Y3 Finals Flashcards
During examination, a 63 year old G10P10 was instructed to bear down, and the cervix protruded out of the vaginal introitus. What is the MOST likely diagnosis?
a. Cervical prolapse
b. Enterocole
c. Uterine prolapse
d. Urethrocoele
The correct answer is: Uterine prolapse
On rectovaginal examination of an infertile woman with dysmenorrhea revealed presence of nodulations in the posterior cul de sac. What is the MOST likely diagnosis?
a. Endometriosis
b. Myoma uteri
c. Pelvic tuberculosis
d. Pelvic inflammatory disease
The correct answer is: Endometriosis
of the following enhances patient satisfaction and safety and decrease the likelihood of medical liability litigation?
a. Honesty
b. Compassion
c. Effective communication skill
d. Responsiveness
The correct answer is: Effective communication skill
In what part of the clinical history should congenital malformations be recorded?
a. Past medical history
b. Obstetrical history
c. Personal social history
d. Family history
The correct answer is: Family history
What is the position of the uterus if the uterus is tipped forward toward the symphysis pubis and the fundus points anteriorly as well?
a. Anteverted anteflexed
b. Anteverted retroflexed
c. Retroverted anteflexed
d. Retroverted retroflexed
The correct answer is: Anteverted anteflexed
What principle is demonstrated if a healthcare worker refrains from discussing about a patient’s condition with a colleague in a public place?
a. Confidentiality
b. Integrity
c. Ethical practice
d. Altruism
The correct answer is: Confidentiality
What maneuver will help in the accurate evaluation of a woman with a mass in the introitus?
a. Valsalva in standing position
b. Kegels
c. Deep inspiration
d. Vaginal vacuum technique
The correct answer is: Valsalva in standing position
20 year old nulligravid consulted because of difficulty with sexual activity. Examination of the genitalia is shown. What is the hymenal anomaly?
a. Septate
b. Incomplete perforate
c. Microperforate
d. Cribriform
REFERENCE: Comprehensive Gynecology 8 Edition, Chapter 11, page 212
RATIONALE: Several variations of partial hymenal perforation exist: microperforate, cribriform and septate hymen, and incomplete perforate hymen. Women with partial hymenal perforation commonly present with difficulty inserting a tampon or difficulty with sexual activity.
The correct answer is: Septate
In which of the following types of uterus is a longitudinal vaginal septum NOT associated with?
a. Septate
b. Bicornuate
c. Didelphys
d. Unicornuate
The correct answer is: Unicornuate
Examination of the newborn’s perineum is shown. What is the MOST likely diagnosis
a. Clitoromegaly with labial fusion
b. Clitoromegaly
c. Ambiguous genitalia
d. Labial fusion
The correct answer is: Clitoromegaly with labial fusion
An infertile patient presented her hysterosalpingogram result showing 2 endometrial cavities. What is the BEST diagnostic modality that should be requested to confirm the type of uterine anomaly?
a. 2D ultrasound
b. 3D ultrasound
c. CT scan
d. MRI
REFERENCE: Comprehensive Gynecology 8 Edition, Chapter 11, page 216
RATIONALE: MRI is the gold standard for the diagnosis of uterine abnormalities.
The correct answer is: MRI
What is the NEXT step in the systematic examination of the newborn’s perineum after the clitoris?
a. Hymen
b. Vaginal introitus
c. Labia
d. Urethral opening
REFERENCE: Comprehensive Gynecology 8 Edition, Chapter 11, page 207
RATIONALE: The physician should systematically observe the newborn’s perineum, beginning with the mons pubis. The clitoris should be examined for any obvious enlargement, the opening of the urethra should be identified, and the labia should be gently separated to see if the introitus can be visualized. If it is possible to separate the labia, the hymen might be observed. Generally the hymen is perforate, revealing the entrance to the vagina. At times the labia are joined by filmy adhesions, which usually separate during childhood but can be treated with the application of estrogen cream when medically indicated. Posteriorly the labia fuse in the midline at the posterior fourchette of the perineum. Posterior to the perineal body the rectum can be visualized, and it should be tested to be sure that it is perforate.
The correct answer is: Urethral opening
Which of the following anomalies is caused by lateral fusion defect?,
a. Septate uterus
b. Cervical agenesis
c. Vaginal agenesis
d. Imperforate hymen
REFERENCE: Comprehensive Gynecology 8 Edition, Chapter 11, page 213
RATIONALE: Lateral fusion defects are the most common category of Müllerian defects and originate from failure of migration of one or both ducts, midline fusion of the ducts, or absorption of the midline septum between the ducts. A range of anomalies can occur, including symmetric or asymmetric and non-obstructed or obstructed Müllerian structures.
The correct answer is: Septate uterus
Speculum examination of a 22 year old nulligravid undergoing her first Pap smear is shown below. What is the MOST likely abnormality of the cervix?
a. Septate
b. Double
c. Fused
d. Hypoplastic
REFERENCE: Comprehensive Gynecology 8 Edition, Chapter 11, page 215
RATIONALE: Cervical duplication occurs when the Müllerian ducts have incomplete or no fusion; it can result in two separate and distinct cervices or two cervices that are fused at the midline. Additionally, a septate cervix can occur when the midline septum within the cervix does not resorb.
The correct answer is: Double
What is a group of mild to moderate symptoms, physical and behavioral, that occur in the second half of the menstrual cycle and that may interfere with work and personal relationships?
a. PMDD
b. PMS
c. Bipolar disorder
d. Depression
The correct answer is: PMS
