Gynecology Flashcards
Genital tubercle forms ……
Genital folds form…..
Labia majora is formed from ….
Clitoris
Labia minora
Labia swelling
Function of doderlein bacilli
Forms lactic acid which maintains Ph of the vagina
Shortest and narrowest part of fallopian tube
Normal position of the uterus
Interstitial part
Anteverted and anteflexed
Uterus measures …….
Surface epithelium of endometrium consists of …..
9 x 6.5 x 3.5 cm
Single layer of ciliated columnar epithelium
No……layer in the endometrium of uterus
Shape of cervix in
Nulliparous
Multiparous
Submucosal
Nulliparous: circular
Multiparous : transverse
Cervical: corpus ratio in
Prepubescent
Puberty
Pregnancy
2:1
1:2
1:3 or 1:4
Length and inner diameter of fallopian tube
Fallopian tube is lined by …..
Length :10cm
Inner diameter: 8cm
Ciliated columnar
Lining of female urethra
Best predictor of ovulation
Transitional epithelium except urethral meatus
Preovulatory rise LH
Inhibin is secreted by …….of ovary
When is the ovulatory period ?
Granulosa cells
14 days before next menstruation
LH stimulates…..&……
Vagina lacks ……
Follicle rupture
Ovulation
Mucus secreting glands
Ph of vagina at
1. Newborn:
2. Children
3. At puberty
4. Reproductive life
5. Menopause
- 5.7
- 6-8
- 4
- 4.5
- > 7
Vaginal smear that is estrogen dependent (5)
Clean, discrete , superficial
Cornified, polygonal
Squamous epithelial cell.
Vaginal smear that is progesterone dominated
Dirty,predominance of intermediate cell.
Navicular cells
Vaginal smear that is postmenopausal
Parabasal and basal cells due to lack of any hormonal activity
Vaginal smears in different age group
1. Neonate
2. Infant, post partum , late menopausal
3. Menopausal
4. Pregnancy
- Mainly transitional epithelium and intermediate cells
- Mainly parabasal cells
- Intermediate cells
- Navicular cells, intermediate cells
Urease positive organism without cell wall
Ureaplasma urealyticum
Chanchroid presents as : (2)
DOC
Genital ulcer
Inguinal adenitis
Doc: ceftriaxone/ azithromycin
Clinical presentation of LGV (3)
- Esthiomene
Chronic ulcerated state of vulva & clitoris - Genital elephantiasis
- Groove sign- when femoral and inguinal LN are involved.
DOC for LGV
Most common site for genital TB
Doxycycline
Fallopian tube
Mc accepted etiological theory of endometriosis
Sampsons theory of retrograde menstruation
Associated feature of endometriosis
Rx for endometriosis (3)
Chocolate cysts
Rx:
1. Progesterone
2. Danazol
3. GNRH analogues
Surgical procedures for endometriosis (3)
Ovarian cystectomy/oophorectomy/ wedge resection
Ideal contraception for newly married couple
Ideal contraception for couple staying away and meeting occasionally
OCP
Barrier method
OCP protects against : (4)
- Ovarian ca
- Uterine ca
- RA
- Endometriosis
Criteria for sterilization (3)
- Age of female >22 yrs
- Age of male <60 yrs
- Couple should have atleast 2 kids
Mc site of laparoscopic sterilization
Portion ligated in female sterilization, known as ……
Isthmus
Isthmo-ampullary portion
KA : Pomeroy’s method
Cystocele is …..
Complications
Prolapse of upper 2/3 of anterior vaginal wall
Decubitus ulcer- due to venous congestion
Management of prolapse in woman <40 yrs with complete family (2)
Fothergill’s repair
Manchester operation
Management of prolapse in young Nulliparous women (2)
Sling operation
Perineal exercises
Management of prolapse in 2nd trimester
Management in 1st trimester
Spontaneous resolution
Pessary
Amount of blood lost in menstruation
Mc pathological cause of secondary amenorhoea
50-80ml
Endometrial TB
DUB is associated with ….
Commonly endometrium in DUB is …..
Metropathia hemorrhagica
Hyperplastic- due to irregular shedding
Irregular ripening
Hormonal status of DUB
Increased estrogen
Decreased progesterone
Mullerian agenesis lacks ……structures (4)
Uterus
Cervix
Fallopian tube
Vagina (upper)
Mc site of cervical cancer
LN affected in cervical cancer (3)
Time taken for conversion of CIN to invasive Ca
Ectocervix
Obturator
External iliac
Internal iliac
10years
Predisposing factors of cervical Ca (3)
HPV
HIV
HSV
100% cute rates are seen in which type of cervical ca
Mc cause of death in cervical ca is …
CIS
Renal failure
Stage 2 cervical ca is ….
Management (3)
Disease extends beyond cervix but not to pelvic wall/ lower 1/3 vagina
1. Extended hysterectomy
2. Chemotherapy
3. Intracavitary brachytherapy
Stage 3 cervical cancer is ….
Management (2)
Disease extends to pelvic wall/ lower 1/3 vagina / causes hydronephrosis
Radiotherapy
Chemotherapy
Mc fibroid to undergo malignant change (2)
Intramural
Subserous
Mc fibroid to undergo calcaneous degeneration
Red degeneration of fibroid seen in…..
Cause
Subserous
2nd half of pregnancy/ Puerperium
Due to thrombosis of large veins of the tumor
Infection has no role
Fibroids are associated with (4)
- Follicular ovarian cysts
- Endometriosis
- Endometrial hyperplasia
- Endometrial cancer
Mc type of fibroid
Mc type of degeneration
Intramural/ interstitial
Hyaline- starts from center
Most fibroid start as ….
Endometrial cancer -mc type
Interstitial fibroid
Adenocarcinoma-upto 80%
Mc malignant type of endometrial cancer
Predisposing factors of endometrial cancer (5)
Clear cell cancer
- Family history
- Obesity
- DM
- Tamoxifen therapy
- PCOD
Adjuvant radiotherapy given in cases of ….(3)
- Deep myometrial involvement
- Ca in situ
- Lymph node involvement
Mc cause of endometrial cancer
Rx of atypical endometrial hyperplasia
Unopposed estrogen
Hysterectomy
Panhysterectomy in elderly
Define meig’s syndrome (3)
Ascites
Right sided hydrothorax
Benign tumour of ovary-fibroma
Malignant ovarian tumour is included in ….
Pseudo meig’s syndrome
Masculinising ovarian tumor (3)
- Androblastoma
- Arrhenoblastoma
- Sertoli/Leydig cell tumor
Feminizing cell tumor (2)
Theca cell tumor
Granulosa cell tumor
Mc ovarian tumor in <20 years
Mc radiosensitive ovarian tumor .
Dysgerminoma
Dysgerminoma
- Rokitansky bodies are seen in ….
- Schiller Duval Bodies are seen in…
- Reinke’s crystal seen in ….
- Call exner bodies seen in ….
- Teratoma
- Endodermal sinus tumor
- Hilus cell tumor
- Granulosa cell tumor
Tumor markers
1. Placental ALP
2. LDH
3. Inhibin
4. CA 125
- Dysgerminoma
- Dysgerminoma
- Granulosa cell tumor
- Ovarian tumors
Clomiphene increases chances of pregnancy by ….
Risk of ectopic pregnancy with clomiphene is increased by ….
3 folds
6-10 folds
Clomiphene is used in treatment of …(2)
- PCOS
- Anovulatory infertility
Danazol MOA (2)
Gonadotropin inhibitor
Androgen agonist
Danazol used in management of …(4)
- Endometriosis
- Premenstrual syndrome
- DUB
- Precocious puberty
Define Gartners cyst
Cystic swelling at the junction of lower 1/3 and upper 2/3 vaginal wall
Define Bartholin cyst
Cystic swelling at junction of posterior 1/3 and anterior 2/3 of labia majoris
For Pap smear, sample is taken from ….
Mc pelvic Timor is …..
Mc site of endometriosis
Posterior part of vaginal wall
Fibroids
Ovary
Mc complaint/ complication after IUCD insertion
Most unfavourable position of fetus is …..
Bleeding
Mento-posterior
Mc cause of post menopausal bleeding in India (3)
- Hormonal therapy
- Ca endometrium
- Ca cervix
Mc type of endometrial cancer
OCP of choice in lactating females
Adenocarcinoma
Mini pill
Mucosal lining of vagina
Pearl index is used for calculating
Non-keratinized stratified squamous
Contraception failure
Total accidental pregnancies/ total months of exposure x 1200
Cannon ball shadow on CXR in case of choriocarcinoma is ……
Metastatic shadows
FIGO stage 2a of cervical carcinoma extends upto…..
Tumor marker for endodermal sinus tumour
Upper 2/3rd vagina
AFP
Investigation of choice for cervical neoplasm
Mc complication of abdominal hysterectomy
Biopsy
Ureteric injury
Chromosome compliment in patient with klinefilters syndrome
Mc symptom of endometriosis
47XXY
Dysmenorrhea
Best test for tubal patency
OCP are c/I in ……(3)
Laparoscopic chromo-tubation
- Suspected breast cancer
- Heart disease
- Thromboembolism
Rx of choice for bartholin’s abscess
Bartholin’s cystadenitis is caused by which bacteria
I&D
Gonococcus
Bonney’s test is done for …..
Retention of urine may be seen in which type of fibroid
Stress incontinence
Anterior type of cervical fibroid
Mc degenerative changes in uterine myxoma
Risk factor for choriocarcinoma
Hyaline degeneration
Full term pregnancy
Tumour marker of choriocarcinoma
Commonest presentation of choriocarcinoma
HCG
Bleeding per vaginum
Denominator of pearl index
According to 10 day rule, radiation of reproductive woman is given at what time of menstrual cycle ?
Total months of exposure
10 days after menstruation
Most sensitive USG marker for fetal growth
Lymphatic drainage of cornua of uterus (2)
Abdominal circumference
Paraaortic
Superficial inguinal
True about menopausal hormonal change
Cryptomenorrhoea occurs due to ….(2)
Increased GNRH, decreased estrogen
Imperforate hymen
Vaginal atresia
Mc complication of ovarian tumor is …
Mc complication of cryotherapy
Torsion
Watery discharge
Activity of corpus luteum is maintained by ….
Not used for ovulation induction
LH
Danazol
Ovarian tumor likely to involve opposite ovary by mets
Asymptomatic carriage of gonococcal infection in female is commonly seen in ….
Granulosa cell tumor
Endocervix
NOT associated with primary amenorrhoea
Masculinizing/ virilizing tumor of ovary
Best prognosis for reversibility is seen in …
PCOD
Arrhenoblastoma
Isthmo-isthmic type
A middle aged woman presents with increasing visual loss, breast enlargement and irregular menses. IOC is ….
Safest drug for TB in pregnancy is…..
Serum prolactin
INH/Rifampicin
Fetus in a diabetic mother are at risk of developing which cardiac lesion
Drugs used for ovulation induction (2)
ASD, VSD, COA
Clomiphene
Tamoxifen
Least observed laboratory findings in neonatal sepsis
Asymptomatic carriage of gonococcal infection in female is commonly seen in ….
Neutrophilia
Endocervix
Failure rate of pomeroy’s method
Copper eluted from CuT daily
0.4 %
50mg
Antispermal antibodies in cervical mucus can be checked by ….
Length of fallopian tube
Platelet count in pregnancy…..
Post coital test
10cm
Decreases
Which disease carries high chances of trans placental transfer in first trimester?
Best diagnosis of endometrial pathology by …..
Best screening tool for cervical carcinoma
Rubella
Biopsy
Pap smear
Testicular biopsy is best indicated in diagnostic workup of patient with ….
Mc malignant ovarian tumor
Azoospermia
Serous cystadeno carcinoma
Best time to do breast exam is …..
Cervix develops from …..
3 days after menstruation
Müllerian duct
Ferning of cervical mucus disasspears on which day
Spigelberg’s criteria is used for dx….
21st day
Ectopic pregnancy
Laparoscopy should not be done in …..
Mc histological type of cervical carcinoma
Acute infections
Squamous
Temperature used in cryosurgery
Gas used in cryosurgery (3)
-60 degree Celsius
CO2,N2O, Freon
Major disadvantage of depot progestin (2)
Irregular bleeding
Prolonged anovulation
Failure rate of depomedroxy progesterone acetate (DMPA)
Function of doderlein bacilli (2)
0.4/100 women year
- Converts glycogen (vaginal epi ) to lactic acid
- Maintaining acidity of normal vagina
MOA of OCP (3)
- Prevents ovulation
- Thickens cervical mucus
- Renders endometrium unfavourable for implantation
Important C/I to laparoscopy (3)
Acute pelvic
Abdominal infection
Peritonitis
Magnification of colposcope
Frozen pelvis is related to …..
10-20 times
PID
Which type of fibroma cannot be seen with laparoscopy?
Peg cells are present in …..
Sub mucosal
Fallopian tube
HAIR AN syndrome is related to which skin condition
Mc cause of menorrhagia in adolescents
Acanthosis nigricans
Coagulation disorders
Sentinel LN biopsy is used to map the LN status of ….(2)
Invaluable tool for dx of chronic pelvic pain
Breast, vulva
Laparoscopy
DUB is mc associated with ….
Which drug is used for rx of 21-OH deficient female fetus to prevent virilization?
Anovulation
Maternal dexamethasone
Mc cancer of pregnancy
Asherman‘s syndrome is secondary to which infection
Mc type of fibroid
Breast cancer
TB
Intramural
Old complete perineal tear is repaired at time …..
Amenorrhoea following hyperprolactinemia is caused by ….
3-6 months
Inhibition of GNRH pulse secretion
Another name for Manchester operation for uterine prolapse is ….
Fothergill
Simultaneous administration of estrogen and progesterone in hormone replacement therapy increases risk for ….Tumor
Lefort‘a operation is done for ….
Endometrial cancer
Old post menopausal woman with advanced prolapse
Tubal patency is done in which phase of menstrual cycle
Mc infection in long term IUCD is caused by ….
Preovulatory
Actinomycosis
Daily release of hormone from MIRENA
Mc benign epithelial tumor of pregnancy
20microgm
Serous cystadenoma
Meig’s syndrome is associated with which tumor?
Swiss cheese pattern is seen in which condition
Fibroma
Metropathica hemorrhagica
Condition where there is ingrowth of endometrium,both glandular and stromal component in myometrium
In PID due to N.gonorrhoea,type of tubal damage is due to ….
Adenomyosis
Endotubal
Mc mode of spread of genital TB
Which gland in female is homologous to prostate?
Hematogenous
Skene gland
Fourchette is formed by joining of …..
Incomplete uterine rupture is defined as ….
Labia minora
Disruption of scar with peritoneum intact
Reifenstein syndrome is …..
Partial androgen insensitivity to receptor mutation
FSH levels in hypergonadotropic hypergonadism is ….
Weekly dose of centchroman
> 40mIU/ml
60mg
Levonorgestrel in MIRENA will be liberated for how many years ?
Tubal cause of female infertility is how much %
7 years
26%
Mc type of ovarian tumors
Surgery to retain conception is done until what stage of carcinoma cervix
Epithelial tumors
1B
Vasomotor symptoms in post menopausal woman,DOC is ……
Causative organism in acute salpingitis
Conjugated estrogen
Neisseria gonorhoea
Initial starting dose of clomiphene citrate in case of infertility is ….
Volume of ovary after menopause
50mg/day
3cm square
What is visualized with green filter while performing colposcopy?
Feature of irregular ripening of endometrium?
Vascular pattern of cervix
Secretory changes amidst proliferative changes in endometrium
Best fertility results are seen in which type of uterine abnormality?
Upper limit of normal CA125
Arcuate uterus
35U/ml
At what level of testosterone, ovarian pathology should be searched?
surgical procedure for genuine stress incontinence is …..
> 10nmol/L
Retropubic urethropexy
What % of patients with simple endometrial hyperplasia without atypia progress to develop endometrial carcinoma?
Bicornuate uterus presents as ….
1%
Recurrent 2nd trimester abortion
Fibroid with maximum symptom
A girl with normal stature and minimal/absent pubertal development is having ……
Submucus
Kallaman’s syndrome
Ovary secretes which hormones (4)
Estrogen
Progesterone
Androgen
Testosterone
Size of Graafian follicles
Bicornuate uterus is due to ….
Epithelial lining of cervical canal
2mm
Incomplete fusion of mesonephric duct
High columnar
Rx for a case of virilizing adrenal hyperplasia
Gonadal sex of a fetus is determined by …..gene
Cortisone
SRY
Cranial end of wolfian duct forms….
Ovarian cause of hirsuitism
Mc form of vaginitis
Epiphoron
PCOD
Trichomonas
Type of abnormality in sexual development carrying best prognosis
HPV vaccine is ……&…..
Congenital adrenal hyperplasia
Bivalent and quadrivalent both
Mc cause of tubal block in India
Stress incontinence is a common symptom in ….
TB
Uterine prolapse
Surgery done for stress incontinence
In VVF surgery, bladder drainage should be done by ….
Kelly’s plication operation
10 days
Endometrial biopsy for infertility is taken on …..
Commonest cause of rectovaginal fistula
23rd and 26th day
Improper repair of perineal tear
Ovarian tumour limited to true pelvis with negative nodes or when there is histology confirmed seeeding of abdominal portioned surface is …
3A
Cystoglandular hyperplasia is associated with which tumour
Pain of ovarian carcinoma is referred to ….
Theca cell tumor
Medial side of thigh
Stage of ovarian carcinoma with B/L involvement with intact capsule and no ascites is …..
1B
Granulosa cell tumor is associated with which gynaecological malignancy
Ca endometrium
35 year old female came with postcoital bleeding. Next step is ….
Cervical smear fixation is done by which substance
Pap smear with clinical examination
Ethyl alcohol
Substance used for uterine artery embolization for fibroid uterus
Fundal myomas commonly present as ….
Polyvinyl alcohol
Menorrhagia
What is the name of combined anterior colporrhaphy colpoperineorrhaphy?
Ligament used for maintaining anteversion of uterus?
Ward-mayo procedure
Uterosacral ligament
40 year old woman presents with excessive menstrual bleeding. The first surgical rx will be ….
Risk of Asherman syndrome is highest in D&C done for …..
D&C
PPH
Decreased motility of fallopian tube is seen in which syndrome?
Condition where glistening spots are found on tubal mucosa ?
Kartegener syndrome
Parovarian cyst
Which gynaecological malignancy associated with HIV ?
Torsion of ovarian Timor occur due to …
Ca cervix
Trauma
Second stage ca endometrium is treated by ….
First line of drug for managing a patient with uterine bleeding with cyclical menorrhagia
Radiotherapy followed by surgery
Tranexaminic acid
Condition where there is pain before onset of menses, and is relieved after beginning of menses
Bleeding pattern in cystic glandular hyperplasia
Congestive dysmenorrhea
Amenorrhoea and bleeding
Sequence of events for termination of pregnancy by medical methods
Mifepristone >misoprostol-> bleeding>USG
Method of sterilisation least suited for recanalization
Manifestation of utero-vesical fistula
Marshall marshetti Krant surgery is done for ….
Bipolar cauterisation
Continuous incontinence
Stress incontinence
20 year female presents with primary amenorrhoea,absent breast,hypoplastic uterus. Most probable diagnosis is …
Not a predictor of ovulation.
Turner syndrome
Measuring serum progesterone on day 14th of cycle
Bleeding from umbilicus in an adult female during menstruation is suggestive of ….
Gonococcal infection spreads by ….
Vicarious menstruation
Involvement of adjacent structures/ ascending aorta
Corpus luteum of menstruation persists for how many days
Early diagnosis of missed intrauterine contraceptive device is by ….
8 days
X-ray pelvis
IUCD should not be inserted in …..
Centchroman is ……
Infections
Nonsteriodal contraceptive
Contraception today contains
9-nonooxynol
Most common condition associated with menorrhagia
DUB is seen in….
Fibroids
Metropathica hemorrhagica
Cystoglandular hyperplasia is seen in ….
Use of tranexaminic acid reduces blood loss by …..
Metropathica hemorrhagica
50%
Precocious puberty is seen in which tumour
Mucinous cystadenoma of ovary arises from ….
Granulosa cell tumour
Surface celomic epithelium
Mode of action of progestin only pills
Common site of extramammary breast tissue
Thickening of cervical mucus
Vulva
Fimbriectomy is also known as …..
In pelvic organ prolapse; sacrispinous ligament strengthening surgery is actually done to strengthen…..
Kroenert method of tubal sterilisation
Apical components of pelvic organs
Level of antimullerian hormone indicates low reserve
Dose of ulipristal acetate for using as an emergency contraceptive
<1mg/dl
30mg single dose
Submucosal fibroid Has less than 50% protrusion in the uterine cavity. As per FIGO classification, This is …..
Type 2
Carboprost used for second trimester abortion is an analogue of …..
Rx of early stage vulvar carcinoma
PGF2 alpha
Surgery
On HSG; beaded appearance of fallopian tubes with clubbed ends of fimbriae is a feature of ….
Most useful parameter in assessing adequacy of sperms for fertilisation ?
Genital TB
Speematocyte morphology
Histology of endometria lesions represents
Maximum risk of ureteric injury is seen in …..hysterectomy
High estrogen
Wertheim’s
Fixative used in Pap smear
Cytocele, enterocele, and urethral descent may be seen if there is injury to deep part of perineal body involving…..
95% ethyl alcohol
Pubococcygeous
Method of sterilisation which is least effective
Most common intrauterine infection
Spermicidal jelly acts through ….
Hysteroscopic tubal ligation
CMV
Disruption of cell membrane