‫‪Gynecology Exam‬‬

‫)‪3RD Batch Group (A‬‬

‫اعداد اللجنة العلمية الدفعة الثالثة‬

‫الطب البرشي جامعة ‪ 21‬سبمتب‬

1- The most common cause of precocious 5- Premenstrual tension should be initially
puberty is: treated with:
a. Idiopathic. a. OCP.
b. Gonadoblastoma. b. Hysterectomy.
c. Albright syndrome. c. Aldosterone.
d. Abnormal skull development. d. Diuretics.
e. Granulose cell tumor e. D &C.

ANSWER (A) ANSWER (A)

2. The most common symptom of luteal 6- The commonest uterine fibroid to cause
phase defect is: excessive bleeding is:
a. Vaginal dryness. a. Submucous fibroid.
b. Early abortion. b. Subserous fibroid.
c. Tubal occlusion. c. Intramural fibroid.
d. Breast tenderness. d. Cervical fibroid.
e. Ovarian enlargement. e. Broad ligament fibroid

ANSWER (B) ANSWER (A)

3- Treatment of PID include all the 7- Untreated patients with cancer of the
following EXCEPT: cervix usually die with:
a. Oral doxycycline. a. Cachexia and starvation.
b. Removal of IUCD. b. Bowel obstruction.
c. Clindamycin. c. Renal failure and uremia.
d. Tetracycline. d. Multiorgan failure.
e. Dilatation and curettage. e. Cerebrovascular accident.

ANSWER (E) ANSWER (C)

4. The initial evaluation in an infertile 8- OCP have the following beneficial

couple should include: effects EXCPET:
a. Ovarian biopsy. A. Decrease endometrial cancer
b. Semen analysis. B. Decrease benign breast disease
c. D&C. C. Decrease iron deficiency anemia
d. Laparoscopy. D. Decreased ovarian cancer
e. Sperm penetration assay. E. Decrease the incidence of renal failure

ANSWER (B) ANSWER (E)

9- IUCD are relatively contraindicated in
the following patient EXCEPT:
A. With past history of chronic Salpingitis.
B. With Submucous fibroid
C. With history of ectopic pregnancy
D. With septate uterus
E. With history of C section
ANSWER (E)
10- Galactorrhea (non-gestational
lactation) may result from all of the
following EXCEPT:
A. pituitary adenoma
B. Hypothyroidism
C. Renal failure
D. Intrapartum hemorrhage
E. Bronchogenic carcinoma
ANSWER (D)
13- The following is related to premature
ovarian failure:
A. There are decreased levels of estrogen.
B. Is associated with autoimmune disease.
C. There are decrease levels of FSH.
D. It is seen in association with autoimmune
disease.
E. Karyotype is indicated in women who
develop the problem before 25
years of age.
ANSWER (A)
14- Recently the main risk of hormone
replacement therapy after menopause is:
A. fracture the neck of femur
B. Cancer of the colon
C. Hirsutism
D. Cancer of breast
E. Genital atrophy

11- Patients with the following condition ANSWER (D)

present with primary amenorrhea:
A. Bicornuate uterus 15- The single largest cause of acquired
B. Polycystic ovary syndrome tubal pathology is:
C. Imperforate hymen A. Acinetobacter
D. Sheehan’s Syndrome B. Bacterial vaginosis
E. Anorexia nervosa C. Chlamydia trachomatis
D. Group A streptococcus
ANSWER (C) E. Mycobacterium tuberculosis

12- Feature characteristically associated ANSWER (C)

with imperforated hymen in a 16 year old
girl include: 16- The most common germ cell tumor is:
A. Acute retention of the urine A. Dysgerminoma.
B. Absence of secondary sexual B. Endodermal sinus tumor.
characteristics. C. Embryonal carcinoma.
C. Hirsutism D. Choriocarcinoma.
D. Short stature. E. Immature teratoma
E. Present with secondary amenorrhea
ANSWER (A)
ANSWER (A)
17- The most suitable treatment for a
thirty four-year-old woman with minimal
endometriosis on laparoscopy, who has
been trying to conceive for two years and
has pelvic pain, is:
a) Laser ablation to endometriosis/excision of
the endometriosis.
b) GnRH analogues.
c) Danazol.
d) Progesterone.
e) Combined oral contraceptive pill.
ANSWER (A)
18- seventeen-year-old girl who is not
sexually active presents with left iliac fossa
pain. An ultrasound scan shows a 5 cm cyst
on the left ovary which is complex in
nature, with solid, calcified elements and
fatty deposits noted on MRI. The likely
diagnosis is:
a) Thecal luteal cyst.
b) Tubo-ovarian abscess.
c) Serous cystadenoma.
d) Fibroma.
e) Dermoid cyst
ANSWER (E)
19-The management of a thirty eight-year-
old woman whose family is complete, with
a BMI of 30 and who has urodynamically
proven stress incontinence and a 4/5 score
on the Oxford Grading Scale, would be:
a) Pelvic floor exercises.
b) Bladder neck injections.
c) Anterior repair.
d) Colposuspension.
e) TVT.
ANSWER (E)
20- A 65yrs old patient underwent TAH+
BSO for a suspicious 8cm right ovarian
mass and normal CA125. She had
originally presented with postmenopausal
bleeding. Frozen section shows Call-Exner
bodies. Likely the pathology specimen will
demonstrate:
a) Brenner cell tumor
b) clear cell carcinoma of the cervix
c) endometrial hyperplasia
d) mucinous ovarian carcinoma
e) serous adenocarcinoma
ANSWER (C)
21-The following are associated with
menstrual disorders except
a) Endometrial polyp.
b) Endometrial simple hyperplasia.
c) Pelvic inflammatory disease.
d) Thyroid disease.
e) Diabetes
ANSWER (E)
22- The following are associated with
molar pregnancy except
a) Dermoid cysts.
b) Large for dates.
c) Hyperemesis.
d) Pre-eclampsia.
e) Diploidy.
ANSWER (A)
23- The following factors on ultrasound
are suspicious of malignancy:
a) A single loculated cyst of 7 cm diameter.
b) Multiple cysts around the periphery of the
ovary with a dense stroma.
c) A single frond floating within a cyst.
d) Solid elements and septate.
e) Calcification and fats.
ANSWER (D)
24-The following are associated with a 28-Trichomoniasis:
raised alpha-fetoprotein (AFP): A. Associated with cytological findings in
a) Endodermal yolk sac tumors. PAP smear.
b) Granulosa cell tumors. B. Associated with pregnancy & Diabetes
c) Epithelial ovarian cancer. mellitus.
d) Dysgerminomas. C. Is sexually transmitted parasite which
e) Choriocarcinoma. causes pruritic discharge.
D. May cause overt warts.
ANSWER (A) E. Is diagnosed on a wet smear which reveals
clue cells.
25-Regarding carcinoma of the ovary:
a) It is most common in developing countries. ANSWER (C)
b) The incidence is similar to carcinoma of
the endometrium with similar prognosis. 29- A patient presents with vulval itching,
c) The peak age is 80–90 years old. sore vagina and a profuse, white, curdy
d) The majority are epithelial in origin. discharge with erythema and redness at
e) The mainstay of treatment is surgery and the introitus. The likely diagnosis is:
radiotherapy combined. a) Bacterial vaginosis.
b) Trichomonas vaginalis.
ANSWER (D) c) Candida.
d) Chlamydia.
26-The following are causes of benign e) HPV
vulval ulcers except:
a) primary syphilis. ANSWER (C)
b) Chancroid.
c) HSV
d) HPV infection. 30- Polycystic ovarian diseases, all of the
e) Crohn’s following can be seen EXCEPT:
A. Acne.
ANSWER (D) B. Streak ovaries.
C. Insulin resistance
27- The procedure most suitable for the D. Hirsutism.
investigation of pelvic pain is: E. Galactorrhea.
a) Cystoscopy.
b) Hysteroscopy. ANSWER (B)
c) Hysterosalpingogram.
d) Laparoscopy.
e) Hysterectomy.

ANSWER (D)
31- On bimanual examination, bilateral
adnexal masses were palpated. A vaginal
US was done for her and it showed
bilateral tubo-ovarian abscess. What is the
most appropriate next step
her management:
A. Admit the patient for emergency
laparoscopic drainage of the abscess.
B. Admit the patient and give her IV
antibiotic.
C. Treat with multiple oral antibiotics as an
outpatient.
D. Cal interventional radiotherapy to perform
"CT guided Percutaneous aspiration".
E. Admit the patient for exploratory
laparotomy and TAH+ BSO
ANSWER (B)
32- 16-year-old adolescent female is
evaluated for lack of pubertal
development. She is diagnosed with
gonadal dysgenesis. Which of the following
laboratory findings are likely to be
elevated in this patient?
A. Follicle stimulating hormone levels
B. Estrogen levels
C. Progesterone levels
D. Prolactin levels
E. Thyroxine levels
ANSWER (A)
33- Bartholin's abscess:
A. Is often asymptomatic.
B. Is usually bilateral.
C. Is most commonly due to gonococcus
infections.
D. Is best treated surgically.
E. Is usually presented as painful swelling to
one side to clitoris.
ANSWER (D)
34- All of the following possible causes of
infertility, EXCEPT:
A. Previous laparotomy for any reason
B. Smoking
in C. High body mass index
D. PCO
E. Uterine subserous fibroids
ANSWER (E)
35- The commonest presenting complaint
in women with primary vaginal cancer
a. bleeding
b. constipation
c. vaginal mass
d. urinary retention
ANSWER (A)
36- A 5-year-old female is noted to have
breast enlargement, vaginal bleeding,
and an 8-cm pelvic mass. Which of the
following is the most likely etiology?
a. Benign cystic teratoma (dermoid).
b. Endodermal sinus tumor,
c. Brenner tumor.
d. Choriocarcinoma.
e. Granulosa-theca cell tumor
ANSWER (E)
37- The follicular phase of menstrual cycle
is characterized by:
a. Endometrial gland proliferation
b. Decreased Ovarian Estradiol production.
c. Progesterone dominance.
d. A fixed length of 8 day
ANSWER (A)
38- First sign of puberty is
A- budding of breast
B- growth spurt
C- menstruations
D- change of voice
ANSWER (B)
39– female pt. presented with multiple
small ulcers surrounded by red erythema
base on the valval with positive lymph
node enlargement mostly the diagnosis is:
A- syphilis
B- herpes Simplex
c- chancroid
d- HIV
ANSWER (B)
40- the following is not a problem arising
from pelvic floor dysfunction.
a. fecal incontinence
b. incompetent cervix
c. pelvic organ prolapses
d sexual dysfunction
e. urinary incontinence
ANSWER (B)
41- 24_A62yrs old woman complains of
constipation and difficulty having bowel
movements. She states that she often needs
to use her fingers to push her vagina
backward to achieve a bowel movement.
The best ttt for this patient is:
a) hysterectomy
b) anterior colporrhaphy
c) posterior colporrhaphy
d) resection and repair of enterocele
ANSWER (C)
42- A The earliest sign of Sheehan
syndrome is:
A. Secondary amenorrhea.
B. Failure of lactation.
C. Loss of axillary + pubic hair.
D. P.V bleeding.
E. Increase appetite
ANSWER (B)
43- Regarding Hyperprolactinemia all are
true EXCEPT:
A. Can be drug induced
B. Stress can play role
C. Can cause infertility
D. In case of pituitary adenoma surgical
removal is the best choice
E. Dopamine agonist is the treatment of the
choice
ANSWER (D)
44- Which of the following contraceptive
methods should NOT be used by a patient
with coronary heart disease?
A. Combined oral contraceptive pills
B. Male condom
C. Female condom
D. Diaphragm
E. Spermicidal agent
ANSWER (A)
45- 36yrs old woman presents with
intermenstrual bleeding as well as
subfertility. Her US shows: AVF uterus
with picture suggestive of adenomyosis.
ET: 7mm with 10x15mm fundal polyp.
Both ovaries are normal and no fluid in
DP. Which of the following is gold
standard for endometrial polyp diagnosis?
a) CT scan of pelvis
b) hysteroscopy
c) pelvic US
d) saline infusion sonogram
e) TVS
ANSWER (B)
46. A 29yrs old patient presents at 12wks
GA with abdominal distension and vaginal
bleeding. TVS suggests molar pregnancy
with bilateral enlarged multicystic ovaries.
The cysts are thin walled with clear
contents and no fluid in Douglas pouch.
Most likely diagnosis:
a) mucinous cystadenoma
b) struma ovarii
c) serous cystadenoma
d) lutoma of pregnancy
e) theca lutein cyst
ANSWER (E)
47- Raised FSH levels are found in all the
following conditions EXCEPT:
a. postmenopausal women
b. Turner syndrome
c. women on combined oral contraceptive pill
d. gonadal dysgenesis
e. perimenopausal women who had
hysterectomy with bilateral salpingo-
oopherectomy
ANSWER (C)
48- The following are true about
Asherman syndrome EXCEPT:
A. Usually causes primary amenorrhea
B. Causes Secondary amenorrhea
C. May result from excessive dilation &
curettage
D. Usually diagnosed by HSG
E. Usually associated with intrauterine
adhesion
ANSWER (A)
49 - A 29yrs old G2P0 woman (who had
history of regular menses) is undergoing
an evaluation for amenorrhea of 10months
duration. Pregnancy test is negative, her
TSH, PRL, FSH and LH are normal. She
had estrogen and progesterone intake but
with no withdrawal. Her diagnosis was
intrauterine adhesions which were
confirmed by imaging. Most accurate
statement is:
a) Her condition usually occurs after uterine
curettage for a pregnancy related process
b) She would best be diagnosed by
laparoscopy
c) The patient likely has severe cramping pain
every month
d) The patient has hypothalamic dysfunction
e) Her treatment includes endometrial
ablation
ANSWER (A)
50- Regarding gonococcal infection of the
female genital tract, the following are
common site of infection:
A. Bartholin gland.
B. Skene gland.
C. Urethra & cervix.
D. Rectal crypt.
E. All of the above.
ANSWER (C)
 Writing Questions
❖ MS Khadija 65 years old females, the last menstrual period
before 10 years, complaining of vaginal bleeding for 5 days
1- which call type of this bleeding in this condition?

Answer: Post menopausal bleeding

2- which are the possible causes of this bleeding?

Answer:
- hormone replacement therapy & Endometrial hyperplasia
- Benign conditions: atrophic vaginitis, atrophic endometritis, vulvar dystrophies,
endometrial and endocervical polyps (most common causes)
- Gynecologic malignancies: endometrial, cervical, vaginal, and vulvar cancers, and
estrogen producing ovarian tumors (most serious causes)
- Systemic disease as hypertension and ITTP

3- Which the most likely malignant cause of this bleeding?

Answer:
- Endometrial carcinoma

4- which the risk factors of this malignant?

Answer:
- Nulliparity, early menarche & Late menopause, Marked Obesity
- Unopposed estrogen therapy (as estrogen replacement therapy in menopause ERT)
- Atypical endometrial hyperplasia EH, PCOS, estrogen producing ovarian neoplasm
5-Which the management of this conditions?
Answer: ????????

❖ Enumerate four contraindications of COCs?

Answer:
- Coronary Heart Disease
- Thrombo-embolic disorders
- Liver disease (impaired function)
- Malignancy of the female genital system.
- Abnormal bleeding from the genital tract.
- Suspected or known carcinoma of breast