51. b.

behavioral
c. pre- menstrual dysphoric symptoms
52. What hormone that inhibits PROLACTIN??? - d.pre-menstrual symptoms
Ans: DOPAMINE
61.
53. A hormone that inhibits lactaDon during Alyssa came to ER due to hypogastrica pain
pregnancy: associated with menstrual bleeding. Pregnancy
A. Dopamine test was negaDve. 7 months prior paDents had
B. Estrogen her menarche. Denies any sexual contact. Labs
C. PRL taken were unremarkable.
D. Progesterone A. Give NSAID
B. Massage and apply warm compress to
54.) PaDent came in for hypogastric pain hypogastric pain
occuring during menses. TVS normal. Lab results C. Refer to behavioral service for evaluaDon and
unremarkable. Diagnosis? management
A.) Primary dysmenorrhea
D. Give OCP "
B.) Pelvic inflammatory disease
C.) Ectopic pregnancy
62.) Cyclic, painful cramping sensaDon in lower
D.) AborDon
abdomen accompanied by headaches, nausea
and vomiDng.
55.
Answer: Dysmenorrhea
56. Mechanism behind primary dysmenorrhea
63.
A. Excessive prostaglandins resulDng in uterine
hypercontracDlity
64. Secondary Dysmenorrhea is a
B. Endometrial hypoxia due to decreased blood
flow ! Crampy lower abdominal pain with
C. underlying pelvic pathology
D. Something about endometriosis
Answer: A 65.

57. Maria 28yo, G2P2 (2002) complained of 66. CharacterisDc pain of primary
pelvic pain during menses. PE and DiagnosDc dysmenorrhea
tests are unremarkable. She desires for birth
spacing. What will you give her for management a. occurs 2 weeks prior to menses
of pelvic pain? b. midline and radiates to the back
c. resolves 12-24 hours a]er onset
A. Mefenamic acid d. conDnuous unDl last day of menses
B. COC ! ans. C
C. Intrauterine device
67. most effecDve management for cervical
D. Behavioral therapt
stenosis
58.
a. mechanical dilaDon w/ hegars
59.
b. mechanical dilaDon w/ laminaria
c. pregnancy and delivery
60.- a group of mild and moderate physical and
d. ApplicaDon of dinoprostone
behavioral symptoms associated with
ans. C
menstruaDon?
a. pelvic
68. (18) Severe Social Impairment 78.
Amswer: PMDD 79.
80.
69. 30yrs old g3p3 (3003) worsening hypogastric
pain. PE shoes nodularity in posterior cul de sac. 81. Primary consideraDon of 34yo G6P4
a. pelvic endometriosis undergone D&C of last pregnancy w/12 months
b. adenomyosis amenorrhea.
c. PID Answer: Menopause
d. myoma uteri
answer: a. pelvic endometriosis 82 . Confirmatory test for ultrauterine
adhesions?
70. A HSG
B TVS
71. First sign of puberty C MRI
A growth spurt D CT scan with contrast
B thelarche Answer: A.
C adrenarche
D menarche 83.
ANSWER: B. Thelarche
84. CondiDon which results from obstetric
72. 10 years old, had breast bud. Shes now 15 hemorrhage
y.o and no mense. A. Asherman's syndrome
A. Precocious puberty B. Simmond disease
B. Primary amenorrhea C. Sheehan's syndrome
C. Secondary amenorrhea D. Primary ovarian failure
Ans. B. Answer: C

73. Breast budding occurs at what age? 85. 40yo G2P2(2002), 10months no menses.
a.10-15 Pregnancy test negaDve. TVS was unremarkable.
b.10-12 (+) history of ovarian surgery. What is your
c.9-15 diagnosis?
d.8-12 A. Asherman's Syndrome
answer:D.8-12years B. Simmond's Disease
C. Sheehan's syndrome
74. Rare complicaDon of meaormin D. Primary Ovarian Failure
-LacDc acidosis Answer: D.

75. What is the most common cause of primary

amenorrhea? 86. The ff condiDon causes increase in catechol
Answer: Gonadal failure estrogen increase which leads to GnRH increase
A. Anorexia nervosa
76. 15 y.o. complained of not menstruaDng B. Severe weight loss
yet..lab taken FSH result of >40mIU C. OCP
D. Stress and exercise
✅ a. Gonadal Failure
b. Primary Amenorrhea
87. A condiDon where there is premature
c. HyperProlacDnemia
maturaDon of hypothalamic-pituitary-ovarian
d. Primary Hypothyroidism
axis?
Answer: Gonadotropin dependent precocious
77.
puberty
 - mri
88.
98. The most common pituitary tumor which
89. (+) Breast buds: 3-4cm, PE findings normal. causes hyperprolacDnemia:
What is your diagnosis?
A. Precocious puberty A. ProlacDnoma
B. Premature thelarce B. Microadenoma
C. Normal findings C. Craniopharyngoma
D. Adrenarche D. Empty sella turcica
Answer: B Answer: A

90. How will you advice the mother of zoey? 99. Women who have prolacDnoma who do not
A. Observe child breast buddding usually regress want to pregnant you should give
B. Refer to pediatric gyne A. Advise surgical resecDon
C. Observe for development of secondary sexual B. Cabergoline
characterisDc C. BromocripDne
D. Advice for wrist xray to check bone age D. Expectant management
Answer: D. Expectant management
91.
100. Visual exam is indicated in
92. Triad of cafe au lait spot, polyostoDc fibrous Answer:macroadenoma
dysplasia, cysts of the skull and long bones
A. Granulosa cell tumor of ovary
B. Iatrogenic
C. Mcune albright syndrome
D. ProlacDnoma
Ans: C

93. The goal in the management of precocious

puberty.
A. Reduce or counteract gonadotropin secreDon
and acDon of sex steroids
B. Decrease growth rate to normal
C. Slow skeletal maturaDon to allow maximal
adult height
D. AOTA
Answer: D

94. Normal value for serum prolacDn — 8 ng/mL

95.
96.nipple discharge, you suspect of
hyperprolacDnemia? What will you order
Answer: A. Bed rest. Then take serum prolacDn
11 am in fasDng state

97. Amenorrhea, increase serum . What

diagnosDc
-tsh
Tvs
Gyne Quiz (Dr. Hamoy): ​Primary & C. Bilateral adnexal tenderness on
Secondary Dysmenorrhea, PMS, PMDD, deep palpation
Primary & Secondary Amenorrhea, D. No pain on cervical motion
Precocious Puberty,
Hyperprolactinemia, Galactorrhea, 56. Mechanism behind primary
Pituitary Adenoma dysmenorrhea
A. Excessive prostaglandins
51. Cindy, 28 yo, G1P1 (1001), presents resulting in uterine
with complaints of amenorrhea for 3 hypercontractility
months without associated findings. Which B. Endometrial hypoxia due to
of the following should you order first? decreased blood flow
A. FSH C. …
B. CBC/UA D. … endometriosis...
C. TSH measurement
D. Pregnancy test 57. Maria, 28 yo, G2P2 (2002),
complained of pelvic pain during menses.
52. Hormone that inhibit prolactin PE and diagnostic tests are unremarkable.
A. FSH She desires for birth spacing. What will
B. Dopamine you give her for management of pelvic
C. TSH pain?
D. GnRH A. Mefenamic acid
B. COC
53. What hormone inhibits lactation during C. Intrauterine device
pregnancy? D. Behavioral therapy
A. Dopamine
B. Estrogen 58. Joy, with irregular menses started 4
C. Prolactin years ago, scanty menses for 6 months. 4
D. Progesterone successive pregnancy losses. Underwent
curettage, what would you consider?
54. Angela, came in for consult of severe A. Pelvic endometriosis
hypogastric pain. Hx revealed that her B. PID
condition is recurrent and usually occurs C. Ectopic pregnancy
during menses. TVS - normal finding. Lab D. Cervical stenosis
test - unremarkable. Primary
consideration? 59. Painful, heavy menses, thick anterior
A. Primary dysmenorrhea of endometrium
B. Pelvic inflammatory disease Answer: Adenomyosis
C. Ectopic pregnancy
D. Threatened abortion 60. A group of mild and moderate physical
and behavioral symptoms associated with
55. Not a characteristic of Primary menstruation?
Amenorrhea A. Pelvic
A. Suprapubic tenderness relieved by B. Behavioral
massage C. PMDD
B. Uterine tenderness on deep D. PMS
palpation

3B VITALIS || GYNECOLOGY DFSP❤

61. Which of the following resolves during B. Occurs 2 weeks prior to
menses menstruation
A. Dysmenorrhea C. Resolves spontaneously within
B. PMDD 12-24 hours
C. PMS D. Starts on start of menses and
D. Sheehans syndrome stops on cessation of menstrual
flow
62. 16 yo, female, breast tenderness
occurs days before menstruation. 67. Most effective management for
Management? cervical stenosis
A. Reassure the patient and advise A. Hegar dilators
her to use a well-fitting brassiere B. Laminaria
B. Inform her that her condition is C. Pregnancy and delivery
normal D. Dinoprostone
C. Advise her to follow-up if condition
is persistent 68. Impaired social function is associated
D. Refer her to a breast surgeon for with
further evaluation and A. Dysmenorrhea
management B. Pelvic venous congestion
C. PMS
63. Cyclic painful cramping sensation D. PMDD
accompanied by headache, nausea, and
vomiting 69. Worsening of hypogastric pain during
Answer: Dysmenorrhea menses. Nodularity of the posterior cul de
sac.
64. Secondary dysmenorrhea A. Pelvic endometriosis
Answer: cyclic menstruation in B. Adenomyosis
association with underlying pathology C. PID
D. Myoma uteri
65. Alyssa with severe hypogastric pain
with menstrual bleeding. Pregnancy test 70. Marie, 16 yo, no menarche, no breast
negative. Had her menarche 7 months budding on PE. Dx?
ago. Denies sexual contact. Labs and A. Constitutional delay
aging studies unremarkable. What is your B. Primary Amenorrhea
management? C. Secondary Amenorrhea
A. Prescribe NSAIDS D. ...
B. Advice exercise and warm
compress in hypogastric area 71. First sign of puberty
C. Refer to behavioral service for Answer: thelarche
evaluation and management
D. Give OCP 72. sofia , 14 yo, went to your clinic for
consultation. Her breast budding was at
66. Characteristic pain of primary 10 yo, but no menstruation until now. Dx?
dysmenorrhea: A. Constitutional delay of puberty
A. Pain midline and radiates to B. Primary amenorrhea
thigh and back C. Secondary amenorrhea

3B VITALIS || GYNECOLOGY DFSP❤

 D. Precocious puberty 81. 34 yo, G4P3 (3013), no menses for 12
months now. Underwent complete
73. Breast budding occurs at what age? curettage during her last pregnancy due to
A. 10-15 retained product of conception. Pregnancy
B. 10-12 test negative. Dx?
C. 9-15 A. Primary ovarian failure
D. 8-12 B. Sheehans syndrome
C. Ashermans syndrome
74. Rare complication of metformin D. Menopause
Answer: Lactic acidosis
82. Confirmatory test for intrauterine
75. Most common cause of primary adhesion?
amenorrhea A. HSG
Answer: Gonadal failure B. TVS
C. MRI
76. 15 yo, complained of not menstruating D. CT scan with contrast
yet. Lab taken FSH result of >40mIU
A. Gonadal failure 83. Activity that can increase brain derived
B. Primary amenorrhea factors and increase catechol estrogen
C. Hyperprolactinemia and opioid peptides and inhibit GnRH
D. Primary hypothyroidism release
Answer: Stress and exercise
77. Short stature, webbing of neck, a short
4th metacarpal and cubitus valgus 84. Amenorrhea related to pregnancy
Answer: Turner’s syndrome Answer: Sheehans syndrome

78. Blind test for smell is indicated in? 85. 40 yo, G2P2 (2002), 10 months no
Answer: Kallman syndrome menses. Pregnancy test negative. TVS
unremarkable. (+) history of ovarian
79. Patient has androgen resistance with surgery. Dx?
inguinally located testes. Patient is at risk A. Asherman’s syndrome
for? B. Simmond’s syndrome
A. Ovarian failure C. Sheehan’s syndrome
B. Gonadoblastoma D. Primary ovarian failure
C. Gonadal failure
D. Testicular malignancy 86. Menstruation before 9 yo
Answer: Precocious puberty
80. Marilou, 34 yo, G4P4 (4004), no
menses for 8 months now. Negative for 87. A condition where there is premature
pregnancy. Dx? maturation of
A. Hyperprolactinemia hypothalamic-pituitary-ovarian axis?
B. P Answer: Gonadotropin-dependent
C. Abnormal uterine bleeding precocious puberty
D. Secondary amenorrhea

3B VITALIS || GYNECOLOGY DFSP❤

88. Most common cause of precocious
puberty 94. Normal value of serum prolactin
Answer: GnRH dependent precocious Answer: 8ng/ml
puberty
95. Prolactin level goes down to
89. Zoey, 3 yo, (+) 3-4 cm breast mound. non-pregnancy state? ​(BONUS)
Dx? A. 2 weeks postpartum ​(based sa
A. Precocious puberty book 2-3 wks)
B. Premature thelarche B. 6 weeks postpartum
C. Normal for overweight children C. 2 months postpartum
D. Premature adrenarche D. 6 months postpartum

90. Refer to case 89. How will you advise 96. Serum prolactinemia, how will you
to Zoey’s mother? instruct the patient?
A. Observe child’s breast budding A. Let the patient rest then extract
usually regresses blood around 11am in a fasting
B. Refer Zoey to a gynecologist state
C. Monitor for signs of secondary B. NPO post midnight then extract
sexual characteristics blood after 8 hours
D. Advise for wrist xray to check bone C. Let the patient eat lunch then
age extract blood
D. Let the patient walk exercise then
91. The most common cause of GnRH extract blood
independent precocious puberty?
A. Granulosa cell tumor 97. Marissa came in to the clinic with
B. McCune Albright syndrome amenorrhea. Elevated prolactin. Test to
C. Iatrogenic perform?
D. Prolactinoma A. TSH
B. FSH
92. Triad of cafe au lait spots, polyostotic C. TVS
fibrous dysplasia, cysts of the skull and D. Cranial MRI
long bones
A. Granulosa cell tumor of ovary 98. Most common pituitary tumor with
B. Iatrogenic prolactinemia
C. McCune Albright syndrome A. Prolactinoma
D. Prolactinoma B. M
C. Cranio pharyngeoma
93. The goal management of precocious D. Empty sella turcica
puberty?
A. Reduce or counteract 99. Patient had prolactinoma, what should
gonadotropin secretion and action you do?
of steroids A. Surgical resection
B. Decrease growth rate to normal B. Give cabergoline
C. Slow skeletal maturation to allow C. Give bromocriptine
maximal adult height D. Expectant management
D. AOTA

3B VITALIS || GYNECOLOGY DFSP❤

100. Needs eye examination
A. Macroadenoma
B. Microadenoma
C. Craniopharyngioma
D. Granuloma

3B VITALIS || GYNECOLOGY DFSP❤

GYNECOLOGY THIRD SHIFTING RECALLS

1. Clinical presentation for patient with hyperandrogenism

Answer: Acne, hirsutism, alopecia, virilization

2. In a quantitative perspective, what hormones are produced by the ovaries?

Answer: Testosterone

3. A condition in which there is presence of hirsutism but normal androgen levels (DHEA
and testosterone)
A. Multicystic ovary
B. Idiopathic hirsutism
C. Leydig-Sertoli cell tumor
D. Hyperandrogenemia

4. MOA of oral contraceptives in treating hyperandrogenism

A. Suppressed by inhibin LH stimulation
B. Inhibit prolactin release
C. GnRH antagonistic activity
D. …

5. Common complication of spironolactone therapy

Answer: Hyperkalemia

6. Side effect of flutamide

Answer: Hepatic toxicity

7. Female pattern hair loss due to increased 5-a-reductase activity is best treated with
A. Metformin
B. Anti-androgen
C. Dexamethasone
D. Diet and lifestyle modification

8. Acne vulgaris treatment

A. OCP
B. Tea tree oil
C. Dexamethasone
D. Diet and lifestyle

9. Hair growth in extremities

Answer: Hypertrichosis

10. Enzyme that directly influences hair growth

A. AFP
 B. BCG
C. 5-a-reductase
D. Progesterone

11. Topical treatment that has been approved for facial hirsutism. An inhibitor of ornithine
decarboxylase, which is an enzyme necessary for the growth and development of the hair
follicle
Answer: Eflornithine cream

12. Pattern of hair loss in women

A. Occipital
B. Vertex, occipital
C. Frontal, vertex
D. Frontal only

13. Major androgen produced by the ovaries

A. DHEA
B. Testosterone
C. Estrogen
D. Androgen

14. Rotterdam criteria (2003)

A. Hyperandrogenism plus polycystic ovaries
B. Menstrual regularity plus polycystic ovaries
C. Menstrual irregularity, hyperandrogenism, polycystic ovaries
D. Menstrual regularity, hyperandrogenism, polycystic ovaries

15. Diagnosis of metabolic syndrome through Adult Treatment Panel III criteria needs ⅗ of the
following:
Answer: Waist circumference >88cm, HDL <50mg/dL, TAGs
>150mg/dL, BP >130/85mmHg, FBS >110mg/dL

19. Rotterdam criteria for ovarian morphology ultrasound in PCOS

A. >12 follicles of 2-8 mm in diameter in both ovaries and ovarian volume of >10cm3
B. >12 follicles of 2-8mm in diameter in one or both ovaries and ovarian volume of <10cm3
C. >12 follicles of 2-8mm in diameter in one or both ovaries and ovarian volume of
>10cm3
D. Ultrasound is not significant

20. Increased level of circulatory estrogen in PCOS

Answer: deceased SBHG, increased peripheral conversion of androgen to estrone

21. Type 2 DM is common among PCOS. What is the screening test used?
A. FBS
 B. OGTT
C. RBS

22. A 23 yo nulligravida with irregular menses since menarche, obese with PCOM. Tx?
A. Diet pills
B. Observation
C. Diet and exercise
D. Ovarian drilling

23. The treatment of choice for patients with PCOS complaining of AUB
A. Diet
B. Letrozole
C. Diet and exercise
D. OCP or cyclic progesterone

24. Long term anovulation and unopposed estrogen stimulation of the endometrium
Answer: Endometrial cancer

25. Associated with hyperandrogenism and polycystic ovaries in ovulatory women

A. Phenotype A
B. Phenotype B
C. Phenotype C
D. Phenotype D

26. Differential diagnosis for PCOS

A. Hyperinsulinemia
B. Late onset of CAH
C. AUB
D. Obesity

27. Insulin resistance in PCOS affects where?

Answer: peripheral tissue

28. First line for ovarian induction

Answer: Clomiphene citrate

29.

30. Medication used in the patients with PCOS and pbesity

A. Metformin
B. OCP
C. Anti-androgen
D. Dexamethasone
31. In normal fertile couple, the chance of getting pregnant or fecundability is
Answer: 20%

32. Cause of infertility?

A. Antisperm antibody
B. Ovarian new growth
C. Bacterial vaginosis
D. Ovulatory disorders

33.

34. Practices that reduce the chance of conception

A. Reduced caffeine intake
B. Folic acid supplementation
C. Endometrial biopsy
D. Vaginal douching

35. If the woman is regularly menstruating, ovulation is documented using

A. Endometrial biopsy
B. 28 day cycle
C. Urine LH kit
D. Ultrasound

36. Male partner should have __ abstinence before semen analysis

A. 4-5 days
B. 3-4 days
C. 2-3 days
D. 1-2 days

37. A marker for ovarian function that is not affected by the menstrual cycle
A. FSH
B. Estradiol
C. Progesterone
D. AMH

38. Liquefaction of semen

A. 15-20 mins
B. 20-25 mins
C. 25-30 mins
D. 30-50 mins

39. Test for ovarian reserve

A. Saline infusion sonography
B. Hysterosalpingography
 C. Laparoscopy
D. Antral follicle count

40. Radiologic diagnostic tool to assess tubal patency

A. Saline infusion sonography
B. Hysterosalpingography
C. Laparoscopy
D. Antral follicle count

41. 37 yo woman, G3P3(3003), S/P bilateral tubal ligation in 2012. She has a new 32 yo partner
and they want to get pregnant. Management?
A. Ovulation stimulation with timed intercourse
B. Controlled ovarian stimulation with intrauterine insemination
C. IVF
D. Advise adoption

42. ART fertilization rate increased to 50%, semen analysis <100,000

Answer: Intracytoplasmic sperm injection

43. 42 yo nulligravid trying to get pregnant for 3 years. Labs done - all normal. Husband is 30
yo, semen analysis normal. How would you manage the case?
A. Ovulation stimulation with timed intercourse
B. Controlled ovarian stimulation with IUI
C. IVF
D. Advise adoption

44. The sperm retrieval is 100% if this hormone is normal. What is this hormone?
A. TSH
B. LH
C. Testosterone
D. FSH

45. A case of EF, 28 yo, nulligravid, desirous of pregnancy for 5 years. She is regularly
menstruating. Workup: TVS, HSG. TSH and prolactin normal. Her husband is 30 years old with
no non-obstructing azoospermia. TSH and testosterone are normal. TESE done: (+) for sperm.
Management?
A. Ovarian stimulation with timed intercourse
B. Controlled ovarian stimulation with IUI
C. IVF and ICSI
D. Advise adoption

46. A complication of ovulation characterized by enlarged ovaries after gonadotropin

administration.
A. Theca lutein cyst
 B. Ovarian hyperstimulation syndrome
C. Gonadotropin hyperstimulation syndrome
D. Molar pregnancy

47. A case of GH, 30, nulligravid desirous for pregnancy 2 yrs. Pelvic endometriosis stage 4,
cystectomy bilateral for endometrial cyst. Management?
A. Ovulation stimulation with timely intercourse
B. Controlled ovarian stimulation with intrauterine insemination
C. IVF
D. Advise couple for adoption

48. A genetic screening technique used to test embryonic cells of all 23 chromosome pairs:
A. FISH
B. Single nucleotide
C. aCGH
D. Real-time PCR

49. An artificial reproductive technique that allows women to preserve their future fertility
potential when faced with possible premature menopause
A. Surrogacy
B. Oocyte preservation

50. IJ, 37 yo, desirous to get pregnant for 5 years, 3x insemination, 3x controlled ovarian
stimulation
A. Ovulation stimulation with timed intercourse
B. Controlled ovarian stimulation with intrauterine insemination
C. IVF
D. Advise adoption

GYNE 3RD SHIFTING EXAM 2015

1. Major site of metabolism of steroids

a. Liver
b. Kidneys
c. Adrenals
d. Intestines

2. First histologic indication of progesterone effect on the endometrium

a. Increase mitotic figures
b. Subnuclear vacuoles
c. Tortuous glands
d. Edematousstroma
3. Facilitates granulosa cell synthesis
a. Estradiol
b. FSH
c. LH
d. Progesterone

4. Peak of progesterone production

a. Early follicular phase
b. Mid follicular phase
c. Early luteal phase
d. Mid luteal phase

5. LH secretion/release is greater than FSH

a. At birth
b. Before puberty
c. At puberty
d. After menopause

6. Regeneration of the endometrium occurs

a. 24 hours before the onset of menses
b. 36 hours after the onset of menses
c. 72 hours after the last day of menses
d. 1 week after the last day of menses

7. The enzyme that converts testosterone to 17 B estradiol

a. Dehydrogenase
b. Aromatase
c. Hydroxylase
d. Oxidase

8. Endometrium 10-12mm
a. Proliferative phase
b. Secretory phase
c. Luteal phase
d. Menstrual phase

9. The most common cause of primary amenorrhea

a. Gonadal
b. Pituitary
c. Hypothalamic
d. Uterine

10. Treatment of women with amenorrhea due to pcos, DESIROUS OF CONCEPTION

a. MPA 10mg x 12 days
 b. MPA 5-10mg x 5 days
c. Conjugated equine estrogen
d. Clomiphene cutrate after withdrawal bleeding

11. Delayed menarche

a. >12 years old
b. >13.5 years old
c. >15 years old
d. >16.5 years old

12. KM 16 year old came in for amenorrhea. Height is short than her age, (+) shield-like chest,
no breast budding, widely spaced nipples. (+) heart disease during childhood. What is your
impression?
a. Klinefelters
b. Noonans
c. Turners
d. Marfans

13. What test/examination result would likely be compatible for the above
a. High estradiol level
b. Low estradiol level
c. Normal estradiol level
d. No relation with the estradiol level

14. Karyotyping was done, and most likely it would be

a. 46XY
b. 46XX
c. 45 Y
d. 45 X

15. 35 year old G2P2002 came in for 3 months amenorrhea, pregnancy test is negative. The
next step would be
a. Endometrial biopsy
b. Fractional D & C
c. MPA 10 mg OD x 5 days
d. Clomiphene citrate 50 mg OD x 5 days

16. Prolactin level that may cause galactorrhea

a. >5 ng/l
b. >10 ng/l
c. >15 ng/l
d. >20 ng/l

17. Major inhibiting factor of prolactin

 a. Thyrotropin
b. Dopamine
c. Thyrotropin releasing factor
d. Serotonin

18. During the 3rd trimester, prolactin level is approximately

a. 50 ng/l
b. 100 ng/l
c. 200 ng/l
d. 300 ng/l

19. The best time too take the prolactin level

a. Late evening
b. Early evening
c. Mid morning
d. Early morning

20. In women with galactorrhea and amenorrhea, the first lab test shall be requested is
a. Serum estradiol
b. TSH
c. Prolactin
d. FSH

21. Galactorrhea, irregular menses, elevated prolactin levels

a. Empty sella syndrome
b. Microadenoma
c. Hypothyroidism
d. Hyperthyroidism

22. Treatment for women with hyperprolactinemia, wanting to conceive

a. Conjugated estrogens
b. MPA 5-10 mg OD x 12
c. Bromocriptine
d. Clomiphene

23. The best therapy for the hut flush

a. Clonidine
b. Tibolone
c. Estrogen cream
d. MPA 5-10 mg once daily

24. The best management of a 35 year old woman, P3003, with premature ovarian failure
a. Hyperectomy and BSO
b. Danazol
 c. Tibolone
d. Conjugated equine estrogen
25. A 50 yo woman came in for 4 months amenorrhea with complaints suggestive of
menopause. The next step should be
a. Hysterectomy
b. Serum FSH determination
c. Give HRT
d. Give MPA 5-10 mg ODx5days

26. Hot flush

Answer: Conjugated equine estrogen

27. DUB
Answer: OCP

28. Anovulation
Answer: Clomiphene

29. Hirsutism
Answer: OCP

30. PCOS with insulin resistance

Answer: Metformin

31. Atrophic vaginitis

Answer: Conjugated equine estrogen

32. Asherman syndrome

Answer: Uterine synechiae

33. Noonan’s syndrome

Answer: Male counterpart of Turner’s syndrome

34. Rokitansky-Kuster-Hauser syndrome

Answer: Uterine agenesis

35. Kallman’s syndrome

Answer: Inadequate GnRH synthesis

36. Sheehan’s syndrome

Answer: Pituitary necrosis

37. Simmond’s disease

Answer: Pituitary necrosis
38. Endometrium
Answer: Estradiol

39. Corpus luteum

Answer: Progesterone

40. Maturing follicle

Answer: Estradiol

41. Adipose tissue

Answer: Estrone sulphate

42. Ovarian stroma

Answer: Androstenedione

Association: Write A - if 1,2,3 are correct; B - if 1 and 3 are correct; C - if 2 and 4 are correct; D -
if only 4 is correct; E - if all are correct.

43. Hyperprolactinemia
1. Amenorrhea
2. Anovulation
3. Galactorrhea
4. Abnormal uterine bleeding
Answer: A

44. (+) Inc prolactin levels

1. Exercise
2. Nipple stimulation
3. Stress
4. Sleep
Answer: E

45. Empty sella syndrome

1. Prolactin level is low
2. Prolactin level elevated
3. Abnormal pituitary function
4. Normal pituitary function
Answer: C

46. Acromegaly
1. Normal prolactin levels
2. (+) growth hormone
3. (+) ACTH
 4. Elevated prolactin levels

47. (+) hyperprolactinemia

1. Diazepam
2. Propranolol
3. Phenothiazines
4. Oral contraceptives
Answer: B

48. SG 28 yo with premature ovarian failure

1. TVS
2. Karyotyping
3. Screen for autoimmune disorders
4. Oocyte donation
Answer: E

49. Menopause
1. Prolactin elevated
2. TSH elevated
3. Estradiol elevated
4. FSH & LH elevated
Answer: D

50. Side effects of HRT

1. Breast tenderness
2. Bloating
3. …. bleeding
4. Hot flush
Answer: A

Multiple Choice:
51. Best describes abnormal uterus bleeding
A. Mean interval between menses 25 days +/- 7 days
B. Mena duration of menses of more than 7 days
C. Average normal menstrual blood loss of 35 ml
D. Mean duration of menstrual blood flow is 4 days

52. Best treatment option of anovulatory dysfunctional uterine bleeding

A. Prolonged regimen of progestogens
B. NSAIDs
C. Antifibrinolytic agents
D. Low dose 20 ug OCP
53. Best modality to manage acute bleeding patients who are hemodynamically unstable
A. Curettage
B. Estrogens
C. Danazol
D. Progestins

54. Best modality to manage AUB caused by uterine prolapse

A. Endometrial ablation
B. Dilatation and curettage
C. Hysterectomy
D. Medical therapy until hemodynamically stable

55. The best methodology for endometrial ablation with regards to uterine size, presence of
fibroids, percentage amenorrhea, success rate and satisfaction
A. Microwave EA system
B. Novosure
C. Her option
D. Thermachoice III

56. Pharmacologic agent to stop bleeding in hemodynamically stable patients

A. Estrogens stop bleeding thru supporting and organizing the endometrium so that an
organized slough occurs after withdrawal
B. Dosing of oral conjugated equine estrogens of 10mg/day in 4 divided doses has been
found as a clinically useful regimen
C. Daily MPA 10 mg/day for 1 month
D. Progestogens have been studied and proven to stop bleeding immediately thus its
extensive use

57. Antifibrinolytic therapy clearly produces a reduction in blood loss for women with
menorrhagia who ovulate. This statement describes one of these agents
A. All equally effective in mean menstrual blood loss reduction with treatment
B. Tranexemic acid yielded the most decrease in MBL
C. EACA yielded the most decrease in MBL
D. Monotherapy compared with combination therapy such as oral contraceptive will yield
same MBL reduction

58. The best recommended regimen for AMCA

A. 18 gms per day for 3 days then reduced to 12, 9, 6, and 3 gms daily on successive days
B. Total dose of at least 48 gms total
C. 6 gms per day for 3 days then reduced to 4, 3, 2, and 1 gm daily on successive days
D. Total dose of at least 28 gms total
GYNECOLOGY FOURTH SHIFT

1. Area in the cervix that is most vulnerable to dysplasia

A. Squamocolumnar Junction
B. Transformation Zone
C. Endocervix
D. Glandular Epithelium

2. More than 90% of CIN is attributable to this agent:

A. HPV
B. HIV
C. HSV
D. HCG

3. Marks the change in the surface epithelium brought about by #2

A. Metaplasia
B. Dysplasia
C. Koilocytosis
D. Atypia

4. Preferred treatment for CIN 2 to 3 in non-adolescent patients:

A. LEEP
B. Cryotherapy
C. Laser therapy
D. Hysterectomy

5. A woman with cytologic finding of HSIL presents to you at your clinic. What should be your
next step?
A. Cervical punch biopsy
B. Colposcopy
C. Cryotherapy
D. LEEP

6. Poorly reproducible among pathologists

A. CIN I
B. CIN II
C. CIN III
D. CIS

7. Best treatment for VAIN III

A. Cryotherapy
B. Wide Excision
C. Laser therapy
D. Electrocautery
8. Instrument used to take biopsies of the vulva
A. Tischler Forceps
B. Kevorkian Forceps
C. Novaks Curette
D. Keyes punch forceps

9. Detected in more than 60%of VIN cases

A. HPV 6
B. HPV 11
C. HPV 16
D. HPV 18

10. Best treatment for VIN III

A. Cryotherapy
B. Wide Excision
C. Laser therapy
D. Electrocautery

11. Most common of all epithelial ovarian cancers, comprising 75%-80%

A. Serous Cystadenocarcinoma
B. Mucinous Cystadenocarcinoma
C. Endometrioid Carcinoma
D. Clear Cell Carcinoma

12. Characteristic of borderline tumors of the ovary, except:

A. Pseudostratification, tufting, cribriform, and micropapillary architecture
B. Mild nuclear atypia and mild increased mitotic activity
C. Detached cell clusters
D. Stromal invasion

13. May reach an enormous size, are multiloculated and are lined by cells resembling the lining
epithelium of the intestine or endocervix
A. Serous Cystadenocarcinoma
B. Mucinous Cystadenocarcinoma
C. Endometrioid Carcinoma
D. Clear Cell Carcinoma

14. This type may contain psammoma bodies and its lining epithelium recapitulates that of an
endosalpinx
A. Serous Cystadenocarcinoma
B. Mucinous Cystadenocarcinoma
C. Endometrioid Carcinoma
D. Clear Cell Carcinoma
15. Tumor marker which is useful for monitoring epithelium ovarian cancer
A. CA 19-9
B. CEA
C. CA 125
D. CK 7

16. True about Lynch Syndrome, EXCEPT:

A. Includes multiple adenocarcinoma
B. Common among Ashkenazi Jews
C. Autosomal recessive pattern
D. Occur in women 10 years younger than those with non hereditary tumors

17. Most common mode of spread of epithelial ovarian cancer

A. Transcoelomic
B. Lymphatic
C. Hematogenous
D. Skip Metastasis

18. Tumor of one or both ovaries with histologically confirmed implants of abdominal peritoneal
surface none exceeding 2 cm in widest diameter
A. Stage IIIA
B. Stage IIIB
C. Stage IIIC
D. Stage IV

19. Most common malignant germ cell tumor, accounting for about 30% to 40% of all ovarian
cancers of germ cell origin
A. Immature teratoma
B. Endodermal sinus tumor
C. Dysgerminoma
D. Embryonal carcinoma

20. Sensitive to radiation therapy

A. Immature teratoma
B. Endodermal sinus tumor
C. Dysgerminoma
D. Embryonal CA

21. Call-Exner bodies are found in which type of ovarian neoplasm?

A. Brenner tumor
B. Dysgerminoma
C. Thecoma
D. Granulosa cell tumor
22. These ovarian tumors produce clinical virilization in 20-85% of patients
A. Thecoma
B. Granulosa cell tumor
C. Sertoli-Leydig tumor
D. Malignant mixed mullerian tumor

23. True of complete H moles

A. Karyotype is triploid
B. Molar chromosomes are maternal
C. Presence of fetal tissues
D. Ovum fertilized by haploid sperm

24. Most common symptom associated with H mole

A. Vaginal bleeding
B. Excessive uterine size
C. Hyperemesis gravidarum
D. Preeclampsia

25. Management of theca lutein cysts >6cm occurring in conjunction with H mole
A. Aspiration
B. Cystectomy
C. Observation
D. Oophorectomy

26. Tumor marker used to monitor patients after molar evacuation or hysterectomy for H mole
A. Inhibin
B. HPI
C. BhCG
D. NOTA

27. This type of GTN is relatively insensitive to chemotherapy

A. Choriocarcinoma
B. Placental site trophoblastic tumor
C. Invasive mole
D. Epithelial trophoblastic tumor

28. Most common site of metastasis of GTN

A. Brain
B. Bone
C. Liver
D. Lungs
29. Vaginal metastasis GTN corresponds to what FIGO stage?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV

30. What is the WHO prognostic score if the patient has the ff
Age 42, antecedent pregnancy abortion, interval between antecedent pregnancy and start of
chemo 6 mons, HCG titer 90,000 mIU/ml, largest tumor 3 cm, no metastatic lesion, and w/o
prior chemotherapy
A. 3
B. 5
C. 7
D. >7

31. NOT a histologic feature of choriocarcinoma

A. Abnormal proliferation of cytotrophoblasts
B. Malignancy of trophoblastic cells
C. Abnormal proliferation of syncytiotrophoblasts
D. Presence of chorionic villi

32. Most common chemotherapeutic regimen used for high risk GTN
A. EMA-EP
B. EMACO
C. Carboplatin-paclitaxel
D. PVB

33. Best contraceptive to be used to prevent pregnancy within 2 yrs after biochemical remission
of GTN
A. IUD
B. Diaphragm
C. Condom
D. Oral contraceptive

34. Risk factors for the development of GTD

A. Dec meat and carotene in diet
B. Young age
C. Industrialized countries
D. Obesity

35. A type of endometrial hyperplasia in which glands are irregular and often close together and
there is no cytologic atypia. If untreated, approx 3% will progress to carcinoma
A. Cystic hyperplasia
B. Complex hyperplasia w/o atypia
 C. Simple hyperplasia w/ atypia
D. Complex hyperplasia w/ atypia

36. The glands are often severely crowded and have abnormal outpouchings, and there is an
abnormal appearance to the epithelial cells of the glands. If untreated, approx 29% will progress
to carcinoma
A. Cystic hyperplasia
B. Complex hyperplasia w/o atypia
C. Simple hyperplasia w/ atypia
D. Complex hyperplasia w/ atypia

37. How many percent of endometrial cancer cases are diagnosed before age of 40
A. 3%
B. 15%
C. 5%
D. 18%

38. Protective factor against endometrial cancer

A. Conjugated estrogens
B. Combination oral contraceptive pill
C. SERMS
D. IUD

39. Majority of endometrial cancers that developed among women who used Tamoxifen for
breast cancer are of this histologic type
A. Endometrioid
B. Papillary serous
C. Clear cell
D. Glassy cell

40. Not considered an independent risk factor for endometrial cancer

A. Diabetes Mellitus
B. Race
C. Nulliparity
D. Hypertension

41. These type of mutations are frequently seen in endometrioid adenocarcinoma of the
endometrium and in complex endometrial hyperplasia
A. Microsatellite instability
B. P53 mutations
C. PTEN mutations
D. Her-2/neu amplification
42. First line method of the diagnosis of endometrial cancer
A. Endometrial sampling
B. Hysteroscopy
C. Transvaginal ultrasound
D. Saline infusion sonohysterogram

43. Management of endometrial hyperplasia (simple or complex) without atypia

A. D&C
B. Combination oral contraceptives
C. Progestins
D. All of the above

44. Women who desire childbearing function and who have complex hyperplasia with atypia are
managed using high dose progestins and periodic sampling of the endometrial every
A. Month
B. 5 months
C. 3 months
D. Annually

45. How many percent of grade 1 tumors of the endometrium have solid components?
A. Less than 6%
B. 6-50%
C. 6%
D. >50%

46. An independent prognostic factor and is reported separately in the FIGO 2009 staging for
endometrial cancer:
A. (+) peritoneal fluid cytology
B. Lymph node involvement
C. FIGO stage
D. Tumor grade

47. Primary treatment modality in endometrial cancer

A. Radiation therapy
B. Concurrent chemoradiation
C. Chemotherapy
D. Surgery

48. Therapeutic option for stage II endometrial cancer which offers treatment in one setting in
the absence of other adverse prognostic factors and which resulted in 75% 5-year survival as
shown in the study done by Homesley et al:
A. Primary radiation followed by extrafascial hysterectomy
B. Extrafascial hysterectomy and pelvic node dissection
C. Radical hysterectomy and pelvic node dissection
 D. Simple hysterectomy followed by external beam radiation

49. A poor prognostic factor in endometrial cancer

A. Tumor size < 2cm
B. Endometrial histology
C. Superficial myometrial invasion
D. Lymphovascular space invasion

50. Characteristic of type 2 endometrial cancer

A. Endometrial histology
B. Normal BMI
C. Premenopausal women
D. Indolent course

51. The most common finding in patients with cervical cancer is

A. Abnormal papanicolaou test result
B. Vaginal discomfort
C. Abnormal vaginal bleeding
D. Malodorous discharge
52. Most carcinogenic HPV type
a. 11
b. 18
c. 16
d. 45

53. The low risk HPV types associated with condylomata and a very small number of low grade
squamous epithelial lesions (SILs)
a. HPV 6
b. HPV 16
c. HPV 11
d. A & B

54. Which is NOT a major risk factor for cervical cancer?

a. Sex at an older age
b. Promiscuous male partners
c. Multiple sexual partners
d. History of sexually transmitted disease

55. Displays dysplastic changes in approximately one third of the thickness of the epithelium
a. CIN 1
b. CIN 3
c. CIN 2
d. Ca In Situ
56. This is diagnosed when dysplasia is seen throughout the epithelium and resembles cervical
cancer but has not invaded into the basement membrane
a. CIN 1
b. CIN 3
c. CIN 2
d. Ca In situ

57. This type of cervical cancer accounts for 85-90% of diagnosed cases
a. Adenocarcinomas
b. Adenosquamous cell carcinoma
c. Squamous cell carcinomas
d. None of the above

58. Lesions consistent with moderate and severe dysplasia

a. ASC-US
b. LSILs
c. ASC-H
d. HSILs

59. As defined by the Bethesda system, these lesions are suggestive of mild dysplasia or
expected CIN I on histology and HPV infections, with high risk types
a. AGC
b. LSILs
c. ASC-H
d. HSILs

60. The newest guidelines recommend starting papanicolaou screening tests at age
a. 18 years
b. 24 years
c. 21 years
d. 28 years

61. Response evaluation criteria in solid tumors to assess clinical response to therapy showed
10% increase in sum of greatest diameters of target lesions
a. Complete response
b. Progresive disease
c. Partial response
d. Stable disease

62. What is the most active and widely used platinum analogue?
a. Cisplatin
b. Doxorubicin
c. Placitaxel
d. Methotrexate
63. Chemotherapeutic agent derived from the bacteria streptomyces parvulus
a. Doxorubicin
b. Dactinomycin
c. Bleomycin
d. Penicillin

64. Chemotherapeutic agents that alter the mitotic spindle during mitosis thus preventing cell
division?
a. Platinum analogues
b. Antitumor metabolites
c. Taxanes
d. Alkylating agents

65. Chemotherapeutic agent group that facilitate the transfer of alkyl groups to DNA groups thus
disrupting the G1/S transition?
a. Antitumor metabolite
b. Antimetabolites
c. Vinca alkaloids
d. Alkylating agents

66. Most common chemotherapeutic agent used for gestational trophoblastic neoplasia?
a. Cisplatin
b. Methotrexate
c. Pacitaxel
d. Doxorubicin

67. Histopathologic type of cervical carcinoma usually described with endophytic growth pattern/
A. Squamous cell carcinoma
B. Adenosquamous carcinoma
C. Endocervical adenocarcinoma
D. Glassy cell carcinoma

68. Histology report showed cervical squamous cell carcinoma invasion up to 3mm in depth.
What is the stage of the disease?
a. Stage IA1
b. Stage IA3
c. Stage IA2
d. Stage IB1

69. Histology report showed cervical adenosquamous carcinoma invasion up to 3.2 mm in depth
and 8mm in width. What is the stage of the disease?
a. Stage IA1
b. Stage IA3
c. Stage IA2
 d. Stage IB1

70. A 35 yo G3P3 patient came to the OPD for post-coital spotting. Speculum exam showed 0.5
cm necrotic mass on the anterior cervical lip. She has no history of pap smear. What is your
next best step?
A. Do pap smear
B. Do transvaginal ultrasound
C. Do cervical biopsy
D. Do fractional curettage

71. You examined a patient with biopsy result of cervical carcinoma. Whole abdomen
ultrasound showed hydronephrosis and non-functioning kidney. What is the most probable
stage of the disease?
A. Stage IB2
B. Stage IIIB
C. Stage IIB
D. Stage IVB

72. What cervical cancer treatment that is applicable to all stage of the disease?
A. Cervical conization
B. Radical hysterectomy
C. Total hysterectomy
D. Chemoradiation

73. What is the most important determinant of prognosis for carcinoma of the cervix?
A. Lymph node involvement
B. Histologic type
C. Lymphovascular space invasion
D. FIGO stage

74. The most frequent malignancy in the lower female genital tract in the Philippines?
A. Vulvar carcinoma
B. Endometrial carcinoma
C. Cervical carcinoma
D. Ovarian carcinoma

75. You received a cervical biopsy showing microscopic squamous cell carcinoma with 2.9 mm
stromal invasion from a 29 year old nulligravid. What is your next best diagnostic and treatment
procedure?
A. Colonoscopy
B. Extrafascial total hysterectomy
C. Cervical conization
D. Small cell carcinoma
76. A rare variety of squamous cell carcinoma of the cervix which is morphologically similar to
those found in the vulva?
A. Verrucous carcinoma
B. Glassy cell carcinoma
C. Adenoma malignum
D. Small cell carcinoma

77. Used for staging of cervical carcinoma

A. Colposcopy
B. Biopsy
C. Physical examination
D. Histopathologic

78. A chemotherapeutic agent that is folic acid analogue that binds tightly to dihydrofolate
reductase which plays a role in intracellular folate metabolism?
A. 5 - FU
B. Folate reductabine
C. Gemcitabine
D. Methotrexate

79. Mode of action of this chemotherapeutic group is to bind to the B-tubulin subunits of the
mitotic spindles
A. Alkylating agents
B. Vinca alkaloids
C. Antimetabolites
D. Antitumor antibiotics

80. What phase in the evaluation of new chemotherapeutic agents where in it tests new drugs at
various doses to evaluate toxicity and determine tolerance to the drug
A. Phase I trial
B. Phase III trial
C. Phase II trial
D. Phase IV trial

81. Radiation acts primarily at what cell replication cycle?

A. M phase
B. S phase
C. G1
D. G2

82. A risk factor for cervical carcinoma

A. Frequent douching
B. Early menarche
C. Cigarette smoking
 D. Late menopause

83. A vulvar condition seen on microscopy as the epithelium becomes markedly thinned out with
loss of the rete ridges
A. Vulvar intraepithelial neoplasia
B. Melanoma in situ
C. Paget’s disease
D. Lichen sclerosus

84. A vulvar condition seen on microscopy as the epithelium becomes markedly thinned out with
los of the rete ridges
A. Vulvar intraepithelial neoplasia
B. Melanoma in situ
C. Paget’s disease
D. Lichen sclerosus

85. The first line treatment of vulvar atypia

A. Cryotherapy
B. Ciobetasol propionate
C. Skinning vulvectomy
D. Electrocautery

86. The most common instrument used to biopsy vulvar atypia

A. Kevorkian punch biopsy forceps
B. Cold knife
C. Keyes punch biopsy
D. Carbon dioxide laser

87. What is the FIGO stage of 2 cm vulvar mass with 1mm stromal invasion squamous cell
carcinoma on biopsy
A. Stage IA
B. Stage II
C. Stage IB
D. Stage IIIA

88. What is the FIGO stage of a 2cm vulvar mass involving the urethra with one 5mm lymph
node metastasis
A. Stage II
B. Stage IIIB
C. Stage IIIA
D. Stage IIIC
89. What is the FIGO stage of a 2cm vulvar mass on the clitoris with 1cm fixed ulcerated right
inguinofemoral lymph node
A. Stage IIIA
B. Stage IIIC
C. Stage IIIB
D. Stage IVA

90. Primary risk factor for fallopian tube cancer

A. Use of OCP
B. Cigarette smoking
C. BRCA mutation
D. History of PID

91. The most common symptom in 90% of women having endometrial CA

A. Postcoital bleeding
B. Postmenopausal bleeding
C. Intermenstrual bleeding
D. Withdrawal bleeding

92. Risk factor for endometrioid adenoCA except

A. Tamoxifen use
B. PCOS
C. Obesity
D. Late menarche, early menopause

93. Who are of greater risk for endometrial cancer

A. Women smoker
B. Nulliparous women
C. Combined OCP use
D. Multiparous women

94. AdenoCA of the endometrium is usually preceded by

A. Endometrial hyperplasia with atypia
B. Endometrial hyperplasia simplex
C. Cervical intraepithelial neoplasia
D. Endometrial intraepithelial neoplasia

95. Represent the most common histology of ovarian tumors

A. Sex-cord stromal tumors
B. Germ cell tumors
C. Epithelial tumors
D. Primary peritoneal CA
96. With regards ovarian cancer, which of the ff is an important etiologic factor
A. Parity
B. Menstrual pattern
C. Gravidity
D. Ovulation

97. The cardinal feature of immature teratoma is

A. Neural tissue
B. Bone marrow
C. Skin and hair appendages
D. Fat tissue

98. ??
A. H mole
B. Invasive mole
C. Choriocarcinoma
D. Placental site trophoblastic tumor

99. The first step in the work up of gestational trophoblastic tumor

A. Serum quantitative hCG
B. Chest xray
C. Liver enzymes
D. Ultrasound

100. Drug of choice in the treatment of nonmetastatic or low risk GTD

A. Vincristine
B. Actinomycin
C. Methotrexate
D. Cyclophosphamide
GYNE QUIZZES - DR. AMORIN

Quiz 1
1. What is the most radiosensitive phase of the cycle?
○ M Phase

2. What is known as “far distance”

○ Teletherapy/ External Beam Radiotherapy

3. Has a half-life of 1622 years

○ Radium

4. What tissues are irradiated by teletherapy

○ ALL (tumor and/or tumor beds are all irradiated along with adjacent tissues at
risk, such as lymph node)

5. What is known as “short distance”

○ Brachytherapy

6. Give one normal tissue often incidentally irradiated with giving radiation therapy
○ Rectosigmoid
○ Bladder
○ Small bowel

7. Give on side effect of radiation therapy on skin

○ Erythema
○ Depigmentation
○ Subcutaneous fibrosis
○ Necrosis of the skin

Quiz 2
Identify the type of tissue as whether STATIC, EXPANDING, or RENEWING
1. Vascular Endothelium - EXPANDING
2. Spermatocytes - RENEWING
3. Neurons - EXPANDING

TRUE OR FALSE.
4. As the tumor mass increases, the time required to double the tumor volume decreases
○ FALSE

Identify whether the tumor has a FAST DOUBLING TIME or SLOW DOUBLING TIME
1. Adenocarcinoma - SLOW
2. Lymphoma - FAST
 3. Embryonal tumor - FAST

4. Chemotherapy that is given after surgery and/or radiation therapy that is performed with
curative effect and no evidence of residual disease
○ ADJUVANT CHEMOTHERAPY

5. Use of chemotherapy to sensitize tumor to the effects of radiation

○ CONCURRENT CHEMOTHERAPY

6. Use of chemotherapy in the management of locally advanced disease where it would be

difficult and impractical to perform immediate surgery or radiation
○ NEOADJUVANT CHEMOTHERAPY

Quiz 3
1. What is the main underlying cause of endometrial carcinoma?
○ UNOPPOSED ESTROGEN

2. What type of DM is associated with endometrial cancer?

○ TYPE 2 (NON-INSULIN DEPENDENT DM)

3. What drug used in breast cancer patients may increase the risk for endometrial cancer?
○ TAMOXIFEN

4. What syndrome predisposes to endometrial cancer at a younger age?

○ LYNCH SYNDROME/ HEREDITARY NON POLYPOSIS COLORECTAL
CANCER (HNPCC) SYNDROME

5. TRUE OR FALSE. OCPs increase the risk for endometrial cancer

○ FALSE

6. What histopathologic type of endometrial cancer is associated with an endometrioid

histology, it occurs in perimenopausal women and is associated with obesity
○ TYPE 1

7. What is the rate of progression of complex hyperplasia with atypia to endometrial

cancer?
○ 29%

8. Most common symptom in endometrial cancer?

○ ABNORMAL VAGINAL BLEEDING - occurring in 90%

9. What i the gold standard for the diagnosis of endometrial cancer

○ ENDOMETRIAL BIOPSY
 10. What is the 2009 FIGO stage of endometrial cancer with cervical stromal invasion
○ STAGE 2

Quiz 4
1. … of intraepithelial neoplasia
● No invasion of basement membrane

2. HPV is transmitted via

● Sexual activity

3. Most common types of HPV

● HPV 16, HPV 18

4. What is the term for the cytopathic effect of HPV

● Koilocytosis

5. What is the area in the cervix where most malignant transformation occurs
● Transformation zone (near squamo-columnar zone)

6. Give one preventive measure for CIN

● Pap Smear
● Vaccination
● Barrier

7. What type of VIN is associated with multifocal lesions

● VIN usual type

8. What instrument is used to get a biopsy from the vulva

● Kevorkian or Eppenddorf punch biopsy forceps
PRINCIPLES OF RADIATION AND CHEMOTHERAPY

1. This is an effect of radiation wherein radiation acts on the sulfhydryl bonds

a. Indirect effect
b. Direct effect
c. Apoptosis
d. By stander effect

2. This type of DNA strand breaks that are remote from each other and has little chance of
deleterious outcome
a. Single strand break
b. Multiple strand breaks
c. Double strand breaks
d. Opposing strand breaks

3. The most radiosensitive phase of the cell cycle

a. S phase
b. G0 phase
c. G1 phase
d. M phase

4. The most radioresistant phase of the cell cycle

a. S phase
b. G0 phase
c. G1 phase
d. M phase

5. A radioactive isotope with the longest half-life and may pose the risk of random gas
contamination
a. Cesium
b. Indium
c. Radium
d. Cobalt

6. True regarding brachytherapy

a. Far distance
b. Tumor and tumor bed irradiated
c. Adjacent tissues are irradiated
d. Uses applicator to deliver RT

7. This is an acute effect of radiation

a. Fistula formation
b. Skin erythema
c. Bowel obstruction
 d. Fractures

8. This is considered to be a relatively radioresistant organ and can tolerate high doses of
radiation, as much as 150 Gy
a. Kidneys
b. Ovaries
c. Vagina
d. Liver

9. This type of tissue is classified as static

a. Hepatocytes
b. Bone marrow
c. Oocytes
d. Spermatocytes

10. These tumors have a slow doubling time and are considered indolent
a. Embryonal tumors
b. Adenocarcinomas
c. Lymphomas
d. Sarcomas

11. These cells are the most sensitive to chemotherapy

a. Slowly proliferating cells
b. Cells with short G1 phase
c. Cells in the G0 phase
d. Cells with long G1 phase

12. This type of chemotherapeutic regimen is when initial use of systemic chemotherapy follows
surgery and/or radiation
a. Neoadjuvant
b. Adjuvant
c. Concurrent
d. Primary

13. This type of chemotherapeutic regimen is when chemotherapy is used to sensitize the tumor
to the effect of radiation
a. Neoadjuvant
b. Adjuvant
c. Concurrent
d. Primary

14. The administration of 5HT3 receptor antagonist prevents this type of toxicity from
chemotherapy
a. Cardiotoxicity
 b. Nephrotoxicity
c. Gastrointestinal toxicity
d. Pulmonary toxicity

15. Management of bone marrow toxicity brought about by chemotherapy

a. Cycle delay
b. Blood transfusion
c. Dose reduction
d. All of the above

CERVICAL CANCER
16. Most common histologic type of cervical cancer
A. SCCA, large cell, non-keratinizing
B. SCCA, large cell, keratinizing
C. Verrucous type
D. Endometrioid type

17. Most common form of spread of cervical cancer

A. Direct extension
B. Lymphatic
C. Hematogenous
D. Skin metastasis

18. Not included in the pretherapy evaluation of patients with cervical cancer:
A. History and PE
B. Routine blood studies
C. Chest X-ray
D. MRI

19. First-line management of advanced stage of cervical cancer

A. Pelvic EBRT
B. Pelvic EBRT followed by brachytherapy
C. Pelvic EBRT followed by chemotherapy
D. Pelvic EBRT with chemotherapy followed by brachytherapy

20. Which of the following is not an advantage of surgery over radiotherapy in the treatment of
select group of patients with cervical cancer
A. Ovarian preservation
B. Completion of treatment in one setting
C. Decreased risk of hemorrhage
D. Decreased fibrosis and loss of sexual function

21. Major risk to a patient with cervical cancer delivering via vaginal route
A. Tumor spread/dissemination
 B. Tumor recurrence in episiotomy sites
C. Tumor emboli
D. Massive hemorrhage

22. Risk factor for cervical cancer

A. Obesity
B. Coitarche at 14 years old
C. Nulliparity
D. Anovulation

23. Bivalent vaccination confers protection against which of the following HPV genotypes?
A. 34, 35
B. 16, 18
C. 41, 44
D. 12, 14

24. Primary preventive measure against cervical cancer

A. Pap smear
B. Visual inspection with acetic acid
C. Mutual lifetime monogamy
D. Yearly pelvic exam

25. Alternative method of screening for cervical cancer and its premalignant lesions in low-
resource settings
A. Colposcopy
B. Visual inspection with acetic acid
C. Liquid-based cytology
D. Cryotherapy

VULVAR CANCER
26. This comprises 5% of primary cancers of the vulva
A. Squamous cell carcinoma
B. Adenocarcinoma
C. Melanoma
D. Sarcoma

27. This is a change in the vulvar skin that appears whitish and is characterized by a markedly
thinned out epithelium with blunting of the rete edges on microscopy
A. Paget’s disease
B. Lichen planus
C. Lichen sclerosus
D. VIN
28. This type of HPV has often been found in VIN and even in vulvar carcinoma
A. HPV 16
B. HPV 18
C. HPV 6
D. HPV 11

29. A 69 year old patient with a complaint of vulvar pruritus consults your clinic. On examination
of the vulca, you noted a friable mass on the right lbia 4 x 3 cm in size with extension to the
lower third of the vagina. There were no palpable inguinal lymph nodes. You performed a tissue
biopsy of the said mass which revealed a malignant tumor of the vulva. What is the stage base
on FIGO 2009?
A. Stage IA
B. Stage IB
C. Stage II
D. Stage III

30. Based on the clark’s classification of superficially spreading melanoma, involvement of the
reticular dermis is clark’s level:
A. I
B. II
C. III
D. IV

31. Primary cancers of the fallopian tube are rare and account for how many percent of
gynecologic cancers?
A. 0.1%
B. 0.3%
C. 0.5%
D. 1%

32. Large reviews have fond an association between fallopian tube cancers and:
A. Pregnancy
B. Oral contraceptive use
C. High parity
D. Infertility

33. Most commonly reported signs/symptoms of fallopian tube cancer

A. Vaginal bleeding
B. Palpable adnexal mass
C. Crampy lower abdominal pain
D. Watery discharge
34. Tumor marker useful in monitoring response to treatment and is elevated in 85% of women
with fallopian tube carcinoma
A. CEA
B. CA19-9
C. AFP
D. CA 125

35. If the fallopian carcinoma is limited to both tubes with extension into the sbmucosa and.or
muscularis, but nir penetrating to the serosal surface, no ascites
A. Stage IA
B. Stage IB
C. Stage IC
D. Stage IIA
Test of Association
A - if 1, 2, 3 are correct
B - if 1 and 3 are correct
C - if 2 and 4 are correct
D - if only 4 is correct

36. The necessary cause/s of cervical cancer

1. HIV
2. HBV
3. HSV
4. HPV

37. The following are considered risk factor/s for cervical cancer
1. Multiple sex partners
2. Late menopause
3. No prior screening
4. Early menarche

38. True regarding ultrasound findings suggestive of fallopian tube cancer

1. Ascites
2. Sausage-shaped mass separate from the uterus and ovaries
3. Solid papillary projections or intramural nodules
4. Snowstorm pattern

39. Acceptable treatment options for stage IB1 cervical cancer

1. Extrafascial hysterectomy ± bilateral salpingooophorectomy, lymphadenectomy
2. Radical hysterectomy ± bilateral salpingoophorectomy, lymphadenectomy
3. Chemotherapy alone
4. Concurrent chemoradiation
40. A patient suspected of having microinvasive carcinoma of the cervix should first undergo
which procedure/s
1. Conization ± endocervical curettage
2. Cryotherapy
3. LEEP
4. Simple hysterectomy

41. Chronic effect/s of radiation

1. Fistula formation
2. Skin ulceration
3. Bowel obstruction
4. alopecia

42. Biopsy of the vulva in a patient suspected of having malignant melanoma can be
accomplished conveniently using which instrument/s
1. Nove’s curette
2. Tischler biopsy forcep
3. Eppendorf biopsy forceps
4. Keye’s punch biopsy forceps

43. Oncogenic type/s of HPV causing cervical cancer

1. HPV 6
2. HPV 16
3. HPV 11
4. HPV 18

44. Standard therapy for melanoma of the vulva

1. Skinning vulvectomy
2. Radiotherapy
3. Radical vulvectomy
4. Wide local incision

45. True about fallopian tube carcinoma

1. Most patients are in the postmenopausal age group
2. The latzko’s triad is pathognomonic
3. Hydrops tubae profluens may be due to blockage of the distal end of the tube
4. Treatment is primarily radiation therapy

C. Matching Type - Cervical Staging - FIGO 2009

46. Gross tumor - 4 cm confined to the cervix
● IB1

47. Cervical tumor has extended up to the pelvic sidewall

● IIIB
48. Depth of stromal invasion is >3 mm but not >5 mm and the horizontal spread is no more
than 7 mm
● IA2

49. Cervical cancer with metastasis to the liver and/or lungs

● IVB

50. Cervical mass measuring 6 x 5 cm with extension to the upper third of the vagina and to the
right parametria but not up to the pelvic sidewall
● IIB

FOR YOUR EYES ONLY!

Fourth Shifting - Dr. Amorin

1. Most common vulvar malignancy histologic type

○ SQUAMOUS CELL
2. This comprises 5% of primary cancers of the vulva
○ MELANOMA
3. This is a change in the vulvar skin that appears whitish, characterized by markedly
thin….
○ LICHEN SCLEROSIS
4. Biopsy of the vulva can be conveniently accomplished using
○ KEYES PUNCH BIOPSY
5. This type of HPVhas often been found in VIN
○ 16
6. The most important therapeutic factor in vulvar carcinoma
○ STATUS OF THE NODES
7. A 69 year old patient with complaints of vulvar pruritus consults to your clinic. On
examination, you noted a mass on the right labia 4x10 cm in size with extension to the
lower third of the vagina. There were no palpable inguinal node. You perform a tissue
biopsy which revealed a malignant tumor of the vulva. What is the stage?
○ STAGE 2. (If with nodal involvement - Stage 3)
8. Effective therapy for clinical Stage 1 or 2, early Stage 3 vulvar carcinoma
○ WIDE RADICAL EXCISION
9. Based on Clark’s classification of melanoma, involvement of the reticular dermis is stage
○ STAGE 3
10. Standard therapy for melanoma of the vulva
○ WIDE LOCAL EXCISION (Skinning vulvectomy - VIN)
11. Gold standard in the diagnosis of VIN
○ BIOPSY
12. Treatment of squamous hyperplasia or keratosis of the vulva
○ STEROIDS
13. What type of vulvar malignancy may arise from a nevus
○ MELANOMA
14. What is the most common vulvar dermatologic complaint of women
○ PRURITUS
15. This is a change in the vulvar skin that appears whitish, icing on the cake
○ PAGET’S DISEASE
16. One of the 2 most common HPV associated with cervical carcinoma
○ 16
17. This is not included in the pretherapy evaluation of cervical carcinoma
○ MRI
18. Most common histologic type of cervical carcinoma
○ SCCA LARGE CELL NON-KERATINIZING
19. Primary preventive measure against cervical carcinoma
○ MONOGAMY
20. Risk factor for cervical cancer
○ COITARCHE AT 14
21. Alternative method for screening for cervical cancer and its premalignant lesion in the
low resource setting
○ VIA
22. A 34 year old female presents to the clinic for malodorous vaginal discharge, on
speculum exam 2 cm mass was noted on the anterior lip of the cervix. What is the next
step?
○ BIOPSY
23. Major risk of a patient with cervical cancer delivering via vaginal
○ HEMORRHAGE
24. First line management of advanced stage cervical cancer
○ PELVIC EBRT WITH CHEMOTHERAPY FOLLOWED BY BRACHYTHERAPY
25. Which of the ff is not an advantage of surgery over radiotherapy in the treatment of
group of patients with cervical cancer - decrease risk of hemorrhage
26. Bivalent vaccination for HPV - 16 and 18
27. Cervical cancer with gross tumor size <4cm confined to the cervix - STAGE IB1
28. Depth of stromal invasion is >3 mm but not more than 5 mm, and the horizontal spread
is no more than 7 mml - STAGE 1A2
29. Cervical mass measuring 6x5 cm with extension to the upper third of the vagina and to
the right parametia but not up to the pelvic sidewall - STAGE 3A
30. Cervical mass 5x4 cm with extension to the pelvic side wall - STAGE 3B
31. Considered a risk factor in the development of cervical cancer - SMOKING
32. Concentration of acetic acid used in the screening for cervical cancer - 3-5%
33. In what area do most malignant transformation occur
○ Transformation zone
34. Common complication ff radical hysterectomy for cervical cancer
○ Bladder dysfunction (radiotherapy-diarrhea)
35. Staging for cervical cancer
○ Clinical (surgico-pathologic-ovarian, clinical - endometrial CA if the 1971
FIGO is used for patients who cant be operated e.g morbidly obese, with
medical morbidities hat are uncontrolled)
36. Staging of fallopian tube CA
○ Spread through peritoneal fluid in similar fashion with ovarian cancer
(most common - adenoCA serous type, not a common type affecting all
ages - usually the post menopausal group, presents with pelvic pain,
vaginal bleeding, and watery vaginal discharge - Latzko’s triad)
37. Pattern of spread of fallopian tube cancer
○ Direct extension
38. Staging of fallopian tube cancer
○ Surgico-pathologic
39. Histologic criteria used to diagnose primary fallopian tube cancer
○ ?? criteria (Samson’s theory for retrograde menstruation - endometriosis,
Spiegelberg
○ Criteria - Ectopic pregnancy of the ovary, L
SWU-MHAM
GYNE QUIZ - JULY 15, 2016

1. The child is susceptible to vulvar infection because of the following

a. The child’s vulva and vagina are exposed to bacterial contamination from the
rectum more frequently
b. The child lacks the labial fat pads
c. The child lacks the pubic hair of the adult
d. All of the above

2. The normal vagina of a prepubertal child is colonized by an average of nine different

species of bacteria
a. Four aerobic and facultative anaerobic species
b. Five obligatory anaerobic species
c. Only A
d. Both A and B

3. The excellent medium for bacterial growth in a prepubertal child is

a. Acidic
b. Neutral
c. Slightly alkaline
d. A and B

4. The prepubertal vagine is

a. Acidic
b. Netural
c. Slightly alkaline
d. B and C

5. A reliable sign that the vaginal pH is shifting to an acidic environment

a. Breast budding
b. Change of voice
c. Mensuration
d. Increase in height

6. A major factor in childhood vulvovaginitis is

a. Poor perineal hygiene
b. Intestinal parasitic invasion with pruritus
c. Foreign bodies
d. Urinary tract infections with irritation

7. The most frequent problem in performing endometrial sampling is

a. Cervical stenosis
b. Spasm
 c. Bleeding
d. A and D

8. Major indications for hysteroscopy include the following except

a. Abnormal uterine bleeding
b. Removal of endometrial polyps
c. Desire of incision sterilization
d. Endometrial ablation

9. Nonpharmacologic treatments for hypoactive sexual desire include

a. Lifestyle changes for reducing stress and fatigue
b. Recognizing and treating depression
c. Increasing quality time with the partner
d. All of the above

10. Which of the following is the best method of pain control for outpatient hysteroscopy
compared with topical or intracervical anesthesia?
a. Paracervical block
b. Spinal block
c. General anesthesia
d. Spinal-epidural block

11. Complications of hysteroscopy include which of the following EXCEPT

a. Uterine perforation with no risk of injury to the surrounding vascular
structures
b. Pelvic infection
c. Bleeding
d. Absorption of the distending media

12. Absolute contraindications to laparoscopy include which of the following EXCEPT

a. Hemoperitoneum that has produced hemodynamic instability
b. Bowel obstruction
c. Coagulation therapy
d. Advanced malignancy

13. Which of the following of the direct visualization of the endometrial cavity via the cervix
using an endoscope and a light source?
a. Hysteroscopy
b. Laparoscopy
c. Hysterosalpingogram
d. None of the above
14. The major complication of hysteroscopy is
a. Uterine perforation
b. Uterine bleeding
c. Uterine atony
d. Uterine inversion

15. The most frequent gynecologic disease of children is

a. Vulvovaginitis
b. UTI
c. Foreign body
d. All of the above

16. Common reasons for a pediatric gynecology visit will inclue the following EXCEPT:
a. Labial adhesions
b. Vulvar lesions
c. Suspicion of sexual abuse
d. Urinary tract trauma

17. Which period of life during which an individual matures physically and begins to transition
psychologically from a child into an adult?
a. Adolescence
b. Early adulthood
c. Late adulthood
d. Puberty

18. Which of the following produces dramatic alterations in both the external and internal female
genitalia and hormonal millieu?
a. Puberty
b. Adolescence
c. Toddler
d. Adult

19. The components of a complete pediatric examination include the following except
a. History
b. Inspection with visualization of the vulva, vagina, and cervix
c. A rectal exam
d. Bimanual exam

20. Any vaginal bleeding not related to menses is known as

a. Intermenstrual bleeding
b. Postcoital bleeding
c. Menstruation
d. Coitarche
21. Pain or discomfort with coitus is known as
A. Dyspareunia
B. Menarche
C. Coitarche
D. Thelarche

22. Possible causal factors of endometriosis include the following

A. Retrograde menstruation
B. Immunologic changes
C. Iatrogenic dissemination
D. All of the above

23. What causes pain and contribute to infertility in endometriosis?

A. Prostaglandins
B. Cytokines
C. Estrogen
D. A and B

24. The two primary short-term goals in treating endometriosis

A. Relief of pain
B. Promotion of fertility
C. Removal of the lesions
D. A and B

25. The primary long term goal in the management of a women with endometriosis is attempting
to
A. Prevent progression
B. Recurrence of the disease process
C. Giving analgesic
D. A and B

26. The three most common symptoms of GnRH agonist therapy are
A. Hot flushes
B. Vaginal dryness
C. Headache
D. A and B

27. Classic symptoms of endometriosis of the large bowel especially during the menstrual
period include
A. Cyclic pelvic cramping
B. Lower abdominal paid
C. Rectal pain with defecation
D. All of the above
28. Which of the following is true with endometriosis of the bladder, EXCEPT
A. It is discovered most often in the region of the trigone of the bladder
B. Bladder endometriosis produces midkine, lower abdominal and suprapubic pain
C. It also causes dysuria and occasionally, cyclic hematuria
D. None of the above

29. Surgical invanment for endometriosis should mainly be carried out via laparoscopy rather by
A. Shorter recovery period
B. A longer recovery period
C. Reduc…….
D. A and C

30. Which of the following is true with the use of oral contraceptives in … the treatment with
endometriosis?
A. Rupture of small endometrioma
B. It will result to acute surgical abdomen during the first _ weeks….
C. During prolonged therapy the endometrial glands hypertrophy and the ….. decidual
reaction
D. All of the above

31. Gonorrhea risk?

A. Men and women having unprotected sex with multiple partners
B. Past or present injection drug use
C. Women who exchange sex for money or drugs or who have partners who are
D. Inconsistent condom use

32. HIV risk

A. Men and women having unprotected sex with multiple partners
B. Past present injection drug use
C. New or multiple sexual partners
D. A and B

33. The three cardinal histologic features of endometriosis are

A. Ectopic endometrial glands
B. Ectopic endometrial stroma
C. Hemorrhage into the adjacent tissue
D. All of the above

34. Five general impression can be transmitted both by facial expression and by posture,
including
A. Happiness
B. Apathy
C. Fear
D. AOTA
35. Apathetic patients generally have a
A. Blank facial expression
B. Eyes lack sparkle
C. Little muscular movement of the face
D. AOTA

36. The angry patient frequently has

a. Narrowed eyes and furrowed brows
b. Narrows and tight lip
c. Defensive and with aggression
d. All of the above

37. A patient who is happy is

a. Self assured
b. In good personal control
c. Has a relaxed face with a smile
d. All of the above

38. The frightened patient frequently has a

a. Tense expression on her face
b. Her mouth is tight the eyes are darting and narrow
c. She is leaning forward, and there is often endless hand activity
d. All of the above

39. The sad patient usually presents

a. He sits with slouched shoulders
b. He has large, sad eyes, and a turned-down mouth
c. The eyes may ? and maybe teary
d. All of the above

40. A complete gynecologic evaluation should always include a

a. Sexual history
b. Contraceptive
c. History of physical or sexual abuse
d. All of the above

41. The various forms of the female genital mutulation include

a. Removal of the elitoral prepuce
b. Excision of the clitoris
c. Removal of the clitoris and labia minora
d. All of the above
42. Which of the following are the frequent components of the domestic violence problem?
a. Murder
b. Suicide
c. ?
d. A and B
5/28/2021 GYN QUIZ 05.27.2021

GYN QUIZ 05.27.2021

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MATCHING TYPE

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5/28/2021 GYN QUIZ 05.27.2021

Principles of Chemotherapy *

Rapidly
Adjuvant Nausea and
Static proliferating Alopecia
chemotherapy vomiting
or short G1

What is the
classification of
the proliferative
activity of
striated muscle?

Type of cells
that are highly
chemosensitive

Administration
of
chemotherapy
after surgery or
radiation
therapy with
curative intent

Almost always a
reversible effect
of
chemotherapy
on the patient’s
hair

A common
gastrointestinal
side effect of
chemotherapy

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Intraepithelial Neoplasia of the Lower Genital Tract (CIN, VIN, VAIN) *

Transformation
Koiloytosis CIN I HPV 16 5-FU
zone

This is the
cytopathic effect
of HPV on
cervical
epithelium

What type of CIN

is a
cytomorphologic
representation of
an active HPV
infection?

Important
landmark in the
cervix where
most
malignancies
arise.

HPV type
associated with
VIN usual type

Treatment for
VAIN

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Principles of Radiotherapy *

Single Mitotic
Direct
strand Teletherapy phase or Brachytherapy
Effect
break mitosis

What is the most

radiosensitive
phase of the cell
cycle?

This type of
radiation is
delivered from a
far distance.

This type of
radiation is
delivered from a
short distance.

This is a type of
DNA strand
break that is
inconsequential
and can be
repaired by the
cellular
machinery.

What is the
effect of
radiation on
tissues wherein
radiation acts on
sulfhydryl bonds
thus causing
mitotic death?

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GYN QUIZ 05.27.2021

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Choose the best answer

Name one factor that decreases the risk of developing ovarian cancer *

Yearly pap smear

Smoking

Routine TVS

Use of OCP

What is the cut-off point for endometrial thickness based on ultrasound? *

2 mm

1 mm

4 mm

5 mm

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The most common group of ovarian malignancies *

Epithelial ovarian tumors

Germ cell tumors

brenner tumors

Yolk-sac tumors

Incidence of fallopian tube cancer among all primary female genital neoplasms *

2-3%

0.15 - 1.8%

6-7%

5%

How many percent of adenocarcinoma of the endometrium occur before the

age of 40? *

40%

20%

5%

10%

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Secretion of copious amounts of fluid per vagina in fallopian tube cancer *

Normal

suggestive of PID

Tubal discharge

Hydrops tubae profluens

Histology in majority of cases of fallopian tube cancer *

Mucinous cystadenocarcinoma

Hydrops tubae profluens

Papillary serous

Serous cystadenocarcinoma

What is the histopathogenetic type of endometrial cancer in young women,

often associated with obesity, and is estrogen-dependent? *

None

Type I

Type II

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What is the gold standard in the diagnosis of endometrial cancer? *

Endometrial biopsy

Transvaginal ultrasound

Laparoscopy

Speculum exam

Most common symptom of endometrial cancer? *

Wasting

Abnormal vaginal bleeding

Enlarged abdomen

Hypogastric pain

Which part of the fallopian tube is usually affected? *

Fimbria

Infundibulum

Isthmic

Ampulla

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Cornerstone in the management of ovarian cancer *

Brachytherapy

Maximal cytoreductive surgery

Chemoradiation

Radical hysterectomy with BSO

Incidence of bilaterality of fallopian tube cancer *

50%

10%

2-5%

5-30%

This type of vulvar malignancy may arise from preexisting pigmented lesion or
from normal appearing skin *

Vulvar melanoma

Pagets

Lichen sclerosus

Lichen planus

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Tumor marker for serous cystadenocarcinoma of the ovary *

AFP

CEA

HE 4

CA 125

This group usually occurs in the younger age group *

Epithelial ovarian tumors

Yolk-sac tumors

Germ cell tumors

brener tumors

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CHOOSE THE BEST ANSWER

This is where most vulvar adenocarcinomas in women 50 years old and above
originate *

Periurethral glands

Skene's gland

Bartholin’s gland

Sebaceous glands in the vulva

Gold standard in the screening for cervical cancer *

VIA

Speculum exam

Biopsy of the cervix

Pap smear

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Most common site of vaginal cancer *

Lower third, posterior wall

Upper third, posterior wall

Upper third, anterior wall

Lower third, anterior wall

Most common histologic type of vulvar cancer *

cuboidal cell type

Glandular type

Squamous cell type

adenocarcinoma

What is the incidence of vaginal cancer among all malignancies of the female
genital tract? *

2-3%

1-2%

5%

7-8%

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Treatment for advanced cases of cervical cancer *

Brachytherapy

Chemoradiation

Teletherapy

Chemoradiation followed by brachytherapy

Instrument used to obtain vulvar biopsies *

Keyes punch

Cervical punch

Tischler

Kelly

This is the necessary cause of cervical cancer *

history of cervicitis

multiparity

multiple sexual partner

HPV

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Type of growth of cervical cancer that is fungating and resembles a cauliflower

appearance *

Exophytic growth

Fungus-like

Endophytic growth

Barrel-shaped

This is an important test that is should be done on follow-up of patients

previously treated for cervical or vulvar neoplasia due to their increased lifetime
risk of developing VAIN or vaginal cancer. *

Speculum exam

BPE

CA-125

Pap smear

Alternative screening method for cervical cancer in low resource areas *

VIA

Pap smear

Speculum exam

Biopsy of the cervix

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Most common mesenchymal tumor of the vagina in infants and young children *

Juvenile Papilloma

Serous cystadenoma

Mucinous cystadenoma

Sarcoma botyroides

What is the FIGO stage when the vaginal carcinoma has extended to the pelvic
wall? *

Stage IV

Stage V

Stage III

Stage II

This is a precursor lesion in some types of vulvar cancer *

Dermatitis

Paget's

Lichen sclerosus

Lichen planus

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