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QUIZ 1: FERTILIZATION, EMBRYOGENESIS, 7. The stage at which the oocytes are arrested
GENETICS, REPRODUCTIVE ENDO, until ovulation?
CONGENITAL ABNORMALITIES OF FEMALE a. Prophase I
REPRODUCTIVE TRACT b. Metaphase I
c. Meiosis II
1. The ff are the steps involved in implantation, d. NOTA
except:
a. Apposition 8. The round ligament is derived from?
b. Invasion a. Gubernaculum
c. Attachment b. Urogenital sinus
d. NOTA c. Medulla
d. NOTA
2. At what stage does the embryo enters the
uterine cavity? 9. Fertilization occurs in what part of the
a. Blast fallopian tube?
b. Zygote a. Ampulla
c. Morula b. Fimbriae
d. NOTA c. Cornua
d. AOTA
3. Where does blood formation occur first
during the second month of gestation? 10. What is the last fetal epithelium to develop?
a. Liver a. Ectoderm
b. Spleen b. Mesoderm
c. Bone Marrow c. Endoderm
d. Lymph nodes d. NOTA

4. What functions as the fetal kidney? 11. The ff arise from the urogenital sinus?
a. Pronephros a. Appendix vesiculosa
b. Metanephros b. Ureter
c. Mesonephros c. Greater vestibular gland
d. NOTA d. Duct of epididymis

5. Which hormone is responsible for 12. The ff is responsible for the development of
decidualization? testes
a. Progesterone a. SRY gene of Y chromosome
b. Estrogen b. XSR gene
c. Both A and B c. STR gene
d. NOTA d. NOTA

6. The ff is suppressed by the AMH/MIS? 13. The ff are nitrogen base purines
a. Wolffian duct a. Thymine
b. Mesonephric duct b. Adenine
c. Uterovaginal primordium c. Thymidine
d. NOTA d. Cytosine

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14. The principles of X inactivation involves c. 22q11.2

a. One X chromosome is inactivated d. NOTA
randomly in early male embryo
b. Either paternal or maternal X 21. Most common cause of labial fusion
chromosome is randomly chosen a. Exposure to exogenous androgens
c. All descendants will have different b. Congenital adrenal hyperplasia
inactive X chromosome c. 11-hydroxylas deficiency
d. NOTA d. 3B-hydroxysteroid dehydrogenase
deficiency
15. The ff is inherited as autosomal recessive
a. Friedrich Ataxia 22. A 16-yr old student consulted her physician
b. Fragile X due to absence of menses. She also
c. NOTA claimed to have been having cyclical pelvic
d. Both pain for the past 2 months. On PE, there
was a slight bulging membrane 3 cm
16. The ff are associated with live births and superior to the introitus. What’s the most
advanced maternal age probable diagnosis?
a. Trisomy 21 a. Imperforate hymen
b. Trisomy 13 b. Vaginal agenesis
c. Trisomy 18 c. Transverse vaginal septum
d. AOTA d. Mayer-Rokitansky-Kuster-Hauser
syndrome
17. The ff is the karyotype of Klinefelter
Syndrome 23. Saddle-shaped uterine fundus on
a. 47, XXX hysterosalpingography
b. 47, XXY a. Arcuate uterus
c. 47, XYY b. Uterus didelphys
d. NOTA c. Bicornuate uterus
d. DES-related uterine anomaly
18. Maternal AFP is used for detection of neural
tube defects between? 24. First-line treatment of vaginal agenesis
a. 12-14 wks AOG a. McIndoe vaginoplasty
b. 18-19 wks AOG b. Progressive vaginal dilatation
c. NOTA – (bet 16-18wks AOG) c. Vechietta procedure
d. AOTA d. Kinderman vaginoplasty

19. Syndrome due to terminal deletion 25. Accdg to the American Fertility Society as to
a. Patau Classification of Mullerian Abnormalities,
b. Cri du chat septate uterus belongs to
c. Turners a. Class II
d. NOTA b. Class V
c. Class III
20. Cat’s eye is a rare condition that involves d. Class VI
duplication of the following?
a. 22q11 26. Characteristics of Mayer-Rokitansky-Kuster-
b. 22q12 Hauser syndrome, except

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a. Elevated postpubertal c. Several organs are involves in the

testosterone levels successful function of the
b. Phenotypically female reproductive system
c. Absent uterus and vagina d. Each of the different organs
d. Ovaries are normal involved act independently of
each other
27. One of the ff is NOT indicated for
unicornuate uterus 32. Tanycytes are cells cells in the 3rd ventricle
a. Reconstruction metroplasty thought to be important in the transfer of
b. Cervical cerclage a. GnRH
c. Intravenous pyelogram b. Thyroxin
d. Removal of rudimentary horn with c. Cortisone
functional endometrium d. FSH

28. Effects of androgen exposure on female 33. FSH has the same alpha subunit as the ff,
genitalia before 12 weeks of fetal except:
development a. LH
a. Labioscrotal fusion b. ACTH
b. Retention of urogenital sinus c. TSH
c. Clitoromegaly alone d. hCG
d. Penile urethra
34. FSH is secreted by what organ?
29. Which of the ff statements about congenital a. Ant. Hypothalamus
adrenal hyperplasia (CAH) is incorrect? b. Anterior pituitary
a. Affected fetus has 46, XX genotype c. Post. Hypothalamus
b. CAH presents primarily with d. Ovaries
ambiguous genitalia and/or labial
fusion 35. GnRH-synthesizing neurons originate from
c. CAH is due to deficiency of 17- a. Brain
hydroxyprogesterone b. Pituitary stalk
d. Cortisol replacement is part of c. Neurohypophysis
management of CAH d. Olfactory placode

30. The ff are features of androgen insensitivity
syndrome, except
a. Short vaginal pouch
b. Normal AMH levels
c. 46, XX karyotype – (46, XY
karyotype)
d. Sparse or no pubic hair
31. Which of the ff statements is NOT TRUE?
a. The reproductive process starts in
the brain
b. The endocrine regulation of the
reproductive process is complex
36. Compared with a woman of normal weight,
obese women have increased conversion of
a. Estradiol to estriol
b. Testosterone to progesterone
c. Androstenedione to estrone
d. Estradiol to androstenedione
37. Majority of GnRH neurons controlling the
HPO axis are located in
a. Anterior Hypothalamus
b. Anterior Pituitary
c. Medial Basal Hypothalamus
d. Arcuate nucleus

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38. Regarding the feedback loop actions of the 44. GnRH is the most active in producing an LH
ovarian steroid hormones on GnRH pulse surge when it is secreted
modulation, which hormone decreases a. Tonically
GnRH pulse amplitude? b. In pulses every 2-4mins
a. Estradiol c. In pulses every hour
b. Progesterone d. In pulses every 3hrs
c. Testosterone
d. Estriol 45. Inhibin, a substance produced in the ovary
a. Is a steroid hormone
39. Which ovarian steroid hormone decreases b. Is synonymous with follistatin
GnRH pulse frequency? c. Inhibits LH more strongly
a. Estradiol d. Stimulates thecal androgen
b. Progesterone production
c. Testosterone
d. Estriol 46. Cervical mucus that can stretch on a slide at
least 6cms is referred to as
40. The structure of the ovum that prevent its SPINNBARKEIT
fertilization by the sperm of another species 47. The ovarian structure evolving from the
is ovulated follicle CORPUS LUTEUM
a. Granulosa 48. The hallmark of the human corpus luteum is
b. Theca interna its secretion of PROGESTERONE
c. Zona pellucida 49. Ovulation occurs about 24 hours after the
d. Vitelline initial rise of LH surge.
50. The second meiotic division of the oocyte
41. There is a direct correlation between the will be completed at time of
increase of serum estrogen during an FERTILIZATION
ovulatory cycle and the 51. The first meiotic division of the oocyte
a. Thickness of the theca externa occurs during FETAL LIFE
b. Size of the dominant follicle 52. The first histologic evidence of ovulation in
c. Thickness of the ovarian cortex the endometrium is the presence of
d. Number of follicles in the ovary SUBNUCLEAR VACOULES in the
endometrial glands
42. Ovulation in the human usually occurs 53. Androgens are converted to estrone or
a. At the same time as the LH peak estradiol by the enzyme AROMATASE
b. Within 24hrs before the LH peak 54. The number of oocytes at birth is 2-4
c. Within 24hrs after the LH peak MILLION
d. At the same time as progesterone 55. The number of oocytes at puberty is
peak 400,000
56. The number of follicles recruited to grow
43. The primary target of FSH activity is the during the follicular phase is 3-7
a. Adenohypophysis 57. The average length of a menstrual cycle is
b. Ovarian granulosa 28 DAYS
c. Ovarian theca 58. The average duration of the menstrual
d. Ovarian hilum phase in a menstrual cycle is 3-5 DAYS.
59. The average blood loss in one menstrual
cycle is 35mL

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60. The average age of puberty is 12, and c. Inhibin

menopause is 45-55. (page 93, Compre d. Activin
Gyne 7th Ed.)
8. Which of the following is not an effect of
menopause?
QUIZ 2: MENOPAUSE, PEDIA GYNECOLOGY, a. Hot flushes, sleep disruption, &
BENIGN GYNECOLOGIC LESIONS dementia
b. Vaginal dryness, dyspareunia,
predominance of parabasal cells on pap
1. Menopause is defined by:
smear
a. Age
c. Osteoporosis, bone loss of cortical
b. cessation of reproductive function
bones greater than trabecular bones
c. symptoms (trabecular>cortical)
d. LMP d. Increased risk for coronary artery
disease and myocardial infarction
2. Which of the following determines the age of
menopause? 9. Which of the following is not part of disease
a. Age at coitarche prevention for side effects of menopause?
b. age at menarche a. Bioidentical therapy
c. genes b. Biphosphonates
d. use of OCPs c. screening for disease
d. diet
3. The following may have some effect on onset of
menopause, except: 10. Which of the following is an alternative therapy
a. Age at menarche for symptoms at menopause that does not
b. parity need FDA approval?
c. smoking a. Antidepressants
d. surgery b. Gabapentin
c. Isoflavone
4. The time after cessation of reproductive d. Clonidine
function is referred to as:
a. Menopause 11. Uterine distention due to accumulation of blood:
b. perimenopause a. myoma uteri
c. Climacterium b. hematometra
d. postmenopausal c. endometriosis
d. adenomyoma
5. Premature Ovarian Failure is cessation of
menses before what age? 12. The most common large cyst of the vulva is a
a. 40 y.o. cystic dilatation of this gland.
b. 42 y.o. a. Skene’s gland
c. 45 y.o. b. paraurethral gland
d. 50 y.o. c. Bartholin’s gland
d. cervical glands
6. All of the following hormones are elevated
during menopause, except: 13. The most common benign solid tumor of the
a. Prolactin vulva:
b. FSH a. fibroma
c. LH b. myoloblastoma
d. Activin c. lipoma
d. hemangioma
7. All of the following hormones are decreased
during menopause, except:
a. Estrogen
b. AMH

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14. The following are skin infections of the vulva d. cervical polyp
caused by Streptococcus or
Staphylococcus, EXCEPT: 21. Risk factors associated with the development of
a. folliculitis myomas include the following, EXCEPT
b. impetigo a. increasing age
c. furunculitis b. high parity
d. hidradenitis suppurativa c. early menarche
d. tamoxifen use
15. The single most common gynecologic problem:
a. vaginal discharge 22. One of the indications for doing surgery for
b. pelvic pain treatment of myomas are those whose sizes
c. pruritus are equivalent to how many weeks age of
d. none of the above gestation?
a. 8 weeks
16. The most frequent cause of trauma to the lower b. 10 weeks
genital tract of adult females: c. 12 weeks
a. straddle injury d. 14-16 weeks
b. coitus
c. foreign object 23. The presence of ectopic endometrial glands
d. vaginismus and stroma in the uterus:
a. endometriosis
17. Which of the following is NOT TRUE of b. adenomyosis
Nabothian Cysts: c. adenomyoma
a. they are retention cysts of the vaginal d. endometrial polyp
squamous cells (columnar cells)
b. may be multiple in many women 24. True of Adenomyosis, EXCEPT:
c. they are translucent or opaque white or a. secondary dysmenorrhea
yellow b. menorrhagia
d. they are formed by spontaneous healing c. dyspareunia
process d. irregularly shaped uterus
e. no treatment is necessary
25. Cysts of the fallopian tube which are common
18. The following are true of cervical myomas, incidental findings during
EXCEPT: gynecologic operations:
a. most are small & asymptomatic a. Adenomatoid tumors
b. may cause dysuria, urgency & b. hydatid cysts
dyspareunia c. paratubal cysts
c. seldom solitary d. functional cysts
d. majority actually arise from the isthmus
26. A mother brings her 6 year old daughter to the
19. Which of the following is NOT a common cause Emergency Room (ER) for white discharge and
of cervical stenosis of the acquired type? vulvar erythema for the past 2 weeks. The child
a. radiation is hesitant to allow her mother to touch her
b. infection vulvar area. Her mother informs you that
c. neoplasia recently the child is reluctant to go near, or be
d. none of the above touched by, an uncle who lives with the family.
The physical finding most likely to be found in
20. Localized overgrowth of endometrial glands & this child is:
stroma that project beyond the surface of a. Posterior hymenal tear?
the Endometrium? b. Vulvar hemangioma
a. Leiomyoma c. Urethral caruncle
b. Endometrial polyp d. Lichen sclerosus
c. endometriosis

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27. You are called to the ER to evaluate a 10 year d. Lichen Sclerosus

old premenarcheal girl with abdominal pain.
Your Physical Examination (PE) is limited by 32. What is the most common cause of
voluntary guarding of the abdomen. An vulvovaginitis?
abdominal ultrasound shows bilateral solid a. Bacterial
adnexal masses each 10 x 10 cm in size. Her b. Protozoal
hCG level is 62 and LDH is 137. What is the c. Nonspecific
most likely diagnosis? d. Mycotic
a. Endodermal sinus tumor
b. Immature teratoma 33. Which of the following is a common cause of
c. Dysgerminoma nonspecific vulvovaginitis?
d. Theca-lutein cyst a. Chemicals (detergents, soaps)
b. Tight-fitting clothing
28. A 17 year old high school student is sent to the c. Poor hygiene and allergens
ER by their school nurse for malaise, d. All of the above
decreased appetite and abdominal pain. Her
history revealed that she has irregular periods. 34. Which of the following is a reason why children
She is sexually active but with a negative hCG. are more susceptible to nonspecific
On PE there is a RLQ pain and rebound vulvovaginitis than adults?
tenderness. What is the next appropriate step? a. Vaginal epithelium has an acidic pH
a. Laparoscopy b. Lack of pubic hair
b. CT Scan of the Abdomen/Pelvis c. Both A and B
c. GI consult d. None of the above
d. Administer antibiotics
35. Labial adhesions does not require treatment
29. In a pediatric patient, for which of the following unless what condition occurs?
conditions would you prescribe clobetasol a. Voiding is compromised
proprionate and inquire about the possibility of b. There is pain
sexual abuse? c. There is a perineal mass
a. Vulvar adhesions d. There is active vaginal bleeding
b. Lichen sclerosus
c. Embryonal rhabdomyosarcoma 36. Which of the following conditions is included in
d. Mullerian agenesis the differential diagnosis of persistent or
recurrent vulvovaginitis?
30. A 7 year old girl presents to the ER with a. Lichen Sclerosus
perineal injury that is actively bleeding. You are b. Urethral Prolapse
told that she fell on the crossbar of her brother’s c. Foreign body
bike. The history obtained from the patient and d. Labial Adhesions
her mother is inconsistent. PE shows no
bruises over the skin and external genitalia but 37. Which of the following organisms is NOT a
with a defect involving the fourchette and cause of specific bacterial prepubertal
extending to perirectal area. Her anal orifice is vulvovaginitis?
intact. What is the next best step? a. Escherichia coli
a. Observation in the ED b. Staphylococcus aureus
b. Laparoscopy c. Group A: β-hemolytic streptococcus
c. Pelvic sonogram d. Trichomonas vaginalis
d. Examination under anesthesia
38. What is the classic symptom of Enterobius
31. What is the most frequent gynecologic disease vermicularis infestation?
of children? a. Itching
a. Vulvovaginitis b. Vaginal discharge
b. Labial Adhesions c. Soreness
c. Urethral Prolapse d. Vaginal bleeding

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d. Infertility
39. What is the most common foreign body found in
the vagina of a child? 3. Absolute contraindication for hysteroscopy:
a. Hair pins a. Active bleeding
b. Toilet paper b. Extensive adhesions
c. Crayons c. Leiomyomata
d. Gravel
d. Acute pelvic infections
40. Which of the following is a differential diagnosis
of persistent vaginal bleeding in a 4. A distension media that is antigenic and
preadolescent female? rapidly crystallizes:
a. Neoplasia a. Normal saline
b. Precocious puberty b. Lactated ringer’s sorbitol
c. Urethral prolapse c. Dextran
d. All of the above
5. Equipment for the office hysteroscopy,
41. Two most common congenital causes EXCEPT:
of hematometra: a. Speculum
- Imperforate hymen b. Tenaculum
- Transverse vaginal septum c. Allis
d. Forceps
42. Three most common types of Uterine
Leiomyoma:
- Submucous 6. Appropriate test to request prior to
- Intramural hysteroscopy:
- Subserous a. Pregnancy test
b. Urinalysis
43. Three types of degeneration of myomas: c. Chest x-ray
- Hyaline d. HbsAg
- Cystic
- Red/carneous 7. Best time during the menstrual cycle to
perform hysteroscopy:
44. Two functional benign ovarian cysts: a. Early to middle proliferative phase
- Follicular cyst b. Late proliferative phase
- Corpus Luteum Cyst c. Late secretory phase
d. Early to middle secretory phase
QUIZ 3 : FAMILY PLANNING,
HYSTEROSCOPY/LAPAROSCOPY, GENITAL 8. Most frequent problem in performing
TRACT INFECTIONS hysteroscopy:
FAMANNING a. Cervical stenosis or spasm
b. Bleeding
1. Direct visualization of the endometrial cavity
c. Infection
a. Laparoscopy
d. Endometrial pathology
b. Hysteroscopy
c. Endometrial biopsy
9. Directly visualize pelvic anatomy:
d. Fractional curettage
a. Ultrasound
b. CT scan
2. Hysteroscopy is most frequently used in the
c. Hysteroscopy
evaluation of:
d. Laparoscopy
a. Abnormal uterine bleeding
b. Recurrent miscarriage
10. Advantage of laparoscopy:
c. Uterine synechiae

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a. Shorter hospital stay

b. Increased risk of wound infection 18. Besides condom, which is another barrier
c. Thromboembolic events method of birth control?
d. Higher cost a. Diaphragm
b. IUD
11. Most common indication for laparoscopy: c. Withdrawal
a. Female sterilization d. Sterilization
b. Diagnostic
c. Ovarian cystectomy 19. Which type of intrauterine device (IUD) is
d. Hysterectomy available?
a. Copper
12. Relative contraindication for hysterectomy: b. Titanium
a. Morbid obesity c. Hormonal
b. Intestinal obstruction d. A and C
c. Hemodynamic instability
d. Tuberculous peritonitis 20. Which of these is a possible side effect of
birth control pills?
13. Indication for laparoscopy in pregnancy, a. Nausea
EXCEPT: b. Irregular bleeding
a. Appendicitis c. Headaches
b. Ovarian torsion d. All of the above
c. Gallbladder disease
d. Leiomyoma 21. How long is the vaginal ring left in place?
a. 1 week
14. Optimal time to perform laparoscopy b. 2 weeks
surgery in pregnancy: c. 3 weeks
a. Early second trimester d. 3 months
b. Late second trimester
c. Late first trimester 22. Which if these methods is called natural
d. Early third trimester family planning?
a. Tracking basal temperature
15. Major complication of laparoscopy: b. Tracking changes in cervical mucus
a. Laceration of blood vessels c. Tracking the menstrual cycle on a
b. Uterine perforation calendar
c. Fluid overload d. All of the above
d. Anaphylaxis
16. Which methods of birth control needs a 23. Which of these methods of sterilization is
prescription? permanent?
a. Male condom a. Tubal sterilization
b. Female condom b. Vasectomy
c. Cervical cap c. A and B
d. Spermicides d. None of the above

17. What do male condoms offer that other 24. Which of the following is NOT a barrier
forms of birth control do not? contraceptive?
a. Least chance of failure a. Diaphragm
b. Best protection against STIs b. Condom
c. Cheapest to use c. Contraceptive patch
d. All of the above d. Cervical cap

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30. Which of the following is NOT a fertility

25. Besides incorrect use, what is another awareness contraceptive method?
reason that condoms may not be effective? a. Cervical mucus method
a. Most men buy the incorrect size b. Body temperature method
b. They do not contain enough spermicide c. Calendar method
c. They can break during intercourse d. Withdrawal method
d. They can break during intercourse
31. A 22 year old woman with severe itchiness
26. Which contraceptive method involves long- in the perineum, wrists and breasts that
acting progesterone injected intramuscularly worsens at night.
every 3 months? a. Allergy
a. Ortho Evra b. Scabies
b. Seasonale c. Molluscum contagiosum
c. Depo-Provera d. Lice
d. Mirena e. Pityriasis rosea

27. Which form of birth control was developed 32. Painless beefy red ulcers on the vulva
in the 19th century and was the first to be a. Syphilis
widely used by women? b. Chancroid
a. The diaphragm c. Herpes simplex
b. The IUD d. Granuloma inguinale
c. Spermicide jelly
d. The pill 33. Bartholin duct infection is usually due to
a. Gonococcus
28. What is meant by the perfect use failure of a b. Chlamydia trachomatis
contraception? c. Polymicrobial flora
a. The number of times in a given year that d. Bacteroides
a woman fails to get pregnant when she e. Escherichia coli
wants to
b. The number of pregnancies that occur 34. Most accurate method for diagnosing acute
while using a particular contraceptive PID
method over an extended period of time a. History
c. The reliability rate of a particular form of b. P.E.
birth control tested in a clinical lab c. Ultrasonography
setting with human volunteers d. Leukocytosis
d. The number of pregnancies (per 100 e. Diagnostic laparoscopy
users)that are likely to occur the first
year of use when a particular 35. Most frequent symptoms of acute PID
contraception method is used a. Vaginal discharge
consistently and correctly b. Abnormal bleeding
c. Nausea & vomiting
29. If a diaphragm is used consistently and d. Lower abdominal pain
correctly, it can be how effective in e. Urinary frequency
preventing pregnancy?
a. Up to 98% 36. A 32 year old multipara with an IUD in place
b. Up to 94% is admitted for acute PID. The IUD should
c. Up to 92% be removed
d. Up to 90% a. As soon as the diagnosis has been
made

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b. As soon as antibiotics have been started 42. The most specific test commonly used to
c. As soon as adequate levels of detect human HIV infection
antibiotic has been achieved a. ELISA
d. 24 hours after the antibiotics has been b. Southern blot
initiated c. PCR
e. As the conclusion of parenteral antibiotic d. Northern blot
therapy e. Western blot

37. 62 year old woman is being treated for PID. 43. A 28 year old woman with severe pubic
The differential should include itching and few small brown spots at the
a. Hypothyroidism suprapubic skin has
b. Genital tract malignancy a. Junctional nevi
c. UTI b. Scabies
d. Exogenous hormone exposure c. Yeast
d. Trichomonas infection
38. Which is associated with a reduction in the e. Lice
risk for PID?
a. Vaginal douching 44. The normal vaginal pH
b. IUD use a. 3.8-4.5
c. A history of a tubal ligation b. 4.5-4.0
d. A history of treated pelvic infection c. 4.0-4.8
d. 2.5-3.5
39. The most common organism associated e. 5.0-5.5
with nonpuerperal endometritis
a. Cytomegalovirus 45. A patient asks for the most effective short-
b. N. gonorrhea term treatment of her vulvar warts. The best
c. Chlamydia trachomatis choice is
d. Streptococcus agalactiae a. Electrocautery
(choose your fighter) b. Laser therapy
c. Interferon
40. Clue cells in wet mount d. Excision
a. Chlamydia cervicitis e. Cryotherapy
b. Gonorrhea
c. Yeast vaginitis 46. Matching Type. Set A (diagnostic
d. Trichomonas vaginitis procedure)
e. Bacterial vaginosis 1. Syphilis - RPR
2. PID – Laparoscopy
41. Clue cells are 3. Herpes Simplex - Clinical
a. White blood cell with phagocytised 4. Chlamydia trachomatis - Culture
bacteria 5. Gonococcal infection – PCR
b. Epithelial squamous cell covered
with bacteria 47. Matching Type. Set B (Pathognomonic
c. Epithelial columnar cell covered with feature)
bacteria 1. Sulfur granules - Actinomyces
d. White blood cell containing gram (-) 2. Violin strings on laparoscopy - PID
paired 3. Bubo formation – Lymphogranuloma
e. Squamous cell epithelium containing veneruem
macrophages 4. ‘school of fish’ - Chancroid

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5. Groove sign - Lymphogranuloma 5. Danazol treatment of endometriosis is

veneruem associated with an increase in
a. FSH
48. Matching Type. Set C (Treatment) b. LH
1. Chlamydia – Doxycycline c. LDL
2. PID - Cerftriaxone d. HDL
3. Lymphogranuloma Veneruem -
6. The most common surgical approach to
Doxycylcine
endometriosis is
4. Chancre – Penicillin a. Hysteroscopy
5. Herpes Simplex - Acyclovir b. Laparoscopy
c. laparotomy
49. 3 essential clinical criteria to diagnose PID: d. transvaginal excision
(enumerate)
a. Lower abdominal tenderness/ uterine 7. The classic signs of endometriosis include all of
contractions the following except
b. Adnexal tenderness a. a uterosacral ligament nodularity
c. Cervical motion tenderness b. a fixed retroverted uterus
c. bilat. Symmetrical adnexal enlargement
50. 2 minor clinical criteria to diagnose PID: d. tenderness on examination
(enumerate)
8. Endometriosis is associated with all of the
a. Fever following except
b. Vaginal discharge a. anovulation
b. pain
c. first trimester abortion
QUIZ 4 PREOPERATIVE, POSTOPERATIVE
d. dyspareunia
COUNSELLING & MGT., ENDOMETRIOSIS
1. The classic symptom of Endometriosis 9. Which of the following is not a treatment modality
a. cyclic lower abdominal pain for endometriosis?
b. constipation a. NSAID
c. abdominal pain b. Progesterone
d. diarrhea c. GnRH
d. none of the above
2. Endometriosis is defined as the presence of
which of the following in an ectopic site? 10. Endometriosis of the ovary:
a. endometrial glands a. Adenomyoma
b. stroma b. Endometrioma
c. Either c. Endometritis
d. both d. Adenometritis

3. The nature of endometriosis as a disease: 11. Explains endometriosis at rare and remote sites
a. Anatomic a. Metaplasia
b. Inflammatory b. Iatrogenic
c. Immunologic c. Retrograde Menstruation
d. Infectious d. Lymphatic and Vascular Metastasis

4. The most common site for endometriosis: 12. Prevalence of endometriosis in women with
a. rectosigmoid chronic pelvic pain
b. appendix a. 11%
c. ovary b. 33%
d. uterosacral ligament c. 45%
d. 21%

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13. Which of the following does NOT define the
characteristics of endometriosis?
a. Invasive
b. locally infiltrative
c. benign
d. non-disseminating
14. The 3 cardinal histologic features of
endometriosis, except:
a. Powder burn appearance
b. Ectopic endometrial stroma
c. ectopic endometrial glands
d. hemorrhage into adjacent tissues
15. Deep infiltrating endometriosis, except:
a. Medical management
b. Penetrations >5mm
c. surgical management
d. retrograde menstruation theory
16. Preoperative discussion about the surgery with
the patient and her family does not include
a. Making them understand the risk of dying
from the surgery
b. What the operation will not accomplish
c. Making them decide in order to obtain the
consent
d. That the surgery will remove her
anxieties and problems on the organ
involved??
17. The informed consent
a. Is a written document given by the patient
even if she does not understand much
about the procedure provided she
understands it is for her own good.
b. Is a verbal or a written document given by
the patient in cases of emergency in order
to carry out the procedure
c. Is a verbal agreement between the patient
and health worker in order to get a desirable
result
d. Is given by the patient after she
comprehends about the procedure and
she decides to agrees.
18. Prophylactic antibiotic
a. This prevents postoperative complication
and is given upon induction of anesthesia
before the start of the surgical procedure
b. Uses broad spectrum antibiotic
especially sensitive to anaerobes
GYNE TRANS TEAM
c. The drug of choice is a single drug used for
overt pelvic infection as the procedure
involves the pelvic organs
d. This decreases the growth of gram positive
organisms predominantly found on the skin
thus diminishing the risk of infection at the
time skin incision during surgery is started.
19. Based on the National Research council
Classification of surgical wounds, cesarean
delivery before the onset of labor is
a. Clean wound
b. Clean-contaminated wound
c. Contaminated
d. Dirty
20. Hysterectomy on a 45 year old G3P3 patient
due to Myoma uteri is
a. Clean wound
b. Clean-contaminated wound
c. Contaminated
d. Dirty wound
21. Performing an emergency Cesarean delivery on
a patient due to Abruptio Placenta with rupture
of membranes for 30 minutes, and a cervical
dilatation of 4 cm.
a. Clean wound
b. Clean-contaminated wound
c. Contaminated
d. Dirty wound
22. Preoperative preparation of patients with
thromboembolic disease who are on anticoagulants
includes
a. Adjusting the dose to a single dose, long
acting at least a week prior to surgery.
b. Shifting the anticoagulant to an oral form, th
given twice daily 5 days before the
procedure
c. Stopping the anticoagulant use at least 5
days before the surgical procedure.
d. Delaying the surgical procedure until the
patient will no longer need anticoagulant,
then schedule her for the surgical procedure
3 days after the last dose of anticoagulant
given
23. There is a higher risk for pelvic infection after
an elective hysterectomy if the patient has this
infection weeks prior to the contemplated
procedure
a. Candidiasis
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b. Hepatitis B infection
c. Bacterial vaginosis
d. Acute gastroenteritis
24. A 48 year old G5P5 is scheduled for elective
total abdominal hysterectomy because of a Left
ovarian new growth measuring 10 x 10 cm. The
history revealed on and off abdominal discomfort
for 8 months with changes in bowel movements.
Blood work up and renal function tests were
unremarkable. Stool exam was positive for guaiac
test. Additional diagnostic tests will include
a. Chest X-ray, ECG, Colonoscopy
b. Chest x-Ray, 2 D echo, Colonoscopy, CT
scan of the ureters
c. Chest x-Ray, ECG, 2 D echo, Colonoscopy,
CT scan of the ureters
d. Chest x-Ray, ECG, 2 D echo, Colonoscopy
25. A 40 year old G2P2 is for hysterectomy due to
a cervical myoma. The uterus measures 15 x 10
cm, with limited mobility. She is a smoker for 10
years and her BMI is 18.
a. She will be advised for practical purposes to
stop smoking at least 2 months before the
operation as part of the preoperative
preparation
b. For practical purposes advise her to stop
smoking at least 1 month before the
contemplated surgery
c. She will be advised to stop smoking and
return when she is ready for the surgery so
the schedule of operation can be definite
d. Ideally, advise her to focus more on the goal
to stop smoking but to return anytime if
complications set in.
26. The risk factor for a surgical procedure begins
to increase at this age, thus more diagnostic work-
ups are necessary.
a. 35
b. 40??
c. 50
d. 55
27. For surgical procedures done among the
elderly, the greatest source of morbidity and
mortality are related to the
a. Cardiac status
b. Pulmonary status
c. Diabetes
d. Renal status
GYNE TRANS TEAM
28. The most common first sign of morbidity among
elderly patients after a surgical procedure
a. Fever
b. Cough
c. Mental status change
d. Loose bowel movement
29 The goal in the preoperative evaluation of
patients no matter what type of procedure she will
undergo
a. To reduce the anxieties of the team doing
the procedure and prepare them for any
unusualities.
b. To obtain adequate information about the
patient and family including the financial
capability and affiliation on health
insurances.
c. To minimize surprise for the patient,
health care workers.
d. To make sure that the operation is
indicated, considering the patient
holistically, not only focusing on the pelvic
area.
30. This does not encompass during the discussion
of the doctor with her patient before the
contemplated procedure
a. The physician may suggest that the patient
seek another professional opinion before
she decides to proceed with the operation
b. The patient will ask all kinds of pertinent
questions to the physician including her
future capability to conceive
c. The patient discloses to the physician her
marital status including her sexual
relationships, sexual practices to make sure
that her concerns are addressed
d. The physician educates the patient about
the normal anatomy, what the pathology
is to assure her that the procedure will
relieve all her concerns and anxieties.
31. The patient underwent a surgical intervention
for 4 hours and the estimated blood loss was 2,000
cc. Postoperatively, the earliest sign that may
indicate decreased intravascular blood volume
a. Tachycardia
b. Dyspnea
c. Low urine output
d. Restlessness
32. The most common diagnostic problem
encountered after a surgical procedure
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a. Cough b. Perioperative stabilization

b. Fever c. Return to Normalcy
c. Dyspnea d. Postoperative recovery period
d. Wound infection
39. During this period, the woman is concerned
33. This non pulmonary factor favors atelectasis about how she looks and dealing with the change in
during the postoperative period her body image
a. Incisional pain a. Postoperative recovery
b. Asthma attacks b. Return to Normalcy
c. Retention of secretions c. Flow phase
d. Prolonged immobility d. Perioperative stabilization period

34. The ebb phase
a. Refers to the state of the patient brought
about by normal physiologic response to
the stress of the operation
b. Results in periorbital edema due to the
retention of fluid through release of
aldosterone
c. The patient experiences brisk diuresis which
indicates her postoperative status is
improving
d. This is the state of the patient brought about
by the surgical procedure as a response to
the intervention
40. The patient after the surgical procedure drifts in
and out of an awake state
a. Return to Normalcy
b. Perioperative stabilization
c. Postoperative recovery
d. Perioperative period
41. Recovery from anesthesia is observed during
this period after a surgical procedure
a. Perioperative stabilization
b. Return to Normalcy
c. Postoperative recovery
d. Flow phase

35. The first cardiovascular response when the 42. After the surgical procedure, the patient had
patient is in hypovolemic shock intraoperatively and circulatory insufficiency preventing adequate
postoperatively vascular perfusion of vascular organs, you consider
a. Tachycardia a. Septic shock
b. Dyspnea b. Hypovolemic shock
c. Low urine output c. Thyroid storm
d. Restlessness d. Disseminated Intravascular Coagulation

36. During the first 24 to 48 hours after surgery, the
attention of the surgical team is toward the
resumption of her normal physiologic functions
a. Ebb phase
b. Return to normalcy
c. Postoperative period
d. Perioperative stabilization
37 During this period, most traditional complications
after the surgical intervention becomes apparent
a. Ebb phase
b. Return to normalcy
c. Postoperative recovery
d. Perioperative stabilization
38. This period encompasses the transmission from
sick role to her usual preoperative status and
activity
a. Flow phase
43. A 50 year old G5P5 with BMI 22 underwent
total abdominal hysterectomy with
salpingoooporectomy due to myoma uteri. Her
procedure was technically difficult and lasted for 5
hours. The estimated blood loss was 3000 cc.
Postoperative management includes
a. Monitor Blood pressure, heart rate,
respiratory rate every 15 minutes
b. Monitor Blood pressure, heart rate,
respiratory rate, urine output every 15
minutes
c. Monitor Blood pressure, heart rate,
respiratory rate every 15 minutes; urine
output every 30 minutes
d. Monitor Blood pressure, heart rate,
respiratory rate every 15 minutes, and
urine output every hour

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44. The principle in the fluid replacement for a

woman who had significant blood loss is that for
every 1 ml of blood lost,
a. Replace with 5 ml of crystalloid
b. Replace with 3 ml of crystalloid
c. Replace with 5 ml of colloid
d. Replace with 3 ml of colloid

45. This is considered as the most common cause

for acute circulatory failure in the field of
gynecology
a. Hypovolemic shock
b. Septic shock
c. Anaphylactic shock
d. Thyroid storm

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1. FSH has the same alpha subunit as the C. FSH

following hormone, EXCEPT D. Progesterone
A. LH
B. TSH 10. Which of the following is an abnormal menstrual
C. hCG cycle/menstrual period?
D. oxytocin A. 35 days long
B. 80 ml vol.
2. GNRH synthesis C. menstrual phase of 4 days
A. Hypothalamus D. spotting for 24 hrs
B. Ant. Pituitary
C. Post. Pituitary 11. A 26-year old woman complains of vaginal
D. Ovary discharge with itching & burning. pH of the
discharge is 5.5. Which of the following is the
3. FSH synthesis most likely diagnosis?
A. Hypothalamus A. Chlamydia cervicitis
B. Ant. Pituitary B. Yeast inf.
C. Post. Pituitary C. Trichomonas vaginitis
D. Ovary D. bacterial vaginosis

4. LH effect: 12. Gumma, an infectious granuloma is

A. Hypothalamus characteristic of what stage of syphilis?
B. Ant. Pituitary A. primary stage
C. Post. Pituitary B. secondary stage
D. Ovary C. late stage
D. neurosyphilis
5. Estrogen synthesis:
A. Hypothalamus 13. The pathognomonic clusters of dark-staining
B. Ant. Pituitary bacteria (bipolar in appearance) found in the
C. Post. Pituitary Cytoplasm of large mononuclear cells in patients
D. Ovary with Granuloma inguinale?
A. Clue cells
6. In a 30-day menstrual cycle, when is peak of LH B. Donovan bodies
surge expected? C. Arias-stella reaction
A. Day 13 D. Hobnail pattern
B. day 14
C. day 15 14. Transvaginal sonographic finding of acute
D. day 16 salpingitis render?
A. violin string sign
7. In a woman’s reproductive life, there will be an B. atoll sign
average of how many opportunities to become C. Cogwheel appearance
Pregnant? D. Scimitar sign
A. 4000,000
B. 2 million 15. A 21-year old visited her OB-GYNE complaining
C. 400 of abdominal pain, irregular bleeding a few
D. 40 weeks ago and foul-smelling vaginal discharge
beforehand. Recently she noted right upper
8. This is secreted by the corpus luteum. quadrant pain, pleuritic, with tenderness in the
A. Estrogen right upper quadrant. The pain radiated to the
B. progesterone shoulder and back. The most likely differential
C. LH diagnosis would be:
D. FSH A. pneumonia
B. Acute cholecystitis
9. This hormone supports the corpus luteum. C. Fitz-Hugh-Curtis syndrome
A. hCG D. Mittelschmerz
B. LH

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16. “Silent PID” C. PCR

A. Chlamydia D. Western blot
B. Gonorrhea
C. Tuberculosis 23. A 23-year old woman complains of severe pubic
D. Bacteroides itching. On examination, a few small brown
spots are seen on the suprapubic skin. The most
17. Which of the following women is likely to have a likely diagnosis is
Bartholin gland carcinoma? A. junctional nevi
A. 13-year old pubertal girl B. scabies
B. 22-year old sexually active woman C. yeast
C. 39-year old monogamous married D. lice
woman
D. 52-year old virginal woman 24. In a tuboovarian complex associated with acute
PID, the flora is predominantly
18. Which of the following is NOT a management for A. Group D Enterococcus
Bartholin’s Abscess? B. mixed Anaerobes
A. topical ointments C. Chlamydia trachomatis
B. marsupialization D. Neisseria gonorrhea
C. I&D
D. Antibiotics 25. The most frequent symptom of acute PID is
A. vaginal discharge
19. A 16-year old examined during her menstrual B. abnormal bleeding
period has hypertension, skin rash, fever, & C. nausea & vomiting
myalgia. She is found to have Staphylococcus D. lower abdominal pain
on her vaginal culture. The girl’s mother asks
you to explain. Her daughter’s illness & asks 26. The average age of menopause for Filipinas
about proposed treatment plan. You should tell A. 45-46 y.o
her that B. 47-48 y.o
A. the symptoms are due to C. 49-50 y.o.
Staphylococcus aureus bacteremia D. 51 y.o.
B. Almost all cases are sexually
transmitted 27. Which of the following is not one of the causes
C. Antibiotic treatment is of no help of Premature Ovarian Failure?
D. She should stop using tampons A. Increased rate of germ cell use
B. Decreased germ cell endowment
20. Long term sequelae of PID does NOT include C. increased germ cell destruction
which of the following? D. Desarda hernia repair
A. ectopic pregnancy
B. chronic pelvic pain 28. All are etiologies of Premature ovarian Failure,
C. recurrence except:
D. infertility A. Gonadal dysgenesis
B. Galactosemia
21. A 22-year old woman complains of severe C. either of A & B
itching in her perineum, wrists& breasts which D. none of the above
worsen at night. Examination reveals
excoriations on these areas. The most likely 29. In managing Premature ovarian failure, the
diagnosis is: following are done except:
A. allergy A. Transvaginal ultrasound
B. scabies B. Estrogen replacement
C. Molluscum contagiusum C. oocyte donation
D. Lice D. none of the above

22. The most specific test to detect HIV infection is 30. Which is NOT an ovarian change at
A. ELISA perimenopause?
B. Southern blot

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A. Marked diminution of reproductive B. Immunologic

capacity
B. Low antral follicle count
C. rising FSH
D. rising estrogen
31. Treatment at perimenopause is addressed to all
of the following, except:
A. abnormal uterine bleeding
B. vaginal dryness
C. hot flushes
D. inability to conceive
32. The most reliable method to establish bone
mineral density is:
A. Computed Tomography (CT)
B. Dual-photon absorptiometry
C. single photon absorptiometry
D. dual-energy x-ray absorptiometry
(DEXA)
33. A patient came for check up because of a mass
at the vulva which made walking difficult. Upon
inspection, you noticed that it was at around 5
o’clock position and is tender. What is your
diagnosis?
A. Herpes Simplex infection
B. Bartholin’s abscess
C. inflamed skene’s duct
D. PID
C. Retrograde Menstruation
D. Hematogenous Spread
38. Management of Deep Infiltrating Endometriosis:
A. NSAIDs
B. SERM
C. Surgery
D. Danazol
39. Etiology of ovarian endometriosis:
A. Coelomic Metaplasia
B. Immunologic
C. Retrograde Menstruation
D. Hematogenous Spread
40. Features of Mayer-Rokitansky-Kuster-Hauser
syndrome, EXCEPT
A. elevated postpubertal testosterone
levels
B. phenotypically female
C. absent uterus and vagina
D. ovaries are normal
41. Hormonal milieu seen in Congenital adrenal
hyperplasia
A. decreased dehydroepiandrosterone
B. normal cortisol level
C. elevated androstenedione
D. increased aldosterone

34. The patient wants immediate relief of pain and
needs to walk comfortably. What will be the
most appropriate management?
A. Incision and drainage
B. Hot sitz
C. antibiotics
D. marsupialization
35. The most common site for ectopic endometrial
glands and tissues outside of the endometrium?
A. Ovary
B. previous incision site
C. peritoneum
D. nose
36. Which of the following does not refer to
endometriosis?
A. Abnormal uterine bleeding
B. Nodularities at the uterosacral area
C. cyclic hypogastic pain
D. infertility
42. DES-related mullerian anomaly
A. “banana-shaped uterus”
B. T-shaped uterus
C. labioscrotal fusion
D. transverse vaginal septum
43. Effects of androgen exposure on female
genitalia before 12 weeks of fetal development,
EXCEPT
A. labioscrotal fusion
B. retention of urogenital sinus
C. clitoromegaly alone
D. penile urethra
44. One of the following is NOT indicated for
unicornuate uterus
A. reconstruction metroplasty
B. cervical cerclage
C. intravenous pyelogram
D. removal of rudimentary horn with
functional endometrium

37. Etiology of Deep Infiltrating Endometriosis: 45. How is septate uterus best diagnosed?
A. Coelomic Metaplasia A. hysteroscopy

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B. hysteroscopy and laparoscopy
C. saline infusion sonography
D. laparoscopy
46. Imperforate hymen
A. membrane is located at the lower third
of the vagina a distance from the
introitus
B. manifests even before puberty
C. due to defect in fusion of urogenital
sinus and sinovaginal bulbs
D. can predispose patient to
endometriosis
47. Pathogenesis of Androgen insensitivity
syndrome
A. defective Leydig cells that produce
testosterone
B. absence of testes
C. presence of defective androgen
receptors
D. due to defective target tissues of
androgens
48. A mother brings her 4-year-old daughter in for
complaints of itching “down there” and staining
on the underwear. Which of the following
condition is the most likely cause of vulvovaginal
symptoms in children?
A. Foreign body
B. Lichen sclerosis
C. Nonspecific
D. Physiologic leukorrhea
49. A 6-year-old girl is referred by her pediatrician
for a friable mass in the genital region. You
suspect a urethral prolapse. Which of the
following is the most common symptom of
urethral prolapse in the prepubertal,
unestrogenized girl?
A. Dysuria
B. Hematuria
C. Painless genital bleeding
D. Urinary frequency
50. An 8-year-old girl is brought in by the mother
after finding her crying and having bloody
underwear. She will not tell her mother what
happened. On examination, there are injuries
consistent with vaginal penetration. You advise
the mother that it is very important to allow the
authorities to speak with the daughter about
what happened. What is the percentage of
sexually abused children who know their
assailant?
GYNE Trans Team
A. 15
B. 35
C. 55
D. 75
51. Which of the following is the most commonly
reported form of incest?
A. Brother-sister
B. Father-daughter
C. Father-son
D. Mother-son
52. A father brings his 9-year-old daughter to the
office after he picked her up for joint custody
visit. He and his ex-wife have been in a long
drawn-out custody battle. His daughter told him
that her mom’s new boyfriend was touching and
poking her “down there” last night while mom
was shopping.
When childhood sexual assault is suspected
within the past 72 hours, which of the following
should be the next action of the physician?
A. Bring family members together for an
interview
B. Contact mental health workers
C. Notify the police
D. Perform a complete physical exam
53. Which of the following is a legal but not a
medical responsibility of the physician caring for
an alleged sexual assault victim?
A. Collecting samples of hair and
vaginal secretions, and microscopic
evaluation of motile sperm
B. Obtaining a complete gynecologic
history
C. Obtaining informed consent from patient
D. Offering postcoital hormonal prophylaxis
to prevent pregnancy if reproductive age
54. An 8-year old girl is brought to your office soon
after suffering a fall on her brother’s bicycle. Her
mother reports that the girl’s foot slipped off the
bicycle pedal, which resulted in the girl falling on
the center bar of the bicycle. The girl complains
of sharp pain between her legs. There has been
no obvious bleeding and no other injuries are
apparent. The girl is in moderate distress with a
pulse of 110 bpm, blood pressure of 118/68
mmHg, and respiration of 28/min. Physical
examination is normal with the exception of
inspection of the vulva where a 6-cm tender
bluish mass is present in the area of the right
labia majora. No further examination is possible
because of the girl’s discomfort. Which
management is most directly related to an
uncomplicated outcome?
A. Topical application of ice
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B. Use of prophylactic antibiotics
C. Bed rest for the next 24 hours
D. Examination under anesthesia
55. Which of the following is the most direct public
health or socioeconomic effect of contraceptive
use?
A. Improved socioeconomic status
B. Stabilized world population growth
C. Reduced maternal morbidity
D. Diminished incidence of fetal
abnormalities
56. A premedical student presents requesting
reversible contraception. She is healthy without
any problems and a normal examination. As you
review her options, she asks which method is
most reliable. Which of the following
contraceptive methods has the lowest
pregnancy rate in 100 women using the method
perfectly for 1 year (100 woman-years of use)?
A. Copper-containing intrauterine
contraceptive device (IUCD)
B. Long-acting progestins (Depo-Provera)
C. Diaphragm
D. Oral contraceptives
57. A 23-year-old woman and her husband wish to
use natural family planning as their
contraceptive method. Her menstrual cycle
length is variable, ranging from 26 to 32 days.
She does not plan to measure her basal body
temperature (BBT).
The time of her fertility, with the first day of
menses defined as day 1, would be between
which cycle days?
A. 1 and 14
B. 6 and 14
C. 6 and 21
D. 14 and 21
58. You mention that by adding BBT curve, they
may be able to determine more effectively when
ovulation has occured. The figure below shows
the basal temperature graph made by the couple
the previous month. Which letter most closely
identifies when ovulation may have occured?
A. Point A
B. Point B
C. Point C
D. Point D
59. One of the initial attempts at contraception
involved placement of various items in the
vagina to prevent sperm from reaching the
uterus. Historically, these have included
crocodile dung, honey, and preparations with
GYNE Trans Team
mercury with varying success and complication.
Currently available spermicides destroy
spermatozoa primarily by which of the following
methods?
A. Activating acrosomal enzymes
B. Disrupting cell membranes
C. Inhibiting glucose transport
D. Altering vaginal enzymes
60. A 19-year-old woman and her boyfriend wish to
use condoms as a barrier contraceptive method.
This couple should be advised that the most
reason for failure (pregnancy or STD
transmission) is which of the following?
A. Breakage
B. Inconsistent use
C. Leakage caused by spermicidal creams
D. Use without concomitant use of a
spermicide
61. An 18-year-old woman presents for care
because a condom broke during sexual
intercourse. Coitus occured 1 day ago when she
was at midcycle. She does not wish to be
pregnant and will terminate the pregnancy if
menses does not occur. Regarding her fear of
pregnancy, which is the most appropriate next
step in her management?
A. Advise her that unprotected midcycle
cootus has a 5% risk of pregnancy
B. Prescribe intravaginal misoprostol
(Cytotec)
C. Advise immediate douching
D. Prescribe a brief course of
levonorgestrel
62. A 42-year-old patient (G3P3(3003)) requests a
diaphragm for contraception. When fitting the
contraceptive diaphragm, it should sit
comfortably between which of the following?
A. Anterior and posterior vaginal fornices
B. Anterior vaginal fornix and posterior
urethrovesical angle
C. Pubic symphysis and anterior vaginal
fornix
D. Pubic symphysis and posterior
vaginal fornix
63. Which among the following are contraindication
to hysteroscopic procedures?
A. Cervical intraepithelial neoplasia I
B. Tuberculous Endometritis
C. Mitral valve prolapse
D. Uterine cavity depth at 13
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64. The most common step in a hysteroscopic
procedure where uterine perforation may occur
during the:
A. Dilatation of the cervix
B. Visualization of cornual regions
C. Fundal visualization in anteflexed
uterus
D. Direct vaginoscopy while inserting scope
65. True of normal saline as distention medium
A. Inferior to carbon dioxide in terms of
visualization during diagnostic
procedure.
B. Suitable for diagnostic hysteroscopy
where monopolar electrosurgery is
used.
C. Not recommended for bipolar operative
hysteroscopy where glycine is preferred.
D. Results in lesser intravasation
compared with low viscosity media.
66. Agents which can be utilized to aid in cervical
dilatation include:
A. Oxytocin drip
B. Topical bupivacaine
C. Glycine polymer
D. Vasopressin
67. Appropriate practice in diagnostic hysteroscopy
include:
A. Routine antibiotic prophylaxis
B. NSAID analgesia before and/or after the
procedure
C. Trendelenburg position during
procedure
D. Paracervical block preferred over
topical lidocaine
68. A 27-year old post IVF primigravid with an
amenorrhea of 6 weeks was referred for
abdominal guarding and a positive pregnancy
test. Ultrasound reveals an extrauterine
gestational sac. Which situation would make
emergency laparotomy the preferred procedure
compared with laparoscopy?
A. A surgeon trained in diagnostic
laparoscopy
B. Blood pressure of 100/70
C. No fluid in cul-de-sac on transvaginal
ultrasound
D. Ampullary location of gestational sac in
oviduct
69. An anxious patient wishes to discuss diagnostic
laparoscopy with you. She is suspected of
having endometriosis and is undergoing fertility
work-up. Which among the following is
appropriate advice to the patient?
GYNE Trans Team
A. Discussion occurrence of shoulder pain
post op is unnecessary since it is
frequent
B. Routine consent for exploratory is not
recommended since the procedure is
simple
C. The patient may choose expectant
management even if endometriosis
associated infertility is suspected
D. Separate consent for chromotubation
not required since it is part and parcel of
diagnostic laparoscopy
70. An informed consent by the patient
A. Agreeing that she will abide with the
procedure such as taking of vital signs,
insertion of catheters and canula
B. Indicates that the patient understood
about the procedure, what she will go
through, including the risks, willingly
and voluntarily abides to it
C. Indicates that the patient and her family
members understood the situation, what
she will go through, and the financial
responsibility to compensate the
surgical team and institution for the
service rendered
D. Depicts that the patient and her family
were educated about her condition, the
indication for surgery, and she decides
to proceed with the surgery despite her
hesitation since she is aware that her
partner’s family is fully financing her
needs, so she takes the opportunity in
order to avoid being blamed for
complications that would set in if she
refuses to undergo the procedure.
71. A person who undergoes a surgical procedure is
at risk for thrombosis, thrombophlebitis,
embolism due to several factors, but the
cornerstone that facilitates its development is
the
A. Activation of the extrinsic and intrinsic
system of coagulation brought about by
the procedure
B. Prolonged immobility during the
operation
C. Injury to the blood vessels during the
surgical procedures brought about by
clamping and splitting of tissues
D. Necrosis of the injured tissues thus
reducing the oxidation-reduction
potential of tissues
72. History of recurrent preterm birth from
incompetent cervix
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A. History of recurrent preterm birth
from incompetent cervix
B. History of intrauterine fetal death during
labor and delivery from asphyxia
C. History of heart attack at 35 years old
D. History of stroke among first degree
relatives especially noted during
postmenopausal period or after
retirement
73. A Pulmonary function test is performed
preoperatively on a patient who will undergo
surgery in the presence of the condition
A. Smoker for the past 5 years
B. BMI 29
C. History of chronic obstructive
pulmonary disease
D. Surgical procedure will be for a duration
of at least 4 hours
74. When contemplating a surgical procedure in the
elderly due to a large ovarian new growth, the
following should be considered
A. Bowel preparation or cleansing is done
when the patient is admitted with an IV
fluid given.
B. Bowel preparation is done at the
minimal number of sessions in the
hospital to lessen her agitation and non-
submission to the procedure
C. Bowel preparation and cleansing may
be started home before she is
admitted using oral meds, then once
upon admission a day before surgery
D. Bowel preparation is not routine
considering the frailty of tissues and the
physical signs of aging.
75. Wound dehiscence usually does not involve the
separation of the
A. Peritoneum
B. Fascia
C. Muscles
D. Subcutaneous tissue
76. Abdominal hysterectomy operative procedure
based on the National Research Council
Classification of Surgical Wounds is classified as
A. Clean
B. Clean-contaminated
C. Contaminated
D. Dirty
77. Post-operatively, the most common cause of
temperature elevation is
A. Presence of retained foreign body
B. Atelectasis
C. Pneumonia
GYNE Trans Team
D. Wound infection
78. A 35 year old G0 underwent surgery for an
intrauterine myoma with the size equivalent to a
7 month pregnancy. The estimated blood loss
was 3,000 cc. Postoperatively, her vitals signs
were stable. After 2 hours, she became
hypotensive. The immediate management will
be
A. Give oxygen to establish cellular
perfusion
B. Insert another IV line and replace the
blood loss with colloids, crystalloid and
blood
C. Secure blood and transfuse, check on
the source of hypovolemia
D. Establish IV line, secure blood, give
oxygen, insert a catheter to measure
urine output.
79. Symptoms of postoperative wound
complications/infection first appear
A. On the 2nd day after surgery
B. On the 3rd day after surgery
C. On the 5th after surgery
D. On the 14th day after surgery
80. A 45 year old G5P5 with BMI 18 underwent an
abdominal surgery through a midline vertical
infraumbilical incision. The procedure lasted for
3 hours. She was discharged apparently well on
the 3rd post-operative day with instructions on
home medications. After 1 week she returned on
a wheelchair, complaining of difficulty in walking.
You consider
A. Injury to the ilioinguinal nerve through
the midline vertical incision.
B. The iliohypogastric nerve was trapped
and sutured during the closing of the
abdominal incision.
C. The femoral nerve was injured due to
the prolonged and forceful traction
using the abdominal retractor during
the procedure.
D. The femoral nerve was devascularized
and denervated when the midline
vertical incision was done.
81. The flow phase
A. This is the state of the patient brought
about by normal physiologic response to
the stress of the operation
B. Results in periorbital edema due to the
retention of fluid through release of
aldosterone.
C. The patient experiences brisk
diuresis which indicates her
postoperative status is improving
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D. This is the state of the patient brought 88. Implantation involves the following process
about by the surgical procedure as a except?
response to the intervention A. Apposition
B. Invasion
82. This is considered the foundation of any C. Both
approach to the management of wound D. None of the above
infections
A. Use of 3rd generation antibiotics 89. How many days after ovulation during the
before the start of surgical procedure implantation stage the lacunar network forms?
B. Encouraging to stop smoking and A. 8-9 days
weight loss before the contemplated B. 10-11 days
procedure C. 11-12 days
C. Maintenance of the Hemoglobin and D. 9-10 days
Hematocrit level to the optimum
D. Prevention by considering local and 90. When does the primitive streak starts to form at
systemic factors of the patient that will the caudal end of the embryonic disk?
affect surgery A. Third week after fertilization
B. Fifth week after fertilization
83. Bilateral Tubal Ligation based on the National C. Second week after fertilization
Research Council Classification of Surgical D. None of the above
Wounds is classified as
A. Clean 91. The mendelian inheritance pattern includes the
B. Clean-contaminated following
C. Contaminated A. Aneuploidy
D. Dirty B. X linked trait
C. Both
84. Surgical removal of the ovary based on the D. None of the above
National Research Council Classification of
Surgical Wounds is classified as 92. Type of chromosomal abnormality wherein two
A. Clean or more genetically different cell lines is present
B. Clean-contaminated in the same individual?
C. Contaminated A. Translocation
D. Dirty B. Robertsonian pattern
C. Mosaicism
85. Which of the following refers to the observable D. None of the above
characteristics of an individual?
A. Genome 93. The most significant characteristics of a
B. Genotype mitochondrial disease due to mutation of the
C. Phenotype mtDNA is?
D. None of the above A. Abnormal number of chromosomes
B. Mendelian inheritance
86. What is the substage of prophase where all the C. Maternal inheritance
homologues have paired already and forms a D. Paternal inheritance
tetrad?
A. Zygotene 94. The following is the karyotype of Klinefelter
B. Leptotene Syndrome?
C. Pachytene A. 47, XXX
D. Diplotene B. 47, YXX
C. 47, XYY
87. At what stage of cell division is the egg when D. None of the above
released from the ovary in most mammals
including humans? 95. The following are examples of microdeletion
A. Metaphase II stage abnormality of chromosomes except?
B. Meiosis I stage A. DiGeorge syndrome]
C. Mitosis stage B. Cat’s eye syndrome
D. None of the above C. Neurofibromatosis
D. None of the above

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96. At what period of life does teratogenic events

occur causing cardiovascular malformations?
A. Embryogenic period
B. Fetal period
C. Implantation period
D. Fertilization period

97. Of the 3 billion base pairs of the whole human

genome, how many percent of the assembled
sequences codes for protein?
A. 2%
B. 1%
C. 1.5%
D. 5%

98. What type of genomic variation does not involve

a change in nucleotide sequence?
A. Genetic variation
B. Epigenetic variation
C. Both
D. None of the above

99. What type of abnormality involves only a change

of a single base?
A. Deletion
B. Translocation
C. Duplication
D. Point mutation

100. Bonus

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QUIZ 6: ABNORMAL UTERINE BLEEDING

(AUB), PREMENSTRUAL SYNDROME (PMS), b. When the volume is around 8 ml per day
AND PREMENSTRUAL DYSPHORIC lasting for 3 days, occurring every 28 days
DISORDER (PMDD) c. when the menstrual flow is around 10 ml
per cycle, lasting for 3 days occurring
1. Chronic Abnormal uterine bleeding every 40 day
a. The condition has been occurring regularly d. when the menstrual flow is 80 ml per cycle,
for the past months lasting for 4 days, occurring every 35 days
b. Prolonged, bleeding occurring 2 x a month
for 3 months 6. To determine the regularity of the menstrual
c. Bleeding has caused the woman to be cycle,
clinically unstable a. The cycle to cycle variation was observed
d. The condition existed for the past 6 over the past 8 months
months and the patient is clinically b. The cycle to cycle variation has to be
stable observed over the past 2 consecutive
months
2. The first line of treatment for a woman with c. The cycle to cycle variation was noted over
Heavy menstrual bleeding the 2 succeeding months
a. Dilatations and curettage d. The cycle to cycle variation was noted
b. Transvaginal ultrasonography over the past 12 months
c. Medical management
d. Endometrial biopsy 7. A 15 year old sought consult about her menstrual
cycle. Her menarche was at 11 years old. She asks
3. A structural category for a woman with AUB about the normal menstrual cycle. You advise her
a. A 35year old woman with heavy menstrual that
bleeding diagnosed with dengue a. The duration of a normal menstrual flow is
hemorrhagic fever at least 3 days
b. A 15year old with Idiopathic b. The minimum number of days for normal
Thrombocytopenic purpura presenting with menstruation is 4 days
prolonged menses c. The duration of a normal menstrual period is
c. A 52 year old woman with up to 8 days
postmenopausal bleeding due to d. The duration of menstruation is determined
endometrial carcinoma by her age of onset of menarche and the
d. A 45year old woman with breast cancer age of menopause of her mother
taking Tamoxifen had vaginal bleeding for 2
months 8. Abnormal uterine bleeding
a. Mostly occurs among the teenagers
4. A 15year old student sought consult at the clinic b. Mostly occurs among the perimenopausal
because she noticed that her menstrual flow is light age
compared to the previous months. She looks pale c. In most cases, the period is shortened
but her vital signs are normal. d. Occurs during the woman’s reproductive
a. This indicates that she has a missed period age and is usually an anovulatory
and is pregnant bleeding
b. The volume of her menstrual blood is only
10 ml for the whole cycle 9. Occurs during the woman’s reproductive age and
c. The volume of her menstrual blood is is usually an anovulatory bleeding
only 3 ml for the whole cycle a. has more estrogen which stimulates
d. This shows an abnormal uterine bleeding secretion of Prostaglandin F2α
and needs to have a transvaginal b. has more progesterone necessary to
ultrasound increase the secretion of prostaglandin
F2α
5. The menstrual cycle is considered infrequent c. has more estrogen which stimulates
a. when it occurs every 21 days secretion of Prostaglandin E2

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d. has less estrogen necessary to increase the
secretion of Prostaglandin F2α
10. When there is anovulation
a. The PGF2ά /PGE₂ ratio steadily increasing
from midcycle to menses
b. The PGF2ά /PGE₂ ratio remains the same
from midcycle to menses
c. The PGF2ά /PGE₂ ratio is not altered from
midcycle to mense
d. The PGF2ά /PGE₂ ratio is reduced from
midcycle to menses
11. A 35 year old G3P3 has heavy menstrual
bleeding for the past 3 months because of
Leiomyoma. The myoma that causes her abnormal
uterine bleeding is mostly likely
a. Intramural
b. Submucous
c. Subserous
d. Cervical type
12. A 30- year old G4P4 came in because of
abnormal uterine bleeding for the past 2 months.
Her last vaginal delivery was 4 months ago and
since she desired pregnancy spacing, an
intrauterine device was inserted immediately
postpartum. Based on the FIGO classification, she
has
a. AUB-C
b. AUB – I
c. AUB-N
d. AUB- O
13. A 28 year old G0, single with one sexual
partner had an abnormal uterine bleeding. She was
diagnosed to have Hypothyroidism for the past year
and on medication, but she had poor compliance.
All other tests were normal. Based on FIGO
classification, she is classified to have
a. AUB-C
b. AUB- I
c. AUB-N
d. AUB-O
14. The first line diagnostic tool to assess structural
abnormalities in a 40 year old woman with
abnormal uterine bleeding
a. Pregnancy test
b. Transvaginal ultrasound
c. Coagulation test
d. Hematologic test
GYNE TRANS TEAM
15. A 30 year old G5P5 has abnormal uterine
bleeding for the past 3 months. At present, she is
on her 15 day of menses. Her ultrasound showed
an endometrial lining that is thickened. She was
prescribed with progesterone as her medication.
a. Progesterone will cause endometrial
proliferation and this will stop the bleeding
b. Progesterone will cause endometrial
proliferation followed by regular shedding of
the endometrium
c. Progesterone will cause organized growth
of the endometrium and will result in uniform
sloughing off the endometrium
d. Progesterone will cause organized
proliferation of the endometrium until spiral
arteries undergo vasoconstriction causing
cessation of menses
16. A 25 year old is having headache, depression
and irritability at work for the past week. On that
day the Head form the Human Resource office
conducted a clinical/Written exam on the
candidates for promotion, which included her. She
topped the exam despite her condition. This
statement will apply in relation to her premenstrual
status.
a. She has PMS since her work is not affected
by her behavior
b. She has PMS since her cognition is not
affected by her signs and symptoms
c. She has PMS since her behavior did not
affect her work
d. She has PMDD because her behavior has
been there for the whole week
17. Serotonin level is secreted in large amounts
a. Brain
b. Platelet
c. Blood
d. Gastrointestinal tract
18. Serotonin is found least in the
a. Brain
b. Platelet
c. Blood
d. Gastrointestinal tract
19. This is not a common somatic finding among
patients with premenstrual symptom
a. Emotional outburst
b. Thirst
c. Headache
d. Change in bowel habits
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20. The most common complaint seen in patients 26. Laboratory work up to aid in the Diagnosis of
with premenstrual syndrome and premenstrual PMS and PMDD
dysphoric disorder a. Electroencephalography
a. Irritability b. Calendar Dating
b. Crying c. Saline Infusion Sonography
c. Loss of concentration d. No applicable test
d. Depression
27. Recommended in the regular management of
21. The basis for Diagnosis of Premenstrual PMS
Dysphoric Disorder
a. The presence of a headache, breast a. Calcium supplementation 300 mg daily
tenderness, acne, hot flushes affecting b. Selective Serotonin Reuptake Inhibitor
interpersonal relationship during the 2nd c. Diuretic
half of menstrual cycle d. Low fat diet
b. The presence of PMS symptoms and
persistent irritability causing interpersonal 28. Recommended in the management of PMDD
conflict on the 1st day of menstrual cycle
c. The presence of PMS symptoms and a. Calcium supplementation 300 mg daily
persistent anger causing interpersonal b. Selective Serotonin Reuptake Inhibitor
conflict on 2nd half of the menstrual c. Diuretic
cycle d. Low fat diet
d. The presence of a headache, breast
tenderness, depression, acne affecting 29. A 35 year old with Premenstrual syndrome is
interpersonal relationship during the 1st half given Serotonin Selective Reuptake inhibitor as
of menstrual cycle treatment for her condition. The potential side
effects may include
22. According to the DSM Criteria for PMDD, the a. Progression of breast tenderness
affective symptoms do not include b. Alteration in sleep
a. Feeling of hopelessness c. Perceived body swelling
b. Mood swings d. Persistent thirst
c. Persistent anger
d. Anxiety 30. Oral contraceptives as management for PMS
e. Headache will provide relief of the following symptom
a. Abdominal cramping
23. The most common physical symptom with PMS b. Breast tenderness
a. Change in bowel habit c. Irritability
b. Headache d. Fatigue
c. Breast tenderness
d. Dizziness
QUIZ 7: IEN OF THE LOWER GENITAL
24. This had not been proven to be a cause for TRACT; NEOPLASTIC DISEASES OF CERVIX,
PMS VULVA, AND VAGINA; NEOPLASTIC
a. Poor dietary habit DISEASES OF UTERUS OVARY AND
b. Hypoglycemia FALLOPIAN TUBE; GTD/GTN
c. Prolactin excess
d. Hormonal imbalance 1. CIN
25. A risk factor for PMS A pap smear result showed polygonal-shaped
a. Menarche at 15 years old squamous cells with small nucleus detail can be
b. History of PMS of partner’s mother seen. What is the next step in the management?
c. No sexual partner a. Annual Conventional Pap Smear?
d. BMI of 20 b. Repeat Pap Smear after 6 months
c. HPV Testing
d. Colposcopy

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2. A woman came in for cervical cancer
screening, which of the following would you
advise?
a. Start screening 3 years after sexual
debut but not less than 28 y/o
b. Conventional pap smear is done
annually
c. Liquid based pap smear is done
annually
d. HPV test every 2 years
3. A patient underwent colposcopic-guided cervical
punch biopsy. Histopathologic examination showed
undifferentiated or immature squamous cells
confine to the lower 3rd of the epithelium. How will
you manage the patient?
a. Co-testing after 1 year
b. Immediate HPV testing
c. Repeat Colposcopy
d. Conization
4. Which of the following is true about the
transformation zone?
a. Corresponds to the squamocolumnar
junction
b. Line by columnar epithelium
c. Area outside the outer old squamocolumnar
junction
d. Area of squamous metaplasia
5. In HPV infection, which of the following viral
factors are necessary for cell immortalization?
a. E1 and E2
b. E4 and E5
c. E6 and E7
d. L1 and L2
6. CERVICAL CANCER
A 45 y/o multigravida came in for post-coital
bleeding. On pelvic exam, a 0.5 cm mass was
noted at the 3 o’clock position of the cervix. What is
your next step in the management?
a. Perform cervical cytology
b. Colposcopic-guided biopsy
c. Cervical punch biopsy?
d. Observe
7. Pelvic exam on a cervical patient revealed a 1x1
nodular mass at the anterior lip of the cervix,
smooth vagina and free parametria. Which of the
following is true regarding the management of this
case?
GYNE TRANS TEAM
a. Type 1 or extrafascial hysterectomy with
bilateral salpingo-oophorectomy is the
treatment of choice
b. Whole abdomen CT Scan is requested to
evaluate the pelvic and para-aortic lymph
nodes
c. Pelvic external beam RT without
brachytherapy is applicable for small tumors
d. Conization done first prior to the
chemoradiation
8. A 55 y/o multigravida is diagnosed with cervical
cancer. On pelvic exam, the cervix is nodular, 7x6
cm, extending up to the lower 3rd of the vagina,
bilateral parametria nodular. The CT scan result
showed no lymph node involvement. What is the
stage of the disease?
a. IIA2
b. IIB
c. IIIA
d. IIIB
9. A patient underwent conization for CIN III.
Histopathologic examination showed malignant
squamous cells occupying the cervical epithelium
with 5 mm invasion to the cervical stroma. What is
the stage of the disease?
a. Carcinoma in situ
b. IA1
c. IA2
d. IB1
10. The CT scan result of a patient newly
diagnosed with stage IIIB cervical cancer showed a
bladder mass measuring 2x1 cm. Which of the
following is correct regarding the evaluation and
management of this case?
a. Change the stage to IVA
b. Advise cystoscopy and biopsy of the
bladder mass
c. Request for an MRI
d. Give systemic chemotherapy immediately
11. ENDOMETRIAL CANCER
Which of the following patients carries the
worse prognosis?
a. 60 y/o nulligravid, normal BMI, with stage
IIIA, grade 1 endometrioid adenocarcinoma
b. 40 y/o G1P1, obese, with stage II, grade 2
endometrioid adenocarcinoma
c. 55 y/o G3P3, normal BMI, with stage IB,
serous papillary carcinoma of the
endometrium
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d. 65 y/o, nulligravid, overweight, with stage

IA, grade 3 endometrioid adenocarcinoma 16. OVARIAN CANCER
A 42 y/o G1P1 came in for sudden abdominal
12. A 55 y/o G1P1 underwent endometrial biopsy enlargement, ultrasound was requested. Which of
for biopsy for postmenopausal bleeding with the following findings will help you rule-out a
thickened endometrium. Histopathology revealed possible ovarian malignancy?
endometrioid adenocarcinoma of the endometrium. a. Cystic, uniloculated adnexal mass?
What is the management of choice? b. Presence of papillary excrescences
a. Radical Hysterectomy with Bilateral c. Peritoneal implants
Salpingo-oophorectomy, Bilateral Lymph d. Presence of ascites
Node Dissection, Para-aortic Lymph Node
Sampling 17. On histologic examination, the ovarian mass
b. Extrafascial Hysterectomy with Bilateral showed epithelial cells resembling those of the
Salpingo-oophorectomy, Bilateral Lymph endocervix. What is your epithelial tumor
Node Dissection, Para-aortic Lymph diagnosis?
Node Sampling a. Serous
c. TAHBSO, Peritoneal Fluid Cytology, BLND, b. Mucinous
PALS, Random Peritoneal Sampling, c. Endometrioid
Omentectomy d. Clear Cell
d. External Beam Radiation Therapy followed
by Brachytherapy 18. A 75 y/o G4P4 underwent surgery for ovarian
malignancy. Intra-operatively, a ruptured ovarian
13. A patient underwent surgery for endometrial mass was noted and the rest of the pelvoabdominal
malignancy. Gross and histologic examination of organs were unremarkable. What is the stage of
the specimen showed and endometrial mass the disease?
invading >50% of the myometrium, the tumor. a. IA
involvement of the right fallopian tube, the rest of b. IC1
the organs were unremarkable. What is the stage c. IC2
of the disease? d. IC3
a. IA
b. IB 19. A 45 y/o G0 underwent surgery for ovarian new
c. IIIA growth. Final histopathology confirmed ovarian
d. IIIB malignancy with microscopic metastatic of the
pelvic peritoneum. What is the stage of the
14. Histologic examination of an endometrioid disease?
adenocarcinoma specimen showed less than 5% of a. IIA
non-glandular or solid tumor growth pattern. How b. IIB
will you grade this findings? c. IIIA1
a. Grade 0 d. IIIA2
b. Grade 1
c. Grade 2 20. What gene mutation is associated with 39-54%
d. Grade 3 of lifetime risk of ovarian cancer
a. BRCA1
15. A 46 y/o nulligravid underwent surgery for b. BRCA2
endometrial cancer. Intraoperatively there was a c. Lynch II
note of 2x2 cm tumor implant of the omentum. d. pTEN
Examination of the uterus revealed and endometrial
mass with >50% myometrial invasion with cervical
stromal involvement. What is the stage of the
disease?
a. IB
b. II
c. IIIB
d. IVB
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QUIZ 8: AMENORRHEA,
HYPERPROLACTINEMIA

1. Primary amenorrhea is most commonly due to a. Ovary

this condition b. Adrenals?
a. Testicular feminization c. Leydig cells
b. Roki Tansky Kuster Hauser syndrome d. Granulosa cells
c. Utero-vaginal agenesis
d. Gonadal failure 9. Roki Tansky-Kuster-Hauser Syndrome is an
isolated developmental defect that is genetically
2. This secretes anti mullerian hormone affecting inherited characterized by
sexual development of the individual a. Breast development, uterus present
a. Testes b. Absent breast development, uterus absent
b. Leydig cells c. Absent breast development, uterus present
c. H-Y antigen d. Breast development, uterus absent?
d. Sertoli cells
10. The last sign of puberty
3. This is considered as delayed menarche when a. Development of pelvic contour
onset of menstruation occurs at this age, in the b. Appearance of pubic hair
absence of an abnormality c. Menarche
a. 15 years old d. Rapid growth rate
b. 18 years old?
c. 16 years old? 11. The most important and probably most common
d. 19 years old cause of amenorrhea in adolescent girls
a. stress?
4. Secondary amenorrhea occurs in this condition b. anorexia nervosa
a. Premature ovarian follicle? c. exercise
b. Gonadal failure d. hormonal changes
c. Roki Tansky Kuster Hauser syndrome
d. Kallman syndrome 12. Prolactin release is mainly inhibited by a
neurotransmitter
5. This structure is not derived from the Mullerian a. Serotonin
duct b. Dopamine
a. Ovary c. Norepinephrine
b. Fallopian tube d. Indolamine
c. Uterus
d. Cervix 13. In order to avoid a falsely elevated result for
Prolactin test, sample collection is done
6. Delayed menarche least likely occurs among a. After a meal
a. Swimmers b. When the patient just woke up
b. Ballet dancers c. After an exercise
c. Pianists d. When the patient is relaxed
d. Runners
14. Galactorrhea due to hyperprolactinemia occurs
7. During puberty, breast budding is followed by due to this mechanism
a. Development of pelvic contour a. elevated estrogen level causing increased
b. Appearance of pubic hair secretion and release of Prolactin on the
c. Menarche breast
d. Rapid growth rate b. elevated Thyroid releasing hormone which
stimulates Prolactin release on the breast
8. During puberty, this is mainly involved mainly in c. estrogen alters the secretion of GnRH from
the secretion of substance responsible for the the hypothalamus affecting Prolactin
development of sexual hair release on the breast

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d. low estrogen level causes Prolactin to act d. monomeric forms

on the receptors on the breast tissue
22. Among the medications that cause
15. The most common cause for Galactorrhea hyperprolactinemia, this does not cause
a. Pregnancy galactorrhea
b. Prolactinoma a. Antihypertensive
c. Ingestion of medications b. Anxiolytics
d. Stress c. Oral contraceptive pills
d. Antiemetics
16. Physiologic hyperprolactinemia is commonly
caused by 23. The most common pituitary tumor associated
a. Sleep with Hyperprolactinemia
b. Exercise a. Lactotroph hyperplasia
c. Buffet banquet b. Prolactinoma
d. Stress c. Empty sella syndrome
d. Functional hyperprolactinemia
17. Prolactin as a polypeptide is best describe as
a. secreted by the chromophobe cells at the 24. This condition does not cause
anterior area of the pituitary gland Hyperprolactinemia
b. secreted by the lactotrophs upon stimulation a. Chronic kidney disease
by the GnRH from the Hypothalmus b. Hyperthyroidism
c. secreted and stored by the lactotrophs c. Liver cirrhosis
on the lateral areas of the pituitary gland d. Cushing syndrome
d. secreted and released by the chromophobe
cells from the pituitary gland 25. This is the most common form of
Cryptomenorrhea
18. When hyperprolactinemia occurs in women of a. Transverse vaginal septum?
reproductive age, this may result in b. Imperforate hymen
a. menorrhagia c. Adhesive vaginitis
b. oligomenorrhea d. Cervical stenosis
c. hypermenorrhea
d. iatrogenic menometrorrhagia QUIZ 9: HYPERANDROGENISM, PCOS, &
FERTILITY
19. Effects of Hyperprolactinemia on the Infertility Dr. Lita Set 1
hypothalamic-pituitary ovarian axis
a. The episodic release of Follicle stimulating 1. This is a major reason for infertility in women
hormone is reduced a. Anovulation
b. There is reduced pulsatility of the GnRH b. Weight
c. The amplitude of LH secretion is reduced c. Age
d. The episodic release of GnRH becomes d. All of these
reduced
2. Boosting the intake of _________ can help
20. Bromocriptine as an ergot alkaloid used for women trying to conceive
hyperprolactinemia is considered as a. Potassium
a. dopamine receptor antagonist b. Folic acid
b. dopamine receptor agonist c. Lycopene
c. blocks Dopamine uptake d. Nickel
d. inhibits the conversion of Tyrosin to dopa
3. Nerve supply of ovary is through
21. The biologically active Prolactin is characterized a. Sacral fibers
as b. Pudendal nerve
a. the larger forms c. Branches of renal and aortic plexus
b. polymeric forms d. none of the above
c. the aggregation of monomeric
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ovaries on ultrasound, menstrual

4. Menstrual phase bleeding is due to irregularity
a. necrosin d. chronic anovulation, hyperandrogenemia,
b. fibrinolysis elevated LH levels
c. menotoxin
d. vasoconstriction and ischaemia 2. Preferred screening test for glucose intolerance
or Type 2 diabetes mellitus in women with PCOS
5. Fertility in women is impaired by a. fasting blood sugar
a. Hernia b. 75-gram oral glucose tolerance test
b. High blood pressure c. HbA1c
c. Obesity d. random blood sugar
d. Gallstones
3. False regarding hormone levels in polycystic
6. Infertility is when a couple fails to conceive after ovarian disease?
a. 4 years of unprotected sex a. Increased androgen
b. 3years of unprotected sex b. Increased insulin
c. 2 years of unprotected sex c. Increased FSH
d. 1 years of unprotected sex d. Increased LH

7. Procedures used to treat infertility are 4. One of the following is not indicative of
a. ICSI – Intracytoplasmic Sperm Injection hyperandrogenism
b. IVF – In Vitro Fertilization a. increased testosterone levels
c. IUI – Intrauterine insemination b. increased sex hormone binding globulin
d. All of these c. increased dehydroepiandrosterone
d. increased androstenedione
8. Right ovarian artery arises from
a. Uterine artery 5. All of the following EXCEPT one describes a
b. Aorta woman with Phenotype D PCOS
c. Renal artery a. with mild PCOS
d. Common iliac artery b. clinical or biochemical
hyperandrogenism
9.This condition impair infertility c. with polycystic ovaries
a. PCO d. anovulation
b. Fibroids
c. Endometriosis 6. Determination for serum 17-
d. All of these hydroxyprogesterone level is requested to rule out
a. Cushing syndrome
10. In women, this sexually transmitted disease can b. Congenital adrenal hyperplasia
result in infertility c. Insulin resistance
a. Human papillomavirus (HPV) d. Androgen-producing ovarian tumor
b. Pelvic inflammatory disease
c. Genital herpes 7. Which of the following is NOT true about sex-
d. None of the above hormone binding globulin (SHBG)?
a. It binds to most of the circulating
PCOS Dr. Vilches Set 2 testosterone.
1. The Rotterdam criteria in the diagnosis b. It is produced by the liver
of Polycystic Ovarian Syndrome consist of the c. It is increased when there is
following? hyperinsulinemia.
a. anovulation, increased LH/FSH ratio, d. It is increased by estrogen
ultrasound finding of polycystic ovaries
b. anovulation, insulin resistance, clinical signs 8. The drug presently recommended by the
of androgen excess American College of Obstetricians and
c. clinical or biochemical evidence of Gynecologists (ACOG) for ovulation induction in
androgen excess, finding of polycystic
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patients with PCOS because of its high pregnancy a. legs

and birth rates compared to clomiphene citrate b. armpit
a. metformin c. chin
b. letrozole d. pubis
c. spironolactone
d. GnRH agonist 6. The resting phase of hair growth such that the
follicle does not go beyond the dermis
9. Which enzyme catalyzes peripheral conversion a. Exogen
of testosterone to the more potent b. Catagen
dihydrotestosterone? c. Telogen
a. 17ß-hydroxysteroid dehydrogenase d. Anagen
b. 5α-reductase
c. cytochrome P450 aromatase 7. Virilization occurs when there is a markedly
d. 3-alpha-G-diol elevated circulating levels of
a. andostenedione
10. The following are the consequences of b. testosterone
hyperandrogenism, EXCEPT c. dehydroepiandrosterone
a. acanthosis nigricans d. dehydroepiandrosterone sulfate
b. anovulation
c. hirsutism, acne or androgenic alopecia 8. When the testosterone level is too high, the
d. arrest in antral follicle development organ of pathology is in the
a. ovary
Hyperandrogenism Dr. Barrot Set 3 b. pilosebaceous unit
1. If there is an abnormality of the pilary unit, this c. adrenal gland
may manifest as d. peripheral tissues
a. alopecia
b. hypertrichosis 9. Dehydrepiandrosterone sulfate is mainly
c. acne produced by the
d. polycystic ovarian syndrome a. ovary
b. pilosebaceous unit
2. This is the main androgen produced by the ovary c. adrenal gland
a. testosterone d. peripheral tissues
b. androstenedione
c. dehydroepiandrosterone sulphate 10. When treating for hirsutism, the effect may be
d. dehydroepiandrosterone noticed
a. after 3 months of therapy
3. The skin manifestation that first responds when b. after 1 month of therapy
treating hyperandrogenism c. after 6 weeks of therapy
a. hirsutism d. after 8 weeks of therapy
b. alopecia
c. acne 11. Characteristic for testosterone is that most of
d. breast atrophy the circulating levels are
a. tightly bound to the albumin
4. A 27 year old office worker seeks consult b. loosely bound to the sex hormone binding
because of virilization. Her testosterone level was globulin
markedly elevated but her dehydroepiandosterone c. biologically inactive
sulfate level was normal The most likely pathology d. tightly bound to sex hormone binding
is in the albumin
a. Ovary
b. adrenals 12. The most common condition during the
c. pilosebaceous unit reproductive period associated with Hirsutism
d. periphery a. Pregnancy luteoma
b. Polycystic Ovarian Syndrome
5. Vellus hair are mainly found on c. Adult-onset Congenital adrenal hyperplasia
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d. Adrenal tumor a. chin

b. below the breast
13. The skin disorder caused by hyperandrogenism c. hips
that is least responsive to therapy d. palms
a. acne
b. alopecia
c. hirsutism
d. hypertrichosis

14. Abnormalities of the sebaceous component

a. alopecia
b. hypertrichosis
c. acne
d. polycystic ovarian syndrome

15. When this phase of hair growth is prolonged,

the hair becomes thicker.
a. Exogen
b. Catagen
c. Telogen
d. Anagen

16. A 32 year old woman presented with hirsutism.

Her laboratory parameters were normal except for
markedly elevated 3αdiol-G. This abnormal result
indicates that that the organ of pathology is in the
a. ovary
b. adrenals
c. kidney
d. periphery

17. A 28 year old G2P1 at 28 weeks came in

because her ultrasound result for fetal aging
revealed an incidental finding of bilaterally cystic,
ovarian enlargement. The patient also presents
with mild hirsutism. The patient most likely has a
concomitant
a. polycystic ovarian disease
b. stromal hyperthecosis
c. hyperreactio luteinalis
d. adrenal tumor

18. Sertoli-Leydig cell tumors cause a markedly

elevated testosterone levels that is
a. more than two and a half times the upper
limits of the normal range
b. more than ½ of the upper limit of normal
range
c. doubling of the upper limit of normal value
d. two times the upper limit of normal value

19. The structure in the human body that is devoid

of the pilosebaceous unit

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1. Where does fertilization normally occur?
A. Uterus
B. Ovary
C. Vagina
D. Fallopian tube
2. The ovum can be fertilized for about how
many hours after ovulation?
A. 5-10
B. 24-48
C. 4-20
D. 1-3
3. Which of the following is NOT a method for
optimizing the chances of conception?
A. Engaging in intercourse within a few
hours of ovulation
B. Checking blood samples for
testosterone levels
C. Analyzing the woman’s urine or saliva
for LH
D. Charting basal body temperature
4. Which of the following is typically NOT a
cause of male fertility problems?
A. Genetics
B. Pituitary imbalance
C. Irregularly shaped sperm
D. Irregularly shaped sperm
5. The major causes of infertility in females
include all of the following, EXCEPT
A. Failure to ovulate
B. Obstructions of the reproductive tract
C. Endometriosis
D. An irregularly shaped uterus
6. Charley and Kirsten have been trying to have
a baby for over a year. They just found out that
Charley has a very low sperm count. What
method are they candidates for?
A. Surrogate fatherhood
B. In vitro fertilization
C. Donor IVF
D. Artificial insemination
7. Bailey and Sarah have been trying to have a
baby for over a year. They just found out that
Sarah’s ova are viable, but she is not ovulating
on a regular basis. What fertility method are they
candidates for?
A. Donor IVF
B. Adoption
C. Embryonic transfer
D. In vitro fertilization
8. Julia missed her period about three weeks
ago and asks her physician for a pregnancy test.
GYNE Trans Team
She is confirmed as pregnant if there is
__________ in her urine.
A. Hyaluronidase
B. Luteinizing hormone
C. Follicle stimulating hormone
D. Human chorionic gonadotropin
9. Which of the following represents the correct
order of prenatal development?
A. Embryonic, fetal, germinal
B. Fetal, embryonic, germinal
C. Germinal, embryonic, fetal
D. Fetal, germinal, embryonic
10. In the developing fetus, the head takes
precedence over the growth of the lower parts
due to
A. Nagele’s rule
B. The proximodistal principle
C. The cephalocaudal principle
D. The embryonic disk
11. What’s the mechanism of action of
finasteride in the treatment of hirsutism?
A. competes with androgens for androgen
receptors
B. blocks conversion of testosterone to
dihydrotestosterone
C. decreases LH pulsatility and amplitude
D. improves insulin resistance
12. The best medical treatment of signs and
symptoms of PCOS in adolescents
A. metformin
B. oral contraceptives
C. ovarian drilling
D. GnRH analogues
13. Which of the following statements is NOT
true?
A. Risk for endometrial hyperplasia or
malignancy is increased with chronic
anovulation.
B. Use of oral contraceptives for at least
2 years can lower risk of ovarian and
endometrial cancers.
C. As woman ages, PCOS phenotype may
change or disappear.
D. Ultrasound is not recommended in the
diagnosis of PCOS in adolescents within
8 years of menarche.
14. In the treatment of PCOS with combined oral
contraceptives, the estrogen component has
which of the following effects?
A. Reduces luteinizing hormone production
B. Reverses endometrial hyperplasia
C. Increases 5α-reductase activity
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D. Increases sex hormone-binding B. abortion

globulin production C. blood dyscrasia
D. diabetes
15. Ultrasound findings of the ovaries in PCOS,
except 22. The part of the endometrium that
A. ovarian volume of >10cu mm regenerates after menstruation
B. presence of at least 10 cystic follicles A. zona basale
in either ovary B. zona functionale
C. presence of cystic follicles about 2-8 C. zona spongiosa
mm in diameter D. zona compacta
D. peripherally-located cystic follicles about
2-8mm in diameter 23. The first line diagnostic tool for assessing
structural abnormality with heavy menstrual
16. Which of the following medications can be bleeding
added to improve the clomiphene citrate A. pelvic exam
response in women with PCOS? B. pap smear
A. Dehydroepiandrosterone C. ultrasound
B. Insulin D. CT scan
C. Metformin
D. Progesterone 24. The Primary cause to be considered as a
cause of AUB in the reproductive age group
17. Which of the following conditions is a long- A. polyp
term consequence of a woman with PCOS? B. blood dyscrasia
A. cervical cancer C. pregnancy
B. osteoporosis D. malignancy
C. Cushing syndrome
D. Type 2 diabetes mellitus 25. The first mechanism for hemostasis during
menstruation
18. If you suspect presence of A. platelet plug formation
hyperandrogenemia, which of the following B. vasoconstriction
would you request for? C. uterine contraction
A. DHEA-S D. coagulation
B. total testosterone
C. free androgen index 26. Menstrual bleeding is light
D. androstenedione A. < 5 ml
B. 5-10 ml
19. Based on the 2018 guidelines by ESHRE C. 10 – 30 ml
and ASRM, which of the following regarding D. 30-35 ml
diagnosis of PCOS in adolescents is TRUE?
A. ultrasound is recommended if patient is 27. Classification of abnormal uterine bleeding
at least 3 years postmenarche commonly seen during the pubertal stage
B. all of the 3 Rotterdam criteria should be A. coagulopathy
present B. av malformation
C. evidence of hyperandrogenemia C. iatrogenic
should be present and not just the D. malignancy
clinical signs
D. ovarian volume measurement on 28. Classification of abnormal uterine bleeding
ultrasound is not necessary due to intake of contraceptive pills
A. coagulopathy
20. First-line treatment for PCOS B. ovulatory dysfunction
A. ovulation induction C. iatrogenic
B. gonadotropins? D. malignancy
C. in-vitro fertilization
D. ovarian diathermy on drilling 29. The blood supply to the endometrium is from
A. Arcuate artery
21. The common cause for abnormal uterine B. Spiral artery
bleeding during the postmenstrual and C. Radial artery
premenstrual years D. Basal artery
A. anovulation

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30. This is a structural cause for abnormal

uterine bleeding in a 20 year old G2P2 37. This is not a common affective symptom
A. Polyp among patients with Premenstrual syndrome
B. Von Willebrand’s disease A. irritability
C. Dengue Fever B. depression
D. Levonorgestrel containing intrauterine C. labile mood
system D. perception of weight gain

31. A 40 year old G0 came in because of vaginal 38. The laboratory test that is performed in
bleeding for 2 weeks. Cervix and ovaries were coming up with a diagnosis of PMDD
normal. Ultrasound revealed a thickened A. estrogen level
endometrium. You assess her as B. FSH level
A. AUB-P C. ultrasound
B. AUB-M D. none available
C. AUB-A
D. AUB-L 39. This has not been proven to be a cause for
PMS
32.a 15 year old was brought in because of A. hormonal imbalance
prolonged menses for 3 weeks. Her menarche B. vitamin deficiency
was at 11 years old for 3 days. Subsequent C. hormonal allergy
menses were unremarkable. She has occasional D. excess prolactin
gum bleeding and epistaxis. The pelvic
structures were normal except for moderate 40. The appearance of pubic hair follows
bleeding seen through the introitus. You A. breast budding
consider B. widened pelvic contour
A. AUB-I C. rapid growth spurt
B. AUB-C D. menarche
C. AUB-P
D. AUB-O 41. This is the first sign that the girl has entered
the stage of puberty
33. A woman experiencing symptoms during her A. breast budding
second half of menstrual cycle has intact B. wide pelvic contour
cognitive function and performance despite C. appearance of pubic hair
having this condition. D. menarche
A. Premenstrual syndrome
B. Premenstrual dysphoric disorder 42. The structure that is not derived from the
C. Heavy menstrual bleeding mullerian duct:
D. Abnormal uterine bleeding A. ovary
B. fallopian tube
34.The most common symptom noted among C. uterus
clients with Premenstrual dysphoric disorder D. upper 3rd of vagina
A. depression
B. hebephrenic behaviour 43. The development of the gonadal sex occurs
C. panic attacks during this period
D. anxiety A. upon fertilization
B. once the ovary develops
35. The neurohormone that is highly associated C. upon secretion of the mullerian
with premenstrual dysphoric disorder hormone
A. bromocriptine D. once there is the conversion of
B. dopamine testosterone to dihydrotestosterone
C. prolactin
D. serotonin 44. The appearance of this manifestation
reflects the last stage of puberty
36. This condition greatly impairs the woman’s A. breast budding
personal functioning B. wide pelvic contour
A. Premenstrual syndrome C. appearance of pubic hair
B. Premenstrual dysphoric disorder D. menarche
C. Heavy menstrual bleeding
D. Abnormal uterine bleeding

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45. The genetic sex is determined during this
period
A. upon fertilization
B. once the ovary develops
C. upon secretion of the mullerian hormone
D. once there is the conversion of
testosterone to dihydrotestosterone
46. The onset of menstruation will be early
among this group, (except):
A. ballet dancers
B. swimmers
C. athletes
D. pianists
47. During puberty, rapid growth spurt precedes
this developmental change
A. breast budding
B. widened pelvic contour
C. appearance of pubic hair
D. menarche
48. Secondary amenorrhea on a 28 year old G0
is least likely to occur from this condition
A. after bilateral cystectomy
B. irradiation
C. chemotherapy
D. asherman’s syndrome
49. This has been observed before onset of
puberty
A. The hypothalamus is sensitive to the
positive effect of low estrogen levels
B. The hypothalamus is sensitive to the
negative feedback of low estrogen
levels
C. The pituitary gland is insensitive to the
negative feedback of the hypothalamus
D. The pituitary gland does not to secrete
gonadotropic hormones causing low
estrogen
50. A 26 year old went to the clinic because of
primary amenorrhea. If you are considering Roki
Tansky-Kuster-Hauser Syndrome you will
observe the following
A. breast exam showed no breast budding
B. she is of short stature for her age
C. pelvic examination reveals a short or
absent vagina
D. the ovaries are absent on transvaginal
ultrasound examination
51. An individual is considered to have a
premature ovarian failure
A. she has secondary amenorrhea at 45
years old
B. she has primary amenorrhea at 25
years old
GYNE Trans Team
C. she has secondary amenorrhea
before 40 years old
D. she has amenorrhea at 48 years old
after undergoing salpingooophorectomy
52. An 18 year old sought consult because of
severe dysmenorrhea. She is unable to report
for work and been in conflict with her employers.
Her menarche was 13 years old for 3 days,
associated with dysmenorrhea. The findings on
the pelvis were unremarkable. This is a case
A. Secondary dysmenorrhea
B. Primary Dysmenorrhea
C. Endometriosis
D. PMDD?
53. A 26 year old G0 presents with severe
dysmenorrhea. Her pelvic structures are
apparently normal. You attribute the cause for
her complaint to:
A. obstruction of the menstrual outflow
B. retrograde flow of menstrual fluid
C. endogenous prostaglandin levels
D. adhesions from previous infections
54. The treatment of choice for a 25 year old G0
married for 5 months complaining of
dysmenorrhea with normal pelvic findings.
A. Mefenamic acid
B. Transcutaneous electric nerve
stimulation since it improves the mood
C. combined OCP since it promotes good
patient compliance
D. Levonorgestrel releasing intrauterine
system because it reduces the pain as
much as 90%
55. Secondary dysmenorrhea is not attributed to
this condition
A. Pelvic inflammatory disease
B. heterotopic pregnancy
C. presence of leiomyoma
D. presence of functional bowel disease
56. Secretion of Prolactin is a function of the
A. hypothalamus
B. pituitary gland
C. amygdala
D. breast
57. This is considered the most common cause
for physiologic hyperprolactinemia
A. sleep
B. exercise
C. stress
D. breast stimulation
58. The biologically active form of Prolactin is
characterized by
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A. being larger in molecular size 66. When the testosterone level is too high,
B. produced in small quantity but with consider a pathology of the
significant effects A. Adrenal gland
C. an aggregation of monomers B. Ovary
D. monomeric forms C. Liver
D. Renal
59. The main symptom with hyperprolactinemia
during the non-pregnant state 67. Results from an abnormality in the pilary
A. anovulation component of the pilosebaceous unit
B. AUB A. Pimple
C. oligomenorrhea B. Black heads
D. galactorrhea C. Acne
D. Alopecia
60. The secretion of Prolactin is mainly inhibited
at the Hypothalamic level by 68. Characteristic with virilization
A. Serotonin A. Rapid onset
B. Thyrotropin B. Breasts enlarge
C. Bromocriptine C. Clitoris recedes
D. Dopamine D. Acne

61. Hyperprolactinemia and Thyroid disorder 69. The resting phase of hair growth such that
A. Hypothyroidism increases Prolactin the follicle does not go beyond the dermis
secretion by the TRH A. Anagen
B. Hypothyroidism increases Prolactin B. Catagen
secretion by the TSH C. Telogen
C. Hyperthyroidism increases Prolactin D. Exogen
release due to increased TSH secretion
D. Hyperthyroidism causes stimulation of 70. The manifestation that first responds when
Prolactin secretion by the Thyroid treating hyperandrogenism
releasing hormones A. Hirsutism
B. Acne
62. Sample collection for Prolactin levels is not C. Alopecia
done D. Breast atrophy
A. before an exercise
B. after attending a party
C. before taking an exam
D. before siesta time

63. Galactorrhea is diagnosed by

A. Ultrasound of the breast
B. CT scan of the breast
C. MRI of the breast
D. microscopic examination of breast
secretion

64. The main androgen produced by the ovary

A. testosterone
B. androstenedione
C. dehydroepiandosterone
D. DHEAS

65. The main androgen produced by the

adrenal gland
A. Testosterone
B. Androstenedione
C. Dehydroepiandrosterone
D. DHEAS

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