[GYNE] LE 4 STI/ INFERTILITY/VIOLENCE Flashcards
Q: Which of the following is NOT progesterone-dependent?
A. Endometrial secretory transformation
B. Basal body temperature rise
C. Luteal phase support
D. Ultrasound monitoring
Ultrasound monitoring
Rationale: Ultrasound monitoring assesses follicular development and ovulation, but it is not affected by progesterone levels.
Q: What is the best evidence of ovulation?
A. LH surge
B. Progesterone rise
C. Pregnancy
D. Endometrial biopsy
Pregnancy
Rationale: Pregnancy is the definitive proof that ovulation has occurred and that fertilization was successful.
Q: What mid-luteal progesterone level is most indicative of conception?
A. 2 ng/mL
B. 5 ng/mL
C. 10 ng/mL
D. 15 ng/mL
10 ng/mL
Rationale: A mid-luteal serum progesterone level ≥10 ng/mL is a strong indicator of ovulation and probable conception.
Q: Which sperm parameter most directly correlates with fertilizing ability?
A. Motility
B. Count
C. Volume
D. Morphology
Morphology
Rationale: Sperm morphology—the shape and structure—best correlates with the ability to fertilize an egg.
Q: Which ovarian reserve test can be performed on any day of the menstrual cycle?
A. FSH
B. Estradiol
C. Anti-Müllerian Hormone (AMH)
D. LH
Anti-Müllerian Hormone (AMH)
Rationale: AMH levels remain stable and can be measured on any cycle day, making it an ideal test for ovarian reserve.
Q: Which antibody titer, when elevated, indicates tubal disease?
A. Rubella IgG
B. Hepatitis B surface antibody
C. Chlamydia trachomatis antibody
D. Toxoplasma antibody
Chlamydia trachomatis antibody
Rationale: Elevated Chlamydia antibodies are associated with previous infection, which can cause tubal damage and infertility.
Q: What is the best time in the menstrual cycle to perform a hysterosalpingogram (HSG)?
A. Day 1–2
B. Day 6–8
C. After ovulation
D. One week before menstruation
Day 6–8
Rationale: HSG is best done during the early proliferative phase (Day 6–8), when the endometrium is thin and there’s no risk of disturbing an early pregnancy.
Q: Interpret this hysterosalpingogram: contrast fills the uterus and flows freely through both fallopian tubes into the peritoneal cavity.
A. Patent bilateral fallopian tubes
B. Blocked proximal fallopian tubes
C. Blocked distal fallopian tubes
D. Normal ampullary fold
Patent bilateral fallopian tubes
Rationale: Free spillage of contrast bilaterally into the peritoneal cavity confirms tubal patency.
Q: Ovulation-inducing agent that competes with estrogen receptors?
A. Letrozole
B. Clomiphene citrate
C. GnRH
D. hCG
Clomiphene citrate
Rationale: Clomiphene citrate acts as an estrogen receptor antagonist, especially in the hypothalamus, promoting gonadotropin release.
Q: Which ovulation agent inhibits estrogen production, resulting in an increase in FSH levels?
A. Clomiphene citrate
B. GnRH
C. Letrozole
D. hCG
Letrozole
Rationale: Letrozole is an aromatase inhibitor that suppresses estrogen synthesis, thereby enhancing FSH release and follicular development.
Q: A 29-year-old nulligravid woman with a history of endometriosis has been trying to conceive for 7 months. Her partner is 45. What is the best advice?
A. Wait until 12 months of trying
B. Continue trying for 6 more months
C. Start fertility work-up as soon as possible
D. Start ovulation induction immediately
Start fertility work-up as soon as possible
Rationale: Endometriosis is a known cause of infertility, so couples do not need to wait 12 months to start a work-up.
Q: What is the usual fecundability rate for a normal couple?
A. 10%
B. 20%
C. 30%
D. 40%
20%
Rationale: Fecundability refers to the monthly probability of conception, which is around 20% in normal couples.
Q: What is the most common cause of infertility?
A. Tubal disorders
B. Male factors
C. Ovulatory disorders
D. Endometriosis
Ovulatory disorders
Rationale: Ovulatory disorders account for the largest percentage (27%) of infertility cases, especially in women with PCOS.
Q: What is the best time to have sexual intercourse after a positive LH kit?
A. Same day only
B. Day before LH surge
C. The day of LH surge and the next day
D. 3 days after LH surge
The day of LH surge and the next day
Rationale: LH kits predict ovulation, which typically follows within 24–36 hours; these two days are the most fertile.
Q: When is the best time to perform an endometrial biopsy?
A. Day 7
B. Day 14
C. Day 21
D. Day 28
Day 21
Rationale: An endometrial biopsy is done on Day 21, during the luteal phase, to assess if secretory changes occurred—indicating ovulation.
Q: What is the expected histologic finding in the endometrium if a woman has ovulated?
A. Proliferative endometrium
B. Secretory endometrium
C. Atrophic endometrium
D. Non-specific endometritis
Secretory endometrium
Rationale: Secretory changes in the endometrium indicate progesterone influence and successful ovulation.
Q: Which of the following is NOT an indication for ovarian reserve testing?
A. Age >35
B. History of chemotherapy
C. Poor ovarian response to stimulation
D. History of heavy menstrual bleeding
History of heavy menstrual bleeding
Rationale: Ovarian reserve tests are indicated in women with age-related decline, prior ovarian surgery, or poor stimulation response, not heavy bleeding.
Q: A 35-year-old male has the following semen analysis: Sperm count = 39M, morphology = 1%, motility = 40%, volume = 1.5 mL. What is the interpretation?
A. Normal semen analysis
B. Low motility
C. Low volume
D. Low morphology (normal forms)
Low morphology (normal forms)
Rationale: A normal morphology threshold is usually ≥4%. 1% is low, which impacts fertilization potential despite normal count/motility.
Q: A 32-year-old with primary infertility, pelvic pain, nodular cul-de-sac, fixed retroverted uterus, and an 8×5 cm cystic adnexal mass. What is the most likely cause of infertility?
A. Pelvic inflammatory disease
B. PCOS
C. Endometriosis
D. Tubal obstruction
Endometriosis
Rationale: This presentation is classic for endometriosis, which causes infertility due to anatomical distortion and inflammation affecting tubal/ovarian function.
Q: A 30-year-old G1P0 woman with PCOS, irregular menses, and poor response to past fertility treatments is being evaluated for secondary infertility. What detail in her history warrants an ovarian reserve test?
A. Age over 35
B. Irregular menses
C. History of curettage
D. Poor response to fertility treatment
Poor response to fertility treatment
Rationale: A poor ovarian response despite previous fertility treatments is a key indication to assess ovarian reserve.
Q: A 40-year-old couple with primary infertility for 10 years. Woman’s HSG shows bilateral tubal blockage; semen analysis shows 2 million sperm, 1% normal forms. What is the best management?
A. IUI
B. Ovulation induction
C. IVF
D. Expectant management
IVF
Rationale: In vitro fertilization (IVF) is indicated when there is bilateral tubal block and severe male factor infertility.
Q: Mrs. Cruz shows you a basal body temperature (BBT) chart with a monophasic pattern. What does this indicate?
A. Ovulation occurred
B. Luteal defect
C. Estrogen deficiency
D. Anovulation
Anovulation
Rationale: A monophasic BBT chart lacks the post-ovulatory temperature rise, suggesting that ovulation did not occur.
Q: A 25-year-old has a transvaginal ultrasound on Day 21. Which finding suggests ovulation has occurred?
A. Multiple small follicles
B. Thin endometrium
C. Corpus luteum
D. Dominant follicle
Corpus luteum
Rationale: Presence of a corpus luteum confirms that ovulation has occurred during that menstrual cycle.
Q: A 24-year-old cancer survivor treated with chemotherapy at age 18 is concerned about fertility. What is the best test to assess her chances of getting pregnant?
A. Endometrial biopsy
B. FSH on Day 3
C. Ovarian reserve test (e.g., AMH)
D. LH surge monitoring
Ovarian reserve test (e.g., AMH)
Rationale: Ovarian reserve testing, especially AMH levels, assesses remaining follicle pool, crucial for post-chemotherapy fertility assessment.
Q: After determining the approximate ovulation day, what is the best timing advice for intercourse?
A. On ovulation day only
B. Starting the day before ovulation
C. Three days before ovulation
D. Day after menstruation ends
Starting the day before ovulation
Rationale: Fertility is highest during the 1–2 days before ovulation, so timed intercourse should begin the day before ovulation.
Q: True or False: The incidence of infertility increases with the advancing age of the female partner.
TRUE
Rationale: Female fertility declines with age, especially after age 35, due to decreased oocyte quality and quantity.
Q: True or False: Semen profile reflects sperm production that occurred in the last 3 months to 1 year.
TRUE
Rationale: Spermatogenesis takes around 74 days, and changes in sperm quality may reflect 3 months or more of production history.
Q: True or False: Routine endometrial biopsy is highly recommended for all infertile couples with primary infertility.
FALSE
Rationale: Endometrial biopsy is not routinely recommended in infertility workups unless there is a specific indication like suspected endometrial pathology.
Q: True or False: It is always possible to diagnose the cause of infertility.
FALSE
Rationale: In up to 15–30% of cases, infertility remains unexplained, even after thorough evaluation of both partners.
Q: What is the most likely causative agent of syphilis?
A. Virus
B. Spirochete
C. Protozoa
D. Fungi
Spirochete
Rationale: Syphilis is caused by Treponema pallidum, a spirochete bacterium transmitted through sexual contact.
Q: A 21-year-old nulligravid complains of a painless genital ulcer on her labia minora with unilateral inguinal lymphadenopathy. What is the most likely diagnosis?
A. HIV
B. Granuloma inguinale
C. Syphilis
D. Chancroid
Syphilis
Rationale: Primary syphilis presents with a painless chancre and regional lymphadenopathy, commonly on the vulva or labia.
Q: A 24-year-old G3P3 presents with painless vesiculopapular rashes on the vulva and suppurative inguinal lymphadenopathy. What is the most likely causative organism?
A. Herpes simplex virus
B. Chlamydia trachomatis
C. Haemophilus ducreyi
D. Treponema pallidum
Chlamydia trachomatis
Rationale: This describes lymphogranuloma venereum (LGV), caused by Chlamydia trachomatis, presenting with painless vulvar lesions and suppurative lymph nodes.
Q: What skin manifestation is characteristic of secondary syphilis?
A. Condyloma acuminata
B. Condyloma latum
C. Herpetic ulcers
D. Genital warts
Condyloma latum
Rationale: Condyloma latum are broad-based, moist, painless, gray-white plaques, commonly seen in secondary syphilis.
Q: What is the confirmatory test for lymphogranuloma venereum (LGV)?
A. Wet mount microscopy
B. Dark field microscopy
C. Nucleic acid amplification test (NAAT)
D. Culture and sensitivity
Nucleic acid amplification test (NAAT)
Rationale: NAAT is the most sensitive and specific test for detecting Chlamydia trachomatis, the causative agent of LGV.
Q: Vaginal squamous cells with clue cells and a polymicrobial profile suggest infection by:
A. Gardnerella vaginalis
B. Candida albicans
C. Trichomonas vaginalis
D. Neisseria gonorrhoeae
Gardnerella vaginalis
Rationale: Clue cells (squamous cells with adherent bacteria) are pathognomonic for bacterial vaginosis, most commonly caused by Gardnerella vaginalis.
Q: Multiple grouped vesicles mixed with painful ulcers on the vulva are characteristic of:
A. Syphilis
B. Genital herpes
C. Chancroid
D. HPV
Genital herpes
Rationale: Herpes simplex virus (HSV) causes painful grouped vesicles that can ulcerate, often with flu-like symptoms during primary outbreaks.
Q: A woman presents with dysuria and crops of vesicles with crusting on her genitalia. What is the most likely diagnosis?
A. Syphilis
B. HPV
C. Genital herpes
D. Trichomoniasis
Genital herpes
Rationale: Dysuria along with vesicles and crusting strongly suggests HSV infection, especially during the primary episode.
Q: Inspection of the inner labia shows rough, warty, carpet-like growths. What is the most likely diagnosis?
A. Condyloma acuminata
B. Condyloma latum
C. Genital herpes
D. Vulvar carcinoma
Condyloma acuminata
Rationale: Condyloma acuminata are cauliflower-like, flesh-colored warts caused by HPV, commonly seen on mucosal and cutaneous genital surfaces.
Q: What is the causative agent of AIDS?
A. HTLV
B. HPV
C. HIV
D. HSV
HIV
Rationale: Human Immunodeficiency Virus (HIV) targets CD4+ T cells, leading to progressive immunodeficiency and ultimately AIDS.
Q: Klebsiella granulomatis causes?
A. Granuloma Inguinale
B. Syphilis
C. Bacterial Vaginosis
D. Lymphogranuloma venereum
Granuloma Inguinale
Rationale: Klebsiella granulomatis is the causative agent of Granuloma Inguinale (Donovanosis), a chronic ulcerative STD.
Q: Buboes are classically seen in which STD?
A. Gardnerella vaginalis
B. Treponema pallidum
C. Haemophilus ducreyi
D. Lymphogranuloma venereum
Lymphogranuloma venereum
Rationale: LGV, caused by Chlamydia trachomatis L1–L3, is characterized by painless genital ulcers followed by painful inguinal lymphadenopathy (buboes).
Q: A 20-year-old OFW presents with dark spots on both hands. What is the most likely diagnosis?
A. HIV
B. Syphilis
C. Chlamydia
D. Gonorrhea
Syphilis
Rationale: Secondary syphilis may present with generalized rashes, including on the palms and soles, along with constitutional symptoms.
Q: A 25-year-old presents with painful blisters on the vulva, low-grade fever, and inguinal lymphadenopathy. What is the most likely diagnosis?
A. Syphilis
B. Genital herpes
C. LGV
D. Chancroid
Genital herpes
Rationale: Genital herpes (caused by HSV) typically presents with painful grouped vesicles, systemic symptoms, and tender lymph nodes.
Q: Infection with the oncogenic types of which organism is most closely associated with cervical carcinoma?
A. HIV
B. HSV
C. HPV
D. Treponema pallidum
HPV
Rationale: High-risk types of human papillomavirus (HPV), especially types 16 and 18, are strongly associated with cervical cancer.
Q: A painful, tender, soft chancre is a clinical sign of:
A. Syphilis
B. Genital herpes
C. Chancroid
D. Granuloma inguinale
Chancroid
Rationale: Haemophilus ducreyi causes chancroid, characterized by a soft, painful ulcer and tender lymphadenopathy (bubo formation).
Q: A 26-year-old sex worker presents with a sore in the vulva and a shallow, painless ulcer on the labia minora. What is the most likely diagnosis?
A. Chancroid
B. LGV
C. Syphilis
D. HPV
Lymphogranuloma venereum
Rationale: LGV begins with a painless ulcer followed by painful inguinal adenopathy, common in high-risk sexual activity.
Q: HIV affects which specific cells of the body?
A. B cells
B. CD8+ T cells
C. CD4+ T cells
D. Macrophages
CD4+ T cells
Rationale: HIV targets CD4+ T lymphocytes, weakening the immune response and progressing to AIDS as the CD4 count drops.
Q: An 18-year-old presents with mucopurulent vaginal discharge, lower abdominal pain, and fever at the end of menstruation. Her partner has profuse morning penile discharge. What is the most likely diagnosis?
A. Syphilis
B. Lymphogranuloma venereum
C. Gonorrhea
D. Bacterial vaginosis
Gonorrhea
Rationale: Caused by Neisseria gonorrhoeae, gonorrhea presents with purulent discharge, abdominal pain, and systemic symptoms, especially around menses.
Q: What is the most appropriate diagnostic test to confirm AIDS?
A. Fieldman illumination
B. Sabin-Feldman dye test
C. Microimmunofluorescent test
D. ELISA and Western blot
ELISA and Western blot
Rationale: ELISA is the screening test for HIV; a positive result is confirmed by Western blot, making this the standard protocol for AIDS diagnosis.
Q: What is the confirmatory test for syphilis?
A. ELISA
B. VDRL
C. FTA-ABS
D. NAAT
FTA-ABS
Rationale: Fluorescent treponemal antibody absorption (FTA-ABS) test is a confirmatory test for syphilis that detects antibodies against Treponema pallidum.
Q: What is the most common site of gonorrhea infection in women?
A. Vagina
B. Urethra
C. Endocervix
D. Bartholin gland
Endocervix
Rationale: The primary site of gonorrheal infection in women is the endocervix, although other sites like the Bartholin glands may also be affected.
Q: What is the most common site affected in lymphogranuloma venereum (LGV)?
A. Urethra
B. Vulva
C. Vagina
D. Cervix
Vulva
Rationale: LGV commonly affects the vulva, presenting initially with a painless ulcer followed by inguinal adenopathy.
Q: What is the major mode of transmission of HIV?
A. Saliva
B. Blood transfusion
C. Vertical transmission
D. Sexual transmission
Sexual transmission
Rationale: Sexual transmission is the most common route of HIV spread worldwide, through unprotected sex.
Q: A 22-year-old commercial sex worker presents with a painless beefy red genital lesion. What is the likely diagnosis?
A. Syphilis
B. Chancroid
C. Donovanosis
D. Genital herpes
Donovanosis
Rationale: Donovanosis (Granuloma Inguinale) presents with beefy red, painless ulcers and is caused by Klebsiella granulomatis.
Q: A 34-year-old woman has a fleshy, non-tender papule on the posterior genital area that turns white with acetic acid. What is the most likely diagnosis?
A. Syphilis
B. Genital herpes
C. Condyloma acuminata
D. LGV
Condyloma acuminata
Rationale: Condyloma acuminata (genital warts) are HPV-related growths that turn white with acetic acid during colposcopic exam.
Q: A 26-year-old sex worker presents with weight loss, fever, dry cough, and lymphadenopathy. What is the appropriate diagnostic test?
A. Dark field microscopy
B. ELISA
C. Tzanck smear
D. PCR
ELISA
Rationale: ELISA is the standard screening test for detecting HIV antibodies, especially in symptomatic individuals.
Q: When are HIV antibodies typically detectable in the serum after exposure?
A. 4–5 weeks
B. 6–12 weeks
C. 13–18 weeks
D. 19–24 weeks
6–12 weeks
Rationale: HIV antibodies can typically be detected in 6–12 weeks post-exposure; this period is referred to as the window period.
Q: A patient presents with inguinal buboes and multiple painful genital ulcers. What is the most likely diagnosis?
A. Syphilis
B. LGV
C. Chancroid
D. Genital herpes
Chancroid
Rationale: Chancroid is caused by Haemophilus ducreyi, characterized by painful ulcers and inguinal lymphadenopathy (buboes).
Q: A 28-year-old G4P4 presents with purulent vaginal discharge and rebound tenderness. A foreign object is noted. What is the next step?
A. Culture and antibiotics
B. Remove the IUD
C. Vaginal swab
D. Give antifungals
Remove the IUD
Rationale: Presence of an IUD with signs of infection (purulent discharge, tenderness) requires immediate removal.
Q: What is a major sequela of pelvic inflammatory disease (PID)?
A. Uterine fibroid
B. Ovarian cyst
C. Ectopic pregnancy
D. Vulvar abscess
Ectopic pregnancy
Rationale: Scarring of the fallopian tubes post-PID increases the risk of ectopic pregnancy significantly.
Q: A 26-year-old woman with pelvic peritonitis, fever, and a pelvic mass tests positive for Neisseria gonorrhea. What is the likely diagnosis?
A. Endometriosis
B. Tubo-ovarian abscess
C. Endometritis
D. Septic abortion
Tubo-ovarian abscess
Rationale: Tubo-ovarian abscess is a severe complication of PID, typically caused by gonorrhea or mixed anaerobes, and requires hospitalization.
Q: What is the gold standard for diagnosing abdominal tuberculosis?
A. Chest X-ray
B. PCR
C. AFB culture
D. CBC with ESR
AFB culture
Rationale: AFB culture from biopsy remains the gold standard for diagnosing abdominal or genital TB.
Q: A 35-year-old woman with infertility and irregular menses has a pelvic exam revealing an eroded cervix with vascular markings. What is the most important differential diagnosis?
A. Endometriosis
B. PID
C. Cervical cancer
D. Endometrial hyperplasia
Cervical cancer
Rationale: In cases of cervical TB, cancer should always be the top differential diagnosis due to overlapping presentations.
Q: A “tobacco pouch” sign seen on transvaginal sonography is associated with:
A. Ectopic pregnancy
B. Salpingitis
C. Endometriosis
D. Polycystic ovaries
Salpingitis
Rationale: The “tobacco pouch” appearance is a classic sign of tubal pathology such as salpingitis, commonly seen in genital TB.
Q: What is the common denominator used by one person over another within an intimate and violent relationship?
A. Love and jealousy
B. Miscommunication and stress
C. Power and control
D. Sexual desire
Power and control
Rationale: The Power and Control Wheel explains how abusers maintain dominance in abusive relationships, using physical, emotional, and psychological tactics.
Q: What describes the chronic and repetitive pattern of abusive behavior in domestic violence?
A. Stalking behavior
B. Cycle of violence
C. Physical assault
D. Trauma bonding
Cycle of violence
Rationale: The Cycle of Violence consists of three phases: tension-building, acute battering, and honeymoon phase, and often repeats in abusive relationships.
Q: What term describes sexual intimacy with or without coitus involving a close family member?
A. Molestation
B. Rape
C. Incest
D. Sexual coercion
Incest
Rationale: Incest is sexual intimacy between close blood relatives and is a criminal form of abuse, regardless of consent or penetration.
Q: A man who batters his wife and says “she nags me to death” is giving a valid justification for domestic violence.
A. True
B. False
C. Sometimes true
D. Depends on culture
False
Rationale: There is no excuse for domestic violence. Blaming the victim is a manipulation tactic to justify abuse and shift responsibility.
Q: What is the act of sexual intimacy performed by one person on another without mutual consent?
A. Violence against women
B. Sexual abuse
C. Rape
D. Incest
Sexual abuse
Rationale: Sexual abuse refers to any sexual act without consent, including unwanted touching, assault, or forced intercourse.
Q: In the wheel of violence, the outermost part (the tire) represents which form of violence?
A. Intimidation
B. Physical violence
C. Emotional abuse
D. Isolation
Physical violence
Rationale: The tire of the Power and Control Wheel represents physical and sexual violence, which enforces the tactics used inside the wheel.
Q: What is a common physical profile of a battered woman?
A. Very friendly and attends social functions
B. Full of high spirits, independent and courageous
C. Often wears dark glasses, long sleeves, and slacks
D. Carries a lot of money, credit cards, or check
Often wears dark glasses, long sleeves, and slacks
Rationale: Victims often conceal physical signs of abuse with clothing and makeup due to shame, fear, or coercion by their abuser.
Q: Which of the following is a direct screening question to identify victims of violence?
A. Are you safe at home?
B. Has your partner ever hit or physically hurt you?
C. Have you been under any stress lately?
D. Are you having problems with your partner?
Has your partner ever hit or physically hurt you?
Rationale: Direct screening involves asking explicit questions about violence or injury, which helps identify abuse more effectively.
Q: Which of the following is a sample of indirect screening for intimate partner violence?
A. Has someone ever tried to restrict your freedom?
B. Did your husband hit you or hurt you physically?
C. Every couple fights; what are fights like in your house?
D. Has anyone, including your partner, ever forced you to have sex?
Every couple fights; what are fights like in your house?
Rationale: Indirect screening uses general or normalized statements to create a safe space for victims to disclose abuse without feeling targeted.
Q: What is the single most important reason why physicians fail to diagnose domestic violence?
A. Reluctance in dealing with the issue
B. Low suspicion index and time constraints
C. Indifference to domestic violence as a health issue
D. Failure to ask the right questions
Failure to ask the right questions
Rationale: Many healthcare providers miss the diagnosis of abuse because they don’t screen or ask questions proactively and consistently.
Q: On average, how many years does it take before a battered woman seeks help?
A. 1 year
B. 2 years
C. 4 years
D. 6 years
4 years
Rationale: On average, it takes a battered woman 4 years before seeking help due to fear, financial dependency, or psychological manipulation.
Q: What is a common emotional response seen in the acute phase of rape-trauma syndrome?
A. Euphoric behavior
B. Emotional control only
C. Emotional control to total loss of control
D. Catatonia
Emotional control to total loss of control
Rationale: Victims in the acute phase of rape trauma may show a range of emotions, from well-controlled behavior to emotional breakdown.
Q: What does the second phase of rape-trauma syndrome typically involve?
A. Suicidal ideation
B. Obsessive behavior
C. Flashbacks and nightmares
D. Isolation and withdrawal only
Flashbacks and nightmares
Rationale: The reorganization phase involves nightmares, flashbacks, and lifestyle adjustments as the victim processes trauma.
Q: In rape trauma victims, what is one of the key medical responsibilities of the physician?
A. Filing a police report
B. Prevention of pregnancy
C. Referring to social work
D. Performing surgical repair
Prevention of pregnancy
Rationale: Physicians should offer emergency contraception after ruling out pregnancy when managing sexual assault survivors.
Q: A 15-year-old girl presents with a history of sexual abuse and an enlarged uterus. What is the first and appropriate laboratory test to perform?
A. Vaginal swab
B. Complete blood count
C. Pregnancy test
D. Urinalysis
Pregnancy test
Rationale: In sexual assault victims, pregnancy must be ruled out first, especially when uterine enlargement is present.
Q: What is the most important responsibility of healthcare providers when managing a rape victim?
A. Psychological counseling
B. Police report filing
C. Proper collection of forensic specimens
D. Conducting pelvic exam
Proper collection of forensic specimens
Rationale: Proper forensic evidence collection ensures validity in legal proceedings and supports justice for the victim.
Q: In cases of sexual assault, what is the term for the process of tracking evidence from collection to legal transfer?
A. Medical documentation
B. Legal referral
C. Chain of evidence
D. Chain of custody
Chain of evidence
Rationale: The chain of evidence ensures that forensic specimens remain untainted and admissible in court.
Q: What is the proper initial protocol in managing domestic violence victims in a clinical setting?
A. Immediately notify the police
B. Provide a safe, non-threatening environment
C. Call social services
D. Refer to psychiatry
Provide a safe, non-threatening environment
Rationale: First and foremost, create a secure space for the victim to disclose abuse and receive care.
Q: A woman is hiding physical injuries with long sleeves and sunglasses. In the Power and Control Wheel, what type of violence is this?
A. Using children
B. Physical abuse
C. Isolation
D. Using male privilege
Physical abuse
Rationale: Wearing clothes to cover injuries indicates physical violence, which is the most visible form of abuse in the wheel.
Q: A woman’s husband makes all family decisions and controls her input. What form of domestic abuse is this?
A. Using children
B. Economic abuse
C. Isolation
D. Using male privilege
Using male privilege
Rationale: Male privilege as a tactic includes acting as the “master of the castle” and making unilateral decisions.
Q: What form of domestic violence is demonstrated by humiliating verbal attacks about the victim’s sorrows or mistakes?
A. Physical abuse
B. Emotional abuse
C. Economic abuse
D. Intimidation
Emotional abuse
Rationale: Emotional abuse includes verbal humiliation, insults, or put-downs meant to control, manipulate, or belittle the victim.
Q: In the Power and Control Wheel, what form of violence involves looks, gestures, loud voice, or smashing things to make the woman afraid?
A. Isolation
B. Threats
C. Intimidation
D. Economic abuse
Intimidation
Rationale: Intimidation includes non-verbal behaviors used to instill fear in the victim, such as aggressive gestures or destruction of property.
Q: A woman is frequently slapped, thrown in the air, and has her head banged on the wall. What form of domestic violence does this represent?
A. Using male privilege
B. Intimidation
C. Threats
D. Physical abuse
Physical abuse
Rationale: Physical abuse involves the use of physical force that causes harm or injury to the victim.
Q: A woman is humiliated by her husband in front of their children. What phase in the cycle of violence is this?
A. Tension Building
B. Pursuit Phase
C. Stand-over Phase
D. Violent Outburst
Stand-over Phase
Rationale: The stand-over phase is marked by emotional abuse and control, where tension escalates before the actual violence.
Q: A husband apologizes, brings gifts, and begs for forgiveness after an episode of violence. What phase in the cycle of violence is this?
A. Build-up Phase
B. Honeymoon Phase
C. Actual Violence
D. Stand-over Phase
Honeymoon Phase
Rationale: The honeymoon phase follows abuse and is characterized by remorse, affection, and gifts, reinforcing the cycle.
Q: A woman is physically attacked—pushed, hair pulled, and thrown to the ground. What phase in the cycle of violence does this describe?
A. Tension Building
B. Calm Stage
C. Remorse Phase
D. Violent Outburst
Violent Outburst
Rationale: The violent outburst phase is where physical violence occurs, releasing the tension built up in earlier phases.
Q: What part of the Wheel of Equality involves mutually agreeing on work and family decisions?
A. Mutual respect
B. Shared responsibility
C. Economic partnership
D. Negotiation and fairness
Shared responsibility
Rationale: Shared responsibility emphasizes fairness in duties and decisions, promoting equality in the relationship.
Q: Supporting her goals in life and acknowledging her feelings falls under what part of the Wheel of Equality?
A. Shared responsibility
B. Respect
C. Trust and support
D. Non-violence
Trust and support
Rationale: Trust and support includes helping each partner achieve their goals and honoring their emotions and autonomy.
Q: Making financial decisions together and ensuring both benefit from arrangements describes what concept?
A. Economic abuse
B. Trust and support
C. Shared responsibility
D. Economic partnership
Economic partnership
Rationale: Economic partnership means both parties share control over finances, promoting transparency and balance.
Q: Listening without judgment and valuing her opinion falls under which concept in the Wheel of Equality?
A. Respect
B. Trust and support
C. Non-violence
D. Negotiation and fairness
Respect
Rationale: Respect means acknowledging the other’s voice, feelings, and individuality in a non-judgmental and affirming way.
Q: Victims of domestic violence often show multiple somatic symptoms.
A. True
B. False
True
Rationale: Victims often report chronic physical complaints like headaches, fatigue, and pelvic pain, linked to emotional trauma.
Q: Batterers can also be violent toward people outside their family.
A. True
B. False
True
Rationale: Abusers may demonstrate aggression toward others, though intimate partners often bear the brunt due to proximity and control dynamics.
Q: Victims of domestic violence demonstrate multiple somatic complaints.
A. True
B. False
True
Rationale: Abuse is often associated with physical manifestations of stress, including headaches, GI disturbances, and fatigue.
Q: Family preservation at all costs is a misconception about why women stay in violent relationships.
A. True
B. False
True
Rationale: Many women stay due to misplaced hope or belief that staying helps preserve the family, often due to cultural or societal pressure.
Q: Domestic abuse is punishable by law.
A. True
B. False
True
Rationale: Domestic violence is a crime with legal consequences under national and international laws protecting victims.
