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    40 views13 pages

    Final Jabir 2018

    Uploaded by

    Mohamed Al-zichrawy

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 13
    Jabir Ibn Hayyan Medical University Collage of Medicine 5" year Dept. of Gynecology &Obstetries Final Examination In gynaecology-1" ‘Trial Date: 3/6/2018 2017-2018 Timi hours 1. The following are the characteristic features of bacterial vaginosis: There is alteration in the normal vaginal flora with massive over growth of Lactobacillus. Aerobic bacilli Gardenella is present. oO E C. Itproduces a discharge of low pH<4.5. D, By naked eyes Clue cells can be demonstrated on a wet mount of vaginal smear. E. Itis common in pregnancy. 2. Bartholin abscess G) is infection of the greater vestibular gland after blockage of its duct most of cases are bilateral . most of cases are painless 1. gland excision is the rule for its treatment . usual presentation after age of 40 ‘cogen is seen in the lumina of endometrial glands : During the luteal phase During pregnaney only . During pre and post ovulatory . During proliferative phase only At the time of ovulation only : 4. Vaginal prolapse is‘caused by all of following exept: A Bladder extrophy B. Chronic bronchitis CG © excess of vitamin C D. ‘Menopause E, -Chronic Constipation 5. The following relate to menorrhagia: It is associated with iron deficiency anemia, |. D&C is the first-line diagnostic tool. ; C. Endometrial ablation is effective in the treatment of menorthagia secondary to adenomyosis. D. It is non-cyclical pattern of bleeding that is.characterized by heavy bleeds. E, Subserous myoma is common underlying cause, 6.Causes of abnormal uterine bleeding may include the following except: Iititable bowel syndrome. |. Adenomyos C. Hyperthyroidism, D.Hypothyroidism. E, Von Willebrand's disease. 7. Regarding dysfunctional uterine bleeding: A. Itis associated with chronic pelvic inflammatory disease, Has an easily identifiable cause. Tranexamic acid is an effective treatment. D.Gestrinone is drug of choice. E. Itis usually ovulatory at the extremes of reproductive age. . Prapesing factors for endometrial hyperplasia include the following except: Use of progesterone-only pill. B C.Obesity. D.Use of tamoxifen, E.Early menarche. 9. Which of the following is FALSE regarding adenomyosis Is associated with primary dysmenorrhea . B. Can be associated with uterine fibroid . C. Pelvic examination will réveal a regular, enlarged and tender uterus D. Diagnosis is usually by histopathology. E, Women with adenomyosis are usually multiparous. 10. Post-coital bleeding is LEAST likely to be caused by which of the following? A. Cervical polyps. B. Ectropion C. Cervical carcinoma. ) Nabothian cysts. E. Vaginal atrophy. (Questions 11,12 ,13)_ A 25 year old single lady presents complaining of hirsuitism, 11. Which of the following is NOT a known cause of hirsutism? A. Idiopathic. B. Polycystic ovary syndrome. C. Congenital adrenal hyperplasia. D. Cushing disease. PAdenomyosis. 12. Which of the following investigations will not help in her diagnosis? A. Testosterone levels. B.LH/FSH ratio. C. Pelvic ultrasound. indomettial biopsy. E. 17-hydroxy progesterone. 13. Ifshe had polycystic ovarian syndrome, Which of the following is NOT used in her management ? A, Diane. | B Danazol. | C. Combined oral contraceptives. D. Laser therapy. E. Waxing and plugging 14, Regarding polycystic ovary syndrome all true except : A. Is exactly the same condition as Stein-Leventhal syndrome. @ B. The cysts in PCOS are atretic follicles. C. There is a hyper secretion of LH relative to FSH. D) Wedge resection of ovaries is considered first-line treatment in anovulation associated with PCOS. E. There may be associated hyperprolactinemia. 15, Patients with a history of polycystic ovary syndrome are at increased risk of: ‘A. Osteoporosis. B. Cervical neoplasia, D C. Late-onset adrenal enzyme deficiencies. Hypertension in pregnant patients. Insulin-dependent diabetes mellitus, 16, A29-y s, area female presents Tequesting contraception. Sheis known to have polycystic ovary syndrome other medical conditie ie and hirsutism, She would like to have a baby in 12 months time. She has no ‘AIUD, ms and is fit and healthy. What would be the best contraceptive option for her? B. Progestogen-only implant. . ©cocp. alesis D. Progestogen-only inject P rabestogen-only injectable. 17. 4 26-year-old patient has had three consecutive spontaneous abortions early in the second trimester. As Part of an evaluation for this problem, the least useful test would be A. Hysterosalpinogram B. Chromosomal analysis of the couple C. Endometrial biopsy in the luteal phase Posteoital test E. Tests of thyroid function 18. A 50-year-old woman is diagnosed with cervical cancer. Which lymph node group would be the first involved in metastatic spread of this disease beyond the cervix and uterus? A.Common iliac nodes B. Parametrial nodes C. External iliac nodes @.Paracervical or ureteral nodes eG E. Parasortic nodes 19, A 51-year-old woman is diagnosed with invasive cervical carcinoma by cone biopsy. Pelvic examination and rectal-vaginal examination reveal the parametrium to be free of disease, but the upper portion of the vagina is involved with tumor. Intravenous pyelography (IVP) and sigmoidoseopyare negative, but a computed tomography (CT) sean of the abdomen and pelvis shows grossly enlarged pelvie and periaortic nodes. This patient is classified as stage B, Ib C. Ila 9 E Iv 20. An intravenous pyelogram (IVP) showing hydronephrosis in the workup of a patient with cervical cancer otherwise confined to a cervix of normal size would indicate stage Al IL om d D.IV EV 21. A 45-year-old woman is diagnosed with an early cervical cancer, noted to be confined to the cervix and about 3 em in diameter. She asks how she developed this condition. Which of the following is a risk factor for cervical cancer? Bexly age of coitus A . Nulliparity C. Obesity D. Late menopause E.Family history of cervical cancer (Questions 22,23) A 22-year-old multiparous obese female comes to your office for a routine gynecologic exam and pap smear. This is her second marriage. Her first marriage was at age 15. She uuses Depo-Provera for birth control, and reports occasionally using condoms as well. She was treated for chlamydia last year, but denies any prior history of abnormal Pap smears. The patient admitted to smoking . Her physical exam is normal. However, 3 weeks later you receive the results of her Pap smear, which indicates a high-grade squamous intraepithelial lesion. 22, Alllof the following factors in this patient's history are risk factors for cervical dysplasia except ‘A. Young age at initiation of sexual activity B. Multiparity C. Previous history of chlamydia & @. Use of Depo-Provera E. Smoking 23. What is the next most appropriate step in the management of this patient? A. Repeat the Pap smear in 4 to 6 months B. Perform a cone biopsy C. Order HPV testing Do random biopsies of the cervix Perform colposcopy 24, Considering Meig's syndrome it is associated with A. Thecoma ovarian fibroma p= D.Brenner tumor E. Teratoma 25. Germ cell tumors include all the following except+ A. choriocarcinoma 4 B (B) androblastoma C. endodermal sinus tumor D. benign cystic teratoma, E. solid teratoma 26, management of ovarian cyst in premenopausal women A. the use of combined contraceptive pill does promote the resolution of functional ovarian cyst BB. ovarian cyst that persist or increase in size are likely to be funetional CC. ovarian cysts larger than 6cm must be removed there is no routine role for MRI and CT scan ~ total abdominal hysterectomy and bilateral oophorectomy preferred in suspected cases 27. the gastrointestinal primary of krukenberge tumor of the ovary is most often found in the: ‘A. gallbladder rectum stomatch colon E, small intestine 28. A female sterilization ‘A. hasa lower failure rate than a vasectomy E B, can never be reversed CC. has better suecess rate than a Mirena IUCD & can only be cartied out on multiparous women ‘There is an increased risk of ectopic pregnancy following the procedure. 4 29. within the luteal phase of the cycle A. the predominant hormone is estrogen. B ® Endometrial glands produce glycogen rich vacuoles with obvious Stromal edema. C. the luteal phase varies in duration depending on the time taken to degenerate a corpus luteum. D. the corpus luteum continue to degenerate in early pregnancy. E. granulosa cell of corpus luteum have yellow pigment owing to accumulation of protiens. 30. In the first half of a normal menstural cycle: A. Serum progesterone levels are high. B, The endometrium is rich in glycogen. D ‘The corpus luteum begins to degenerate. 4 Some ovarian follicles degenerate. E. The endometrium decrease in thickness from 8 to 2 mm. 31. Puberty. A. the age at puberty is defined as the age at menarche yAN B. breast development is almost always in evidence at the age of twelve years © the average age of menarche is 13 years = \O D, failure to menstruate by the age of 15 should be fully investigated E, cyproteron acetate may cause precocious puberty. 32. Allof the following are effects of premature menopause, apart from : Bi decreased cardiovascular risk A B. infertility . C. osteoporosis D. vasomotor symptoms E. vaginal dryness . 33, The main symptom of menopause is : A.Hot flashes. B. Night sweat C. Vaginal dryness. D, Sleep disturbance .) All the above, 34, HRT is useful in all except ‘A. Flushing B. Osteoporosis D C. Vaginal atrophy i O)Coronary heart disease E. hypercholesteremia (35,36,37) A 40-year-old lady who is para 3 , presenting to you with complaints of leakage of urine during exercise and coughing . A subsequent urodynamic study shows a normal bladder capacity ,a free flow of 18 mV/second and a stable bladder. 35. Incontinence in female is most commonly due to : ®@ Stress inconstance A Vesicovaginal fistula Outlet obstruction D. UTI E. Detrosal over activity A i for her: 36. The body mass index for this lady was 34, what is the most appropriate conservative reat ‘A. Topical oestrogen A device to block the external meatus G Weight reduction D. Pelvic floor exer E. Non of the above 37. Itis best corrected by : ‘Tension-free vaginal tape (IVT) |. Hysterectomy A C. Bladder neck repair D. Bladder exercise E. None of the above 38. The best method for inducing mid trimester abortion is: A. Injection of hypertonic saline B, Ethaeridine ‘© ©) Prostaglandin D. D&C E. Oxytocic drugs 39. What is the major risk factor for ectopic pregnancy? ‘A. The use injectable progesterone for contraception. Previous pelvic inflammatory disease B . Cigarette smoking, D .Medical abortion E Salpingitis isthmica nodosa. 40. Which of the following is not considered to be a risk factor for ectopic pregnancy? ‘A. Prior ectopic pregnancy D B history of infertility Prior tubal surgery | maternal age of 16-19 years

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