A married 52 year old woman who has a family history of breast cancer has been experiencing mild discomfort for a few hours following intercourse for the last month. She is worried about using hormones. The most helpful treatment would be
a) Clonidine J Vaginal lubricant
b) Combined Oestrogen and progestogen replacement therapy
c) vaginal estrogens
d) vaginal lubricant
e) Mineral supplements |
Answer
Amenorrhea in a 28 year-old with a high LH and high LH/FSH ratio is a most recognised feature of:
 a) ovarian failure
b) hyperprolactinemia
c) Sheehans syndrome
d) Hypothyroidism
e) Asherman's syndrome |
Answer
Genital warts:
A. are due to herpes virus infection
B. may be treated with Diflucan
C. are grounds for Caesarean section to prevent neonatal infection
D. podophyllin therapy should be avoided in pregnancy
E. are grounds for more frequent than normal cervical smears
Answer
You diagnose Trichomonas vaginitis in a 25-year-old white female, and treat her and her partner with metronidazole (Flagyl), 2 g in a single dose. She returns 1 week later and is still symptomatic, and a saline wet prep again shows Trichomonas.
Which one of the following is the most appropriate treatment at this time?
A) Metronidazole gel 0.75% (Metro Gel) intravaginally for 5 days
B) Metronidazole, 2 g orally, plus metronidazole gel 0.75 % intravaginally for 5 days
C) Metronidazole, 500 mg orally twice a day for 7 days
D) Clindamycin cream (Cleocin) 2 % intra vaginally for 7 days
E) Sulfadiazine (Microsulfon), 4 g orally in a single dose, plus pyrimethamine (Daraprim), 200 mg orally in a single dose
Answer
A 19-year-old married white female complains of vaginal discharge, odor, and itching. Speculum examination reveals a homogeneous yellow discharge, vulvar and vaginal erythema, and a "strawberry" cervix.
The most likely diagnosis is:
A) candidal vaginitis.
B) bacterial vaginosis.
C) trichomonal vaginitis.
D) chlamydial infection.
E) herpes simplex type 2.
Answer
A 16-year-old sexually active nulliparous white female complains of pelvic pain and vaginal discharge. On examination she is found to have a temperature of 39.8° C (102.0° F), pain with movement of the cervix, and tenderness and a mass in the right adnexa.
According to CDC guidelines, which one of the following treatments would be appropriate?
A) Outpatient treatment with penicillin G procaine (Wycillin) intramuscularly; probenecid (Benemid) orally; plus doxycycline (Vibramycin) orally for 14 days and reexamination in 3 days
B) Outpatient treatment with ceftriaxone (Rocephin) intramuscularly; probenecid orally; plus doxycycline twice a day for 14 days and reexamination in 1 week
C) Outpatient treatment with cefoxitin (Mefoxin) intramuscularly; plus doxycycline twice a day for 14 days and reexamination in 10 days
D) Hospitalization for treatment with cefoxitin intravenously and doxycycline orally or intravenously, then doxycycline orally twice a day to complete 14 days of treatment
E) Metronidazole (Flagyl) 2 grams orally as a single dose and Pap smear
Answer
THE FOLLOWING ARE TRUE OF PRE MENSTRUAL SYNDROME
A. caffeine restriction has been shown to decrease symptoms.
B. fertility is decreased in those who suffer from severe symptoms.
C. the majority of women seek help from their doctor with symptoms related to the condition.
D. suppression of ovulation typically relieves symptoms.
E. None Of The Above
Cells from the endometrial lining of the uterus are detected in a Pap smear. This finding is abnormal in
a. a 70 year old woman
b. a 26 year old woman who is menstruating
c. a 34 year old woman on Day 9 of her menstrual cycle
d. a 47 year old woman on Day 18 of her menstrual cycle
e. a and d
Answer
A 31-year-old woman comes to the physician for follow-up after an abnormal Pap test and cervical biopsy. The patient's Pap test showed a high-grade squamous intraepithelial lesion (HGSIL). This was followed by colposcopy and biopsy of the cervix. The biopsy specimen also demonstrated HGSIL. The patient was counseled to undergo a loop electrosurgical excision procedure (LEEP). Which of the following represents the potential long-term complications from this procedure?
A. Abscess and chronic pelvic inflammatory disease
B. Cervical incompetence and cervical stenosis
C. Constipation and fecal incontinence
D. Hernia and intraperitoneal adhesions
E. Urinary incontinence and urinary retention
Answer
A 16-year-old female comes to the physician because of an increased vaginal discharge. She developed this symptom 2 days ago. She also complains of dysuria. She is sexually active with one partner and uses condoms intermittently. Examination reveals some erythema of the cervix but is otherwise unremarkable. A urine culture is sent which comes back negative. Sexually transmitted disease testing is performed and the patient is found to have gonorrhea. While treating this patient's gonorrhea infection, treatment must also be given for which of the following?
A. Bacterial vaginosis
B. Chlamydia
C. Herpes
D. Syphilis
E. Trichomoniasis
Answer
A 16-year-old nulligravid woman comes to the emergency department because of heavy vaginal bleeding. She states that she normally has heavy periods every month but missed a period last month and this period has been unusually heavy with the passage of large clots. She has no medical problems, has no history of bleeding difficulties, and takes no medications. Her temperature is 37 C (98.6 F), blood pressure is 110/70 mm Hg, pulse is 96/minute and respiration are 12/minute. Pelvic examination shows a moderate amount of blood in the vagina, a closed cervix, and a normal uterus and adnexae. Hematocrit is 30%. Urine hCG is negative. Which of the following is the most appropriate management?
A. Expectant management
B. Hysteroscopy
C. Oral contraceptive pills
D. Laparoscopy
E. Laparotomy
Answer
A 12-year-old female comes to the physician because of a vaginal discharge. The discharge started about 2 months ago and is whitish in color. There is no odor. The patient has no complaints of itching, burning, or pain. The patient started breast development at 9 years of age and her pubertal development has proceeded normally to this point. She has not had her first menses and she is not sexually active. She has no medical problems. Examination is normal for a 12-year-old female. Microscopic examination of the discharge shows
no evidence of pseudohyphae, clue cells, or trichomonads. Which of the following is the most likely diagnosis?
A. Bacterial vaginosis
B. Candida vulvovaginitis
C. Physiologic leukorrhea
D. Syphilis
E. Trichomoniasis
Answer
A 38-year-old woman, gravida 4, para 4, comes to the physician 8 days after a cesarean delivery complaining of redness and pain at the leftmost aspect of her incision. Her cesarean delivery was performed secondary to a non-reassuring fetal heart rate tracing. She was feeling well after the operation until 4 days ago, when she developed pain and redness around her incision. Her temperature is 37 C (98.6 F), blood pressure is 118/78 mm Hg, pulse is 88/min, and respirations are 12/min. There is marked ery
thema and induration around the incision. At the left margin of the incision there is a fluctuant mass. Which of the following is most appropriate next step in management?
A. Expectant management
B. Oral antibiotics only
C. IV antibiotics only
D. Incision and drainage
E. Laparotomy
Answer
Tags:
MCQ, Gynecology, Wound abcess
A 67-year-old woman comes to the physician because of pain with urination and frequent urination. She has
hypertension for which she takes a beta-blocker, but no other medical problems. She states that she is not sexually active. She does not smoke and drinks cranberry juice daily. Examination shows mild suprapubic tenderness and genital atrophy but is otherwise unremarkable. Urinalysis shows 50 to 100 leukocytes/high powered field (hpf) and 5 to 10 erythrocytes/hpf. Which of the following is the most likely cause of the infection?
A. Cardiac disease
B. Cranberry juice ingestion
C. Hypoestrogenism
D. Nephrolithiasis
E. Sexual intercourse
Answer
Tags:
MCQ, Gynecology, Sexually Transmitted disease, UTI
A 40-year-old woman comes to the physician for an annual examination. She has no complaints. She has menses every 28-30 days that last for 3 days. She has no intermenstrual bleeding. She has asthma, for which she uses an occasional inhaler. She had a tubal ligation 10 years ago. She has no known drug allergies. Examination is unremarkable, including a normal pelvic examination. One of her friends was recently diagnosed with endometrial cancer, and the patient wants to know when and if she needs to be screened for this. Which of the following is the most appropriate response?
A. Screening for endometrial cancer is not cost effective or warranted
B. Screening is with endometrial biopsy and starts at age 40
C. Screening is with endometrial biopsy and starts at age 50
D. Screening is with ultrasound and starts at age 40
E. Screening is with ultrasound and starts at age 50
Answer
Tags:
MCQ, Gynecology, Endometrial Cancer
A 20 year old female who recently delivered had a dilatation and curettage performed for retained placental fragments. Three days after the procedure she developed lower abdominal tenderness, pain on wiggling the cervix, and spiking fever. The causative agent least likely to be the cause of these signs and symptoms is:
a. group B streptococcus
b. E. coli
c. bacteroides
d. Neisseria gonorrhea
e. Clostridium
Answer
Tags:
MCQ, gynecology, Dilatation and curettage
More than 90% of women with this lesion are smokers
A. Fat necrosis
B. Periductal mastitis
C. Acute mastitis
D. Mammary duct ectasia
Answer
Tags:
MCQ, Gynecology, Smoking
An 18 year old woman develops a vaginal mass that on biopsy shows invasive glandular structures composed of cells with abundant clear cytoplasm and small round nuclei. which of the following clinical features would most likely be present?
a) Coexistent squamous cell Ca of the cervix
b) exposure to DES in utero
c) gonorrhea infection
d) herpes virus infection
e) HPV infection
Answer
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