pediatric/adolescent gyno

Question 1

What is the effect that counts for the differentiation of the gonads?
A) testosterone
B) estrogen
C) sex chromosome
D) hypophyseal hormones

Answer 1

C) sex chromosome

Question 2

In case of primary amenorrhea the first step after general gynecological examination should be:
A) clomiphene test
B) genetical screening
C) estrogen-progesterone test
D) gonadotropin stimulation test

Answer 2

C) estrogen-progesterone test

Question 3

Which of the followings is not progesterone effect?
A) endometrial proliferation
B) increase of basal body temperature
C) development of breast acinars
D) endometrial secretion

Answer 3

A) endometrial proliferation

Question 4

In adolescents, secondary amenorrhea is defined as missing the menstrual period for at least:
A) 2 months
B) 4 months
C) 6 months
D) 12 months

Answer 4

C) 6 months

Question 5

The estimated amount of an average menstruation is about:
A) 10-15 ml
B) 25-50 ml
C) 75-100 ml
D) 100-120 ml

Answer 5

B) 25-50 ml

Question 6

The origin of lutein cells:
A) theca externa
B) theca interna
C) granulosa cells
D) corona radiata

Answer 6

C) granulosa cells

Question 7

The most frequent malignant tumor in adolescents is:
A) cervical cancer
B) clear cell adenocarcinoma of the vagina
C) ovarian cancer
D) rhabdomyosarcoma

Answer 7

C) ovarian cancer

Question 8

A 17-year-old girl underwent transabdominal ultrasound scan due to the reason of cystopyelitis. A simple ovarian cyst measuring 4,5 x 3,5 cm was detected. The next step in the management should be:
A) start to use combined oral contraceptive pill
B) repeat the ultrasound scan after 1 month
C) ultrasound guided transvaginal/transabdominal punction
D) laparoscopy

Answer 8

B) repeat the ultrasound scan after 1 month

Question 9

Which of the following is not characteristic for Turner’s-syndrome?
A) pigmented nevus
B) hypoplastic fingernails and toenails
C) incidence is increasing in newborns with maternal age
D) high-arched roof of mouth

Answer 9

C) incidence is increasing in newborns with maternal age

Question 10

Which of the followings is not characteristic for polycystic ovarian syndrome?
A) increased GnRH pulsatoric frequency
B) increased LH/FSH ratio
C) increased estradiol/estron ratio
D) increased DHEAS level (dehydroepiandrosterone-suphate)

Answer 10

C) increased estradiol/estron ratio

Question 11

With a short history of existing acute abdominal complaints, a 16-year virgin girl was admitted. Based on the complaints and the physical examination, diagnostic laparoscopy was performed and the torsion of the right adnexa was detected with blue-colored ovaries. The best solution during surgery:
A) salpingo-oophorectomy
B) detorsion of the ovary and wait until normal color returns
C) converting to laparotomy, detorsion and resection of the ovary
D) converting to laparotomy, salpingo-oophorectomy

Answer 11

B) detorsion of the ovary and wait until normal color returns

Question 12

Which of the followings is frequently related to hematometra?
A) polycystic ovarian syndrome
B) hirsutism
C) endometriosis
D) adnexal torsion

Answer 12

C) endometriosis

Question 13

Which organs are formed from the Müllerian-tube?
1) the fallopian tubes
2) lower third of the vagina
3) uterus
4) ovaries

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 13

B) 1st and 3rd answers are correct

Question 14

Mild hirsutism is influenced favorably by combined oral contraceptives because:
1) LH-regulated androgen produce is decreased
2) SHBG level elevates
3) free testosterone level decreases
4) androgen produce of the suprarenal gland is decreased

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 14

E) all of the answers are correct

Question 15

Diagnostic criteria of bacterial vaginosis:
1) greyish-white adherent vaginal secretion
2) positive KOH-test (amin-test)
3) presence of „clue-cells”
4) vaginal pH is less than 4,5

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 15

A) 1st, 2nd and 3rd answers are correct

Question 16

Characteristics of Chlamydia trachomatis infection:
1) mucopurulent cervicitis
2) the infection is frequently asymptomatic
3) parallel treatment of the partner is necessary
4) risk of HIV infection is higher

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 16

E) all of the answers are correct

Question 17

Most common causes of cervicitis:
1) Neisseria gonorrhoeae
2) Trichomonas vaginalis
3) Chlamydia trachomatis
4) Candida albicans

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 17

B) 1st and 3rd answers are correct

Question 18

Applicable medications to treat uncomplicated Chlamydia trachomatis infection:
1) doxycycline
2) erythromycin
3) azithromycin
4) clindamycin

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 18

E) all of the answers are correct

Question 19

In case of juvenile vaginal bleeding we should consider the following conditions:
1) foreign body in the vagina
2) botryoid sarcoma
3) isosexual pubertal praecox
4) endometrial cancer

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 19

A) 1st, 2nd and 3rd answers are correct

Question 20

Malignant ovarian tumors originated from germ cells include:
1) dysgerminoma
2) choriocarcinoma
3) endodermal sinus tumor
4) granulosa-cell tumor

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

Answer 20

A) 1st, 2nd and 3rd answers are correct

Question 21

The cytology smear below is characteristic for which phase?
A) early follicular phase
B) late follicular phase
C) early luteal phase
D) late luteal phase

OBG - 1.28 - Mainly surface cells are visible; number of cells from the intermedier layer is small.
OBG - 1.29 - Some of the cells of the intermediate layer are located in smaller groups, the edges of the cells curl, the number of cells of the superficial layer decreases.
OBG - 1.30 - Mainly isolated cells of the intermediate layer are seen, with less superficial and parabasal cells.
OBG - 1.31 - Pronounced group formation in the intermediate layer, the number of cells in the superficial layer is low.

Answer 21

28- B
29- C
30- A
31- D

Question 22

Pair intrauterine drug exposure with possible side effects:
A) adenocarcinoma of the vagina
B) disorder in the development of the bones
C) aplasia cutis
D) masculinization of the female fetus
E) deafness

OBG - 1.32 - Progesterone
OBG - 1.33 - Diethylstilbestrol
OBG - 1.34 - Tetracycline
OBG - 1.35 - Streptomycin
OBG - 1.36 - Methimazole

Answer 22

32- D
33- A
34- B
35- E
36- C

Question 23

The following statements are characteristic of which stage of sexual maturation?
A) pubarche
B) thelarche
C) menarche

OBG - 1.37 - It occurs for a low amount of oestrogen.
OBG - 1.38 - In Hungary it occurs at 12,4 years of age.
OBG - 1.39 - It is present also in testicular feminization.
OBG - 1.40 - It is the puberty of the suprarenal gland.
OBG - 1.41 - Usually this is the first somatic change during puberty.

Answer 23

37- B
38- C
39- B
40- A
41- B

Question 24

Match the statements with the clinical scenario:
A) female pseudo hermaphroditism
B) male pseudo hermaphroditism
C) testicular feminization
D) ovotesticular intersexuality

OBG - 1.42 - At birth, the genital gender is not clear based on the examination of the external genitalia.
OBG - 1.43 - It is typically the result of endogenous or exogenous hormonal effects during pregnancy.
OBG - 1.44 - It is the rarest intersexual disorder.
OBG - 1.45 - It is the consequence of insufficient testicular secretion or target organ reaction.
OBG - 1.46 - This includes the adrenogenital syndrome.
OBG - 1.47 - It is characterized by regular internal female genitalia

Answer 24

42- C
43- A
44- D
45- B
46- A
47- A

Question 25

Pair homologous male and female organs.
A) gubernaculum testis
B) prostate
C) scrotum
D) vas deferens
E) penis

OBG - 1.49 - major labia
OBG - 1.50 - round ligament
OBG - 1.51 - Gärtner-duct
OBG - 1.52 - clitoris

Answer 25

49- C
50 - A
51- D
52- E

Question 26

Hypothyroidism may cause premature sexual maturation because increased TSH production can coexist with increased GnRH production.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 26

A) both the statement and the explanation are true and a causal relationship exists between them;

Question 27

At birth, the proliferation of estrogen-target organs of female newborns is observed, because the fetal ovary has a temporarily expressed endocrine activity.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 27

C) the statement is true, but the explanation is false;

Question 28

In testicular feminization breasts are well developed because peripheral estrogen transformation is enhanced.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 28

C) the statement is true, but the explanation is false;

Question 29

The small body-stature characteristic of Turner-syndrome is apparent even in early childhood because no regular ovarian tissue can be detected.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 29

D) the statement is false, but the explanation itself is true

Question 30

Pregnancy may also conceive in real pubertal praecox because the full functional maturation of the hypothalamus-pituitary-ovarian axis occurs.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 30

A) both the statement and the explanation are true and a causal relationship exists between them;

Question 31

In children, a 3.5 MHz abdominal transducer can easily detect ovaries because the typical location of the ovaries is the area between the bifurcation of the iliac artery and the fallopian tubes.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 31

B) both the statement and the explanation are true but there is no causal relationship between them;

Question 32

In case of recurrent vaginal bleeding in childhood vaginoscopy should always be performed because the cause of bleeding is most often cervical cancer.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 32

C) the statement is true, but the explanation is false;

Question 33

In nulliparous teenagers we usually do not recommend the use of an intrauterine device because the risk of uterine perforation is higher due to the smaller size of the uterus.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

Answer 33

C) the statement is true, but the explanation is false;