Pediatric Gynecology

Question 1

What is the most common position during examining a child?

Answer 1

frog leg postion

Question 2

What is the position in examining an anxious child?

Answer 2

Modified frog-leg position

Question 3

What is the vaginal pH in new born vagina?

Answer 3

pH is acidic

prepubertal is slightly alkaline to neutral

Question 4

What is the shape of the hymen of prepubertal patient?

Answer 4

crescent-shape, annular

Question 5

What is the most common gynecologic problem in the prepubertal female

Answer 5

vulvovaginitis

Question 6

What is the pathognomonic finding of labial adhesion?

Answer 6

midline vertical line

Tx: topical estrogen cream

Question 7

What is the cause of urethral prolapse in pre menarcheal stage

Answer 7

lack of estrogen

Question 8

What is the most common sign of urethral prolapse?

Answer 8

prepubertal bleeding

Question 9

[Diagnose]

thinning of the vulvar epithelium, loss of rete ridges

hourglass or figure-8 formation in genital and perianal area

Answer 9

Lichen sclerosus

Tx: Sitz baths, clobetasol

Genital area is whitened, lichenified with hypopigmented parchment-like apperance

Question 10

What are the signs of possible sexual abuse?

Answer 10

1. Presence of posterior fourchette laceration

2. Transection from 3 to 9 o’clock position

Question 11

In patients with suspected sexual abuse, examination should immediately done if the incident occured _____

Answer 11

<72 hours

Question 12

What is the suggested emergency contraception dose

Answer 12

Give 2 doses 12 hours apart

1. EE 100mg + levonorgestrel 0.50 mg
2. Levonorgestrel 1.5mg one dose only OR levonorgestrel 0.75mg for 2 doses

Question 13

What is the most common ovarian tumor?

Answer 13

functional cyst

Question 14

What is the most common benign tumor?

Answer 14

Germ cell tumor (benign ovarian teratoma)

Question 15

What is the most common malignant germ cell tumor?

Answer 15

1. Dysgerminoma
2. Endodermal sinus tumor
3. Immature teratoma

Question 16

[Hyperadnrogenism]

What are the hormones produced by the ovaries

Answer 16

1. DHEA
2. Testosterone
3. Estrogen

Question 17

_____ ng/mL of androgen is associated with hirsutism

Answer 17

<1.5

2ng/mL or more is associated with virilization

Question 18

Elevated maternal serum AFP is associated with _____

Answer 18

1. Pre-eclampsia
2. Omphalocele
3. Maternal hepatoma or teratoma

Question 19

What is the most common cause of fetal tachycardia?

Answer 19

chorioamnionitis

Question 20

What is the most accurate test to diagnose cushing syndrome?

Answer 20

Late Night Salivary Cortisol

Question 21

What are the components of Rotterdam Crtiteria

Answer 21

1. Menstrual irregularity
2. Hyperandrogenism
3. PCO on UTZ

Question 22

What are the implicated causes of PCOS

Answer 22

1. Increased androgen secretion
2. Increased LH secretion
3. Insulin resistance
4. Decrease SHBG

Question 23

What is the androgen receptor blocker (DOC) for PCOS?

Answer 23

Spironolactone

Question 24

PCOS in UTZ is diagnosed as ____

Answer 24

12 or more follicles measuring 2 to 9 mm

Question 25

[Pharma for PCOS]

Treatment if the chief complaint of the patient is infertility

Answer 25

1. Letrozole

2. Clomiphene

Question 26

[Pharma for PCOS]

Treatment if the chief complaint of the patient is skin manifestation

Answer 26

1. OCP + antiandrogen

2. GnRH agonist

Question 27

[Pharma for PCOS]

Treatment if the chief complaint of the patient is abnormal bleeding

Answer 27

1. Cyclic progestogen

2. OCP

Question 28

[Pharma for PCOS]

Treatment if the chief complaint of the patient is metabolic or weight gain

Answer 28

1. Diet/Lifestyle management

2. Metformin