normal FSH E. High testosterone level
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A* Is best treated by clomiphene 103
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Stein-Leventhal syndrome (polycystic ovary is usually characterized by all the following, except: A. Hirsutism B. Infertility C. Menorrhagia D. Obesity E. Anovulation
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C* Menorrhagia 104
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All of the following problems may occur with an ovarian cyst, except: A. May undergo torsion B. May undergo rupture C. May undergo hemorrhage D. Retention of urine is common E. May undergo malignant changes
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D* Retention of urine is common 105
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Primipara 20 weeks pregnant was found to have ovarian cyst 7x7 cm, the proper treatment is: A. Weekly assessment of the size of the cyst B. Termination of pregnancy C. Cystectomy after puerperium D. Cesarean section and cystectomy after 37 completed weeks E. Laparotomy and cystectomy as soon as discovered
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E* Laparotomy and cystectomy as soon as discovered 106
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A 65 years old woman was found to have ovarian cyst 6x6 cm, the proper treatment is: A. Observation B. Laparoscopy C. Laparotomy and cystectomy D. Hysterectomy E. Treatment no need
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C* Laparotomy and cystectomy 107
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Regarding polycystic ovaries all are true except: A. Are associated with hirsutism B. Are associated with infertility C. Have an increased risk of malignant change in the ovaries D. Are associated with obesity E. Show dense thickening of the capsule
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C* Have an increased risk of malignant change in the ovaries 108
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One of the following about childhood vulvovaginitis is true: A. Is commonly due to staphylococcal infection B. Is commonly due to monilial infection C. Is caused by thread worms D. Estrogen cream is of little help E. Commonly requires treatment with systemic antibiotic
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E* Commonly requires treatment with systemic antibiotic 109
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Pruritus vulvae may be present in all of the following, except: A. Monilial infection B. Diabetes mellitus C. Gonorrhea D. Psychological problems E. Leukoplakia (vulvar dystrophy
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E* Leukoplakia (vulgar dystrophy 110
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Which of the following conditions is the most likely cause of vulvovaginal symptoms in children: A. Foreign body B. Lichen sclerosus C. Physiologic leucorrhea D. Trauma E. Non-specific
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E* Non-specific 111
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The most common skin disease affecting the vulva is: A. Psoriasis B. Vulval cancer C. Vulval injury D. Vulval abscess E. Contact dermatitis
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E * Contact dermatitis 112
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Which of the following is most likely to cause vulval pruritus: A. Anemia B. Leukemia C. Heart failure D. Hypertension E. Personal hygiene products
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E * Personal hygiene products 114
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In a patient complaining of bad smelling, frothy and irritative vaginal discharge, wet smear showed "clue cells", the causative organism is: A. Candida albicans B. Gardnerella vaginalis C. Bacteroides D. Mycoplasma E. Trichomonas vaginalis
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B* Gardnerella vaginalis 115
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Profuse cream frothy vaginal discharge is characteristic of: A. Moniliasis B. Trichomoniasis C. Gonorrhea D. Tuberculosis E. Syphilis
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B* Trichomoniasis 116
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Regarding vaginal candidiasis, all the following are true except: A. Caused by yeast B. Acid media in the vagina C. Best treated by metronidazole D. Commonly associated with vulvar pruritus E. Patients partner may need treatment
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C* Best treated by metronidazole 117
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All of the following are predisposing factors for monilial infection, except: A. Combined oral contraceptive pills B. Diabetes mellitus C. Pregnancy D. Intrauterine contraceptive device E. Patients on broad spectrum antibiotics
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D* Intrauterine contraceptive device 118
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The commonest cause of vaginal itching during pregnancy is: A. Non specific vaginal infection B. Trichomonal vaginal infection C. Vaginal moniliasis D. Gonorrhea E. Cervical erosion
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C* Vaginal moniliasis 119
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Blood stained vaginal discharge occurs in the following, except: A. Carcinoma of the cervix B. Moniliasis C. Cervical polyp D. Senile vaginitis E. Carcinoma of the body of the uterus
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B* Moniliasis 120
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The following might increase vaginal discharge during pregnancy except one: A. Bacterial vaginitis B. Trichomonas vaginalis C. Candida vaginitis D. Simple ovarian cyst E. Physiological
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D* Simple ovarian cyst 121
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In vulvo-vaginal hematoma, all the following are true except: A. Usually related to child birth B. Is usually painless purple colored swelling C. Incision and evacuation is the treatment of choice D. The bleeding is usually of arterial origin E. Packing is rarely necessary
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C* Incision and evacuation is the treatment of choice 122
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Sexually transmitted diseases include all of the following except: A. Trichomonas vaginalis B. Type II herpes hominis C. Condyloma acuminate D. Chlamydial infections E. Tuberculosis
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E* Tuberculosis 123
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All of the following are sexually transmitted diseases, except: A. Trichomoniasis B. Candidiasis (moniliasis C. Condyloma acuminate D. Gonorrhea E. Syphilis
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B* Candidiasis (moniliasis 124
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Gonorrhea may affect all of the following, except: A. Fallopian tubes B. Urethra C. Vagina D. Cervix E. Bartholin gland
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C* Vagina 125
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All the following are true about Neisseria gonorrhoeae, except: A. Is a Gram-negative coccus B. Is a Gram-negative bacillus C. Occurs in pairs D. Has a capsule E. Sensitive to penicillin
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B* Is a Gram-negative bacillus 126
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Regarding Neisseria gonorrhea culture during pregnancy, the highest positive culture is got from: A. Urethra B. Cervix C. Vagina D. Rectum E. Throat
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A* Urethra 127
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Identification of donovan bodies in large mononuclear cells in Gimsa-stained from vulval lotion during pregnancy is diagnostic of: A. Chancre B. Chancroid C. Granuloma inguinale D. Lymphogranuloma venereum E. Sarcoid
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C* Granuloma inguinale 127
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Sexually transmitted diseases include all of the following except: A. Trichomonas vaginalis B. Type II herpes hominis C. Condyloma acuminate D. Chlamydial infections E. Type I herpes hominis
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E* Type I herpes hominis 128
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All of the following diseases are transmitted sexually, except: A. Cytomegalovirus B. Hepatitis B C. Herpes simplex D. Scabies E. Granuloma annulare
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e*granuloma annulare 129
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All of the following diseases are transmitted sexually, except: Chancroid Hepatitis B AIDS Gonorrhea Pemphigoid
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e* pemohigoid 130
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In bartholin abscess, one of the following statements is true: A. It occurs bilaterally in most cases B. Treatment is by surgery (marsupialization C. It may cause infertility D. The most common causing agent is staphylococcus E. Antibiotic treatment is enough
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B* Treatment is by surgery (marsupialization 131
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All of the following microorganisms may cause acute salpingitis, except: A. Neisseria gonorrhea B. Chlamydia C. Bacteroids D. Candida albicans E. Gram negative streptococci
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D* Candida albicans 132
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All of the following conditions may be confused with acute salpingitis, except: A. Acute appendicitis B. Tubal pregnancy C. Acute pyelonephritis D. Bartholin's abscess E. Ruptured ovarian cyst
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D* Bartholin's abscess 133
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Management of septic pelvic thrombophlebitis usually will include: A. Bed rest and analgesics alone B. Antibiotics alone C. Antibiotics and heparinization D. Heparinization alone E. Immediate vena cava ligation
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C* Antibiotics and heparinization 134
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Pelvic fallopian tube adhesions causing infertility may be due to all of the following, except: A. Appendicitis B. A post abortion infection C. A post puerperal sepsis D. Adenomyosis E. Pelvic endometriosis
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D* Adenomyosis 135
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Symptoms of PID include all of the following except: A. Abdominal pain B. Dyspareunia C. Amenorrhea D. Abnormal vaginal discharge E. Fever and chills
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C* Amenorrhea 136
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PID differential diagnosis includes all of the following except: A. Ectopic pregnancy B. Endometriosis C. Spontaneous abortion D. Intrauterine pregnancy E. Diverticulitis
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D* Intrauterine pregnancy 137
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About tuberculosis of the genital tract, all the following are true except: A. Most commonly affects the fallopian tubes B. It is transmitted by hematogenous spread C. Causes infertility D. Causes amenorrhea E. Predisposes to endometrial carcinoma
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E* Predisposes to endometrial carcinoma 138
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Concerning menopause the following are correct, except: A. Serum androstenedione levels increase B. The quantity of estrogens present increase by obesity C. Therapy is rarely needed for more than 4 months D. Combined estrogen and progesterone therapy is best E. Withdrawal bleeding following combined therapy is not an indication for curettage
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C* Therapy is rarely needed for more than 4 months 139
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During menopause one of the following is true: A. Serum FSH only is elevated B. Serum LH only is elevated C. Both FSH and LH are elevated D. Serum FSH is low E. Serum FSH and LH are low
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C* Both FSH and LH are elevated 140
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All of the following may occur in menopausal women, except: A. The breast tend to decrease in size B. The uterus atrophies C. The endometrium hyper-atrophies D. The vaginal mucosa becomes thin E. The pH of the vagina rises
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C* The endometrium hyper-atrophies 141
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All of the following symptoms are true for menopause, except: A. Irritability B. Headache C. Vasomotor instability D. Backache E. Ovulation
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E* Ovulation 142
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Regarding the climacteric, all the following are true except: A. Headache B. Palpitation C. Hot flushes D. Low FSH E. Sweating
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D* Low FSH 143
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Menopause is associated with all of the following, except: A. Hot flushes B. Insomnia C. Decreased incidence of myocardial infarction D. Osteoporosis E. Loss of libido
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C* Decreased incidence of myocardial infarction 144
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Symptoms of uterine prolapse are the following, except: A. Retention of urine B. Backache C. Vaginal discharge D. Vaginal bleeding E. Heaviness in the vagina
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A* Retention of urine 145
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Concerning stress urine incontinence the following are correct, except: A. Can be caused by rectocele B. Is more common in multi parous C. Long term antibiotic therapy will not improve it D. Can be treated by anterior colporrhaphy E. Can be treated by colposuspension
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A* Can be caused by rectocele 146
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Risk factors of endometrial carcinoma include all of the following except: A. Estrogen therapy B. Early menopause C. Obesity D. Low parity E. Adenomatous hyperplasia
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B* Early menopause 147
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A 47 year old woman complains of heavy post-coital bleeding. The most likely origin of his bleeding would be: A. Cervical polyp B. Ectropion C. Carcinoma D. Nabothian cyst E. Infection
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C* Carcinoma 148
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One of the following drugs causes endometrial hyperplasia: A. Progesterone hormone B. Clomiphene citrate C. Estrogens D. Combined oral contraceptive pills E. Bromocriptine
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C* Estrogens 149
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The most common symptom of endometrial hyperplasia is: A. Vaginal discharge B. Vaginal bleeding C. Amenorrhea D. Pelvic pain E. Abdominal distention
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B* Vaginal bleeding 150
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Endometrial carcinoma is most common in which of the following: A. 10 to 25 years B. 25 to 30 years C. 30 to 40 years D. 40 to 50 years E. More than 60 years
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E* More than 60 years 151
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A 69 years old postmenopausal woman is being admitted for surgical treatment of endometrial cancer. Which of the following is the best preoperative test to look for metastasis: A. Chest X-Ray B. Hysterosalpingogram C. Pelvic US D. Intravenous pyelogram (IVP E. Barium enema
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A* Chest X-Ray 152
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The primary mode of treatment for endometrial carcinoma confined to the uterine body is: A. External beam radiation B. Intracavitary radium C. Hysterectomy D. Chemotherapy E. Progestin therapy
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C* Hysterectomy 153
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All of the following are estrogen actions on the uterus, except: A. It causes an active development of the myometrium B. The endometrium undergoes proliferation C. Stimulates the growth of the glandular component D. It causes increase of cervical mucus E. Has no effect on enlargement of the uterus during pregnancy
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E* Has no effect on enlargement of the uterus during pregnancy 154
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One of the following ovarian tumors is more likely to cause hirsutism: A. Theca lutein cyst B. Androblastoma C. Krukenberg tumor D. Serous cystadenoma E. Follicular cyst
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B* Androblastoma 155
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One of the following ovarian tumors is malignant: A. Follicular cyst B. Luteal cyst C. Dysgerminoma D. Chocolate cyst E. Dermoid cyst
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C* Dysgerminoma 156
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Concerning dermoid cysts the following are correct, except: A. Are germ cell tumors B. Are bilateral in 10% of cases C. Are the commonest cysts defected during pregnancy D. Are malignant in less than 5% of cases E. Are frequently XY (karyotype
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E* Are frequently XY (karyotype 157
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Concerning malignant ovarian tumors, all the following are true except: A. Are often bilateral B. Often present as an asymptomatic mass C. More common post menopause D. Have a good prognosis after treatment E. Are mostly hormone secreting
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E* Are mostly hormone secreting 158
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The most frequent diagnosed type of ovarian cancer is: A. Epithelial B. Germ cell C. Specialized stromal cell D. Non-specialized stromal cell E. Metastatic disease to the ovary
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A* Epithelial 159
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The first line of treatment for ovarian cancer is: A. Radiotherapy B. Surgery C. Chemotherapy D. Radiotherapy and chemotherapy E. Observation
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B* Surgery 160
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The primary lesion of Krukenberg ovarian tumor is commonly in: A. Large bowels B. Brain C. Stomach D. Bone E. Liver
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C* Stomach 161
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A 65 years old woman was found to have ovarian cyst 6x6 cm, the proper treatment is: A. Observation B. Laparoscopy C. Laparotomy and cystectomy D. Hysterectomy E. Treatment no need
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C* Laparotomy and cystectomy 162
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Childhood neoplastic ovarian masses most commonly from: A. Gonadal epithelium B. Gonadal stromal C. Germ cells D. Sex cord E. Metastatic disease
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C* Germ cells 163
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The most common complication of large cystic teratoma during the first trimester is: A. Torsion B. Rupture C. Intracystic hemorrhage D. Solid degeneration E. Luteinization
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A* Torsion 164
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A medium-size ovarian cyst may be subjected to the following except: A. Torsion B. Necrosis C. Infection D. Rupture E. Malignant changes if she gets pregnant
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E* Malignant changes if she gets pregnant 165
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The commonest malignant tumors of the ovary are: Germ cell tumors Epithelial tumors Metastases from other tumors Stomal tumors Knikenburg tumors
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B* Epithelial tumors 166
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Most common neoplastic ovarian masses in postmenopausal women originate from: Ovarian epithelium Ovarian stroma Ovarian germ cells Ovarian sex cord Metastatic disease
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1* Ovarian epithelium 167
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Benign cystic teratoma (dermoid cyst is characterized by one of the following: It occurs bilaterally in 50% of cases It is formed of squamous epithelium only It is formed of squamous epithelium and sebaceous glands only It is formed of all three germ cell layers The commonest ovarian tumor associated with pregnancy
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1* all three 168
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Regarding carcinoma of the cervix, all the following are true except: A. Cervical smear is a screening method B. In the early stages of the disease there are no symptoms C. Cervical cancer spreads only by direct spread D. Post coital bleeding can be first sign E. Adenocarcinoma of the cervix account for 5% of cases
answer
C* Cervical cancer spreads only by direct spread 169
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The lining of cervical erosion is: A. Squamous epithelium B. Squamous epithelium with keratin C. Columnar epithelium D. Transitional epithelium E. Cervical stroma
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C* Columnar epithelium 170
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The histologic differentiation between invasive carcinoma of the cervix and carcinoma in situ depends upon one of the following: A. The Papanicolau smear report B. The basement membrane having been penetrated by abnormal epithelial cells C. The finding of cluecells in the basement membrane D. The finding of increased eosinophilic cytoplasm in the surface epithelium E. The surface epithelium taking up nils blue sulfate staining
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B* The basement membrane having been penetrated by abnormal epithelial cells 171
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In case of cervical carcinoma in situ in 50 years old woman, the treatment of choice is: A. Hysterectomy B. Cervical cryo-surgery C. Cervical cone-biopsy D. Selective biopsy under colposcopy E. Radiotherapy
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A* Hysterectomy 172
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One of the following is recommended for cervical cancer screening: A. Aspiration from the anterior fornix B. Cervical canal curettage C. Aspiration from the posterior fornix D. Ultrasound to the genital tract E. Papanicolau (pap smear
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E* Papanicolau (pap smear 173
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Asymptomatic cervical erosion in a pregnant patient is best managed by: A. Heat cautery B. Pap smear and follow up C. Cone biopsy D. Cryocautery E. Cervical amputation
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B* Pap smear and follow up 174
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Invasive carcinoma of the cervix commonly present with all the following, except: A. Post coital bleeding B. Intermenstrual bleeding C. Vaginal discharge D. Acyclic vaginal bleeding E. Menorrhagia
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E* Menorrhagia 175
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The most common benign neoplasm of the cervix and endocervix is: A. Leiomyoma B. Endometriosis C. Metastasis of uterine cancer D. Metastasis of ovarian cancer E. Polyps
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E* Polyps 167
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Often the first symptom of cervical cancer is: A. Leg pain B. Pain during intercourse C. Vaginal bleeding D. Weight loss E. Vulvar pruritus
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B* Pain during intercourse 177
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Cervical smear is a method to detect early cancer of: Ovarian Endometrial Vaginal Cervical Urethral
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D* Cervical 178
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The etiologic agent for vulvar cancer is: A. Squamous cell hyperplasia B. Atrophic dystrophy C. Chronic granulomatous disease D. Chronic irradiation E. Unknown
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E* Unknown 179
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The most common symptom of vulvar cancer in elderly woman is: A. Abnormal bleeding B. Foul smell C. Pruritus D. Vulvar atrophy E. Painful intercourse
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C* Pruritus 180
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A blue swelling on the vulva is most likely due to: A. Melanoma B. Varicosity C. Endometriosis D. Lipoma E. Hemangioma
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B* Varicosity 181
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The most common histopathological finding in primary carcinoma of the vagina is: A. Clear cell carcinoma B. Melanoma C. Squamous cell carcinoma D. Sarcoma E. Choriocarcinoma
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C* Squamous cell carcinoma
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113 The most effective treatment of vulvar pruritus associated with atrophic vulvitis is: A. Antihistamines B. Hydrocortisone C. Alcohol injection D. Tranquilizers E. Topical estrogen therapy
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Answer: E* Topical estrogen therapy
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