Plating #1 in Gynecology, 11/27/06 Fill in the blanks: 1. Withdrawal of the penis from the vagina before ejaculation 2.

The least effective method among the periodic abstinence/Natural Family Planning 3. Condoms are usually pre lubricated by this spermicide 4. Besides contraception what other benefit can one derive with the use of condoms 5. It consist of a circular spring with fine latex rubber 6. An intrauterine device that is approved for 1 year use only 7. What is the amount of estrogen in the higher dose OCs 8. Combination OC basically suppress these hormones #8 & #9 9. 10. Content of the OC recommended for breast feeding mothers Write T if the statement is correct, and F if the statement is incorrect 11. The pituitary is sometimes referred to as the master control gland of the body because it has the potential to control many of the other endocrine organs in the body. 12. The hypothalamic-pituitary axis is located at the base of the brain; it is bordered by four distinct landmarks the thalamus (cranially), optic chiasm (rostrally), sphenoid bone (caudally), and mammillary body (dorsally). 13. The pituitary gland lies protected within the ephenoid bone in a saddle-shaped depression called the sella turcica. 14. The posterior lobe of the pituitary gland secretes two hormones. The first of these, an antidiuretic hormone (ADH) vasopressin, limits the development of large volumes of urine by stimulating water reabsorption by the distal and collecting tubules of the kidneys. The second hormone, oxytocin, stimulates both the ejection of into the mammary ducts and contraction of the pregnant uterus. 15. Follicle-stimulating hormone (FSH) stimulates the growth of graafian follicles secretion of estrogen in the female, and the development of the seminiferous sperm cells in the male. 16. A luteinizing hormone (LH) stimulates the formation of the corpus luteum and of estrogen and progesterone in the female 17. Luteinizing hormones induces steriodogenesis on the theca cells 18. LH induces ovulation by stimulating a plasminogen-activator that decreases strength of the follicle wall before follicular rupture occurs 19. Follicle stimulating hormones stimulates follicular growth and granulose cell 20. The release of each anterior pituitary hormone is controlled by one or more from the hypothalamus. 21. The kidneys become functional starting this period of gestation: A. 4-6 weeks A. metanephros B. 6-7 weeks B. pronephros C. 8-11 weeks C. mesonephros D. at birth D. all of the above 22. This is referred to as the middle kidney, which is believed to function briefly before regressing:

23. Development of the metanephros is initiated by the _____, which sprout from the distal mesonephros ducts: A. cloaca A. ureteric buds A. presence of estrogen B. absence of testosterone A. 4-6 weeks B. 6-7 weeks B. ureteric buds B. allantois C. allantois C. cloaca C. both D. neither C. 8-11 weeks D. 12 weeks D. urogenital sinus D. urogenital sinus 24. The bladder and urethra form from the most superior portion of the: 25. Female development has been called the basic development path of the human embryo requiring:

26. The end of the indifferent phase of genital development is at what gestational age: 27. The proliferation of cells in the adjacent mesonephros form a supporting aggregate of cells the _______________, the invest the germ cells without which the gonads would degenerate. 28. The Sertoli cells secrete a glycoprotein known as _______________ which causes regression of the paramesonephric duct system in the male embryo 29. The descent of the ovaries into the pelvis by differential growth is made the control of _______________. 30. Dihydrotestosterone results in the development of the following, EXCEPT: A. male external genitalia B. epidedidymus C. prostate D. bulbourethral glands Plating #2 in Gynecology, 12/8/06 1. What is the classic symptom of endometritis? A. pelvic pain B. menorrhagia endometrial stroma A. monocytes B. plasma cells A. Chlamydia trachamatis B. Neisseria gonorrhea A. Chlamydia trachamatis B. Neisseria gonorrhea A. multiple sexual partner C. lymphocytes D. A, B, and C are correct C. Mycoplasma D. Ureaplasma C. Mycoplasma D. Streptococcus C. Use of OCPs E. Streptococcus E. Streptococcus E. B and C C. Intermenstrual bleeding D. Vaginal discharge E. fever

2. The classic histologic finding of severe endometritis is an inflammatory reaction of what cell/s in the

3. These organisms are frequently cultured during the first 24 to 48 hours of the disease (PID)

4. Produces a mild form of salpingitis with an insidious onset

5. The following may increase the risk for the development of acute PID

B. insertion of IUD

D. A, B, and C are correct

E. A and b

6. If on laparoscopy the following were observe: erythema, edema, no spontaneous purulent exudates, tubes freely movable. What is the severity of the acute PID? A. normal B. mild A. ofloxacin B. metronidazole C. Moderate D. Severe C. Cefoxitin D. A, B and C are correct E. a and b D. A, B and C E. A and B E. none of the above

7. Regimen A outpatient management of acute PID include

8. True regarding tuberculosis of the upper genital tract A. Primarily of the chronic salpingitis and chronic endometritis B. Caused by Mycobacterium tuberculosis and M. bovis C. It is spread from the lungs primarily via the hematogenous route 9. Most cases described with the Actinomyces infection have been in women with this form of contraception A. OCPs A. Metronidazole B. ofloxacin Cytochrome P450 enzymes, EXCEPT: A. Phenytoin B. Phenobarbital A. Endometrial cancer B. Ovarian cancer A. 35 ug of ethinylestradiol B. 20 ur of ethinylestradiol given continuously for 3 weeks A. Monophasic OCP B. Biphasic OCP A. Immediately B. 2 to 3 weeks after A. Decreased PID B. Decreased endometrial cancer C. Multiphasic OCP D. Triphasic OCP C. 1 week later D. On the first day of menstruation C. Decreased ovarian cancer D. Decreased anemia C. Rifampin D. Ampicillin C. Cervical cancer D. Colonic cancer C. 50 ug ethinylestradiol D. 100 ug ethinylestradiol B. IUD C. condom D. spermicides E. diaphragm 10. Drug of choice for Actinomyces infection include C. Penicillin D. Cefoxitin E. Ceftriazone

11. The following drugs reduces the effectiveness of oral contraceptives by inducing synthesis of

12. OCP used my reduced the incidence of the following carcinoma, EXCEPT:

13. The lowest-dose OCs all contain the same amount of the same estrogen w/c is:

14. This OC formulation consist of tablets containing fixed dose of both estrogen and progesterone

15. When would you start OCP used after spontaneous abortion or induced abortion?

16. The following are noncontraceptive benefits of depomedroxyprogesterone acetate EXCEPT:

17. The following procedure/s can be employed for female sterilization, EXCEPT: A. At the time of laparotomy for a cesarean section B. Interval minilaparotomy C. Postpartum minilaparotomy soon after vaginal delivery D. Hysterectomy 18. This surgical technique is done by ligating the base of the loop with a single absorbable suture followed by ligation of the segment with two separate absorbable sutures after excision of the midportion of the tube. A. Classic Pomeroy technique B. Modified Pomeroy technique A. Nitrous oxide B. Carbon monoxide C. Madlener technique D. Irving technique C. Carbon dioxide D. All of the above E. A and C only

19. What gas/es is/are used to inflate the abdomen in the standard laparoscopy technique?

20. The following statement/s is/are TRUE of vasectomy: A. Readily accomplished with local anesthesia in an office setting B. It decrease sexual performance after the procedure C. Regarded as a temporary means of sterilization D. All of the above Identification. 21. Widespread velvety pigmentation of the skin folds including the axilla, neck vulva and submammary area 22. Genital and oral ulcerations with ocular inflammation 23. Midline fusion of the labia as a result of chronic vulvar inflammation from any cause. 24. Oozing eczematoid lesion associated with HPV 25. Accumulation of blood in the uterus 26. To distinguish benign from pre-malignant or malignant vulvar lesions 27. Chronic, pruritic eruption of small papules/cysts formed by keratin plugged apocrine glands 28. Abnormal partition across the width of vagina usually at midlevel, caused by faulty canalization of vagina during embryonic devt E. A and B only

29. Most common single anatomic disorder of puberty that prevents passage of endometrial tissues and blood 30. Pain during intercourse particularly during entry Identify. Wrong spelling is considered wrong. 31. & 32. Identify the two most probable differential diagnosis in a woman who complains of acute sever pelvic pain with findings of abdominal tenderness, adnexal tenderness and cervical motion tenderness. 33. This is pain experienced during the midcycle resulting from the peritoneal irration from the follicular fluid and prostaglandings. 34.On culdocentesis, the fluid obtained was purulent. The most probable condition associated with this finding is 35. A woman was diagnosed to have corpus luteum cyst hemorrhagicum with signs of orthostatic vital signs and decreasing hematocrit. The best management is 36. The ovarian cyst which is most prone to undergo torsion is 37. The most suggestive clinical finding/ sign in ectopic pregnancy is 38. This condition causes late onset dysmenorrhea and is defined as ectopic endometrial glands and stroma found in the myometrium. 39. This condition causes chronic pain and on ultrasound dilated pelvic vessels may be seen. 40. The substance responsible for primary dysmenorrhea is Plating #3 in Gynecology, 1/12/07 1. Most frequent manifestation of androgen excess in women A. hypertrichosis A. axillary B. hirsutism B. facial C. midline C. Virilization D. intermammary D. A and B 2. The following hairs are dependent on gonadal androgen EXCEPT 3. The following are characteristics of virilization EXCEPT A. coarsening of the voice B. increase in muscle mass D. enlargement of the clitoris E. loss of female body contour

C. increase in breast size 4. The following may increase SHBG, EXCEPT: A. pregnancy B. luteal phase A. thecomas B. sclerosing stromal tumors A. ovary B. adrenal C. Liver cirrhosis D. use of estrogen C. Sertoli-Leydig cell tumor D. PCOS C. periphery E. pure sertoli tumor D. H-P compartment D. obesity

5. The most common cause of hyperandrogenism and hirsutism

6. This is the most consistent contributor of androgen in patients with PCOS 7. The ovarian compartment contributes to hyperandrogenism in PCOS patients in the following way/s: A. total and free testosterone levels correlate directly with LH levels B. the ovaries are more sensitive to gonadotropic stimulation, possibly as a result of CYP 17 dysregulation C. treatment with a GnRH agonist effectively suppresses serum testosterone and androstenedione levels D. A, B and C are correct A. hyperandrogenism B. acanthosis nigricans A. endometrial cancer B. ovarian cancer E. A and B only C. Polycystic ovaries D. A, B and C are correct C. Coronary artery disease D. hypertension D. ABC E. A and B E. bronchial asthma E. A and B only 8. _____ is considered a marker for insulin resistance in hirsute women

9. Long term risk of PCOS include the following, EXCEPT:

10. True regarding weight reduction in patients with PCOS A. initial recommendation to obese patients B. reduces SHBG and androgen C. increase insulin 11. The most common benign tumor of the uterus in the reproductive age group is A. Leiomyoma B. Endometrioma A. 4 to 8 weeks B. 3 to 6 months 13. This age group has the highest rates of PID: A. Prepubertal B. Reproductive A. Mature cystic teratoma B. Germ cell tumor C. Adolescent D. Postmenopausal C. Epithelial tumor D. Functional cyst C. Adenomyosis D. Fibroma C. 10 to 12 weeks D. 10 to 12 months

12. Unilocular cysts are virtually benign and will regress in _______________

14. The most frequent neoplastic tumor of children and adolescent:

15. The diagnosis of obstructive uterovaginal anomalies is suspected if an adolescent patient presented within the following symptoms, EXCEPT: A. Cyclic pain B. Vaginal mass A. Follicular cyst B. Corpus luteum cyst malignancy: A. 2 is _______________ 19. A triad of persistent corpus luteum cyst, delayed menses and abdominal pain is known as _____ 20. This type of epithelial tumor may be difficult to distinguish histologically from metastatic GIT malignancies _______________ Plating #4 in Gynecology, 1/19/07 1. The following hormones have significant lactogenic activity A. Prolactin B. Human growth hormone A. Glycosylation B. Reducing disulfide bonds C. Heterogeneicity 3. The following may stimulate prolactin release EXCEPT A. -endorphin B. estradiol A. 5:00-7:00 AM B. midmorning A. True A. Coned-down view B. CT scan A. vascular isolation of the tumor B. reduction in dopamine concentration in the hypophyseal portal system C. histamine D. somatostatin C. late afternoon D. 1 hour after sleep B. False C. MRI D. ultrasound E. B and D E. midnight E. serotonin C. TSH D. Placental lactogen D. A, B and C E. A and C only B. 5 C. 6 D. 10 18. The definitive surgical treatment for young patient with myoma who is still desirous of pregnancy C. Menorrhagia D. Hematocalpos C. Theca lutein cysts D. Dermoid cyst

16. The most common functional cyst associated with molar pregnancy and choriocarcinoma:

17. A score of _____ on Ultrasonagraphic Scoring System for adnexal masses would signify

2. The bioactivity and immunoreactivity of little prolactin is influenced by:

4. Lowest prolactin level may be observed

5. An elevated prolactin level should always be rechecked 6. Considered by neuroradiologist to be the optimal technique to evaluate the sella/suprasellar region

7. Hypotheses for the formation of microadenomas and macroadenomas

C. necrosis of the mass D. A, B and C E. A and B 8. The following statement/s is/are true regarding the expectant treatment of pituitary adenoma A. in women who do not desire fertility B. done if menstrual function remains intact C. repeat imaging is done every 3 months 9. Major adverse effect of bromocriptine include the following EXCEPT A. nausea B. headache A. Prolactin B. MRI Multiple Choice: A. Fibroadenoma B. Fibrocystic Changes C. Papilloma D. Duct Ectasia E. Radial scar and Complex Sclerosing Lesion F. Atypical Epithelial Hyperplasia 1. A dense benign lesion with elastic tissue including epithelial elements 2. It has a feature similar to the micropapillary or cribiform types of ductal carcinoma, except that involved spaces, bounded by a basesment membrane, and are fully involved by uniform population of cell 3. It is lesion of true ducts and classically identified as having a base, a papillary structure, and a branching fibrovascular supporting tissue covered by benign epithelium 4. Clinically presented with an easily movable regular mass, seemingly unfixed to surrounding breast tissue 5. The histologic pattern is benign, although the epithelium is may be proliferatea presenting more than two cells above a well-defined basement membrane region, and separated from what may be a quite cellular, fibrous or myxoid stroma 6. It is the dilated elements of the branching ductal and glandular system of the breast. They are formed by the distal glandular elements of lobular units 7. A disease complex that probably begins with periductal inflammation in the region of the nipple and evolves by filling of the involve duct with grumous materials 8. Most common benign cause of acquired nipple inversion 9. Most common cause of periareolar abscess and fistula C. dizziness D. hypertension C. serial gross visual field E. constipation D. ABC E. A and B

10. The following may be done to follow-up patients with pituitary adenoma in pregnancy, EXCEPT:

10. It is characterized histologically as having some of the features of carcinoma in situ, but in less than fully developed form Plating #5 in Gynecology, 1/26/07 1. This/These is/are the only undisputed cause/s of recurrent abortion: A. parental chromosomal anomalies B. thrombotic complications of APAS C. maternal infection 2. This is the most common parental chromosomal abnormality contributing to recurrent abortion: A. mosaicism B. single gene defects A. 24% loss? A. uterus didelphys B. intrauterine system C. anomalies due to maternal exposure to DES 5. This is the most common endocrine factors associated with recurrent abortion A. luteal-phase insufficiency B. diabetes mellitus C. thyroid disease 6. The following maternal infections have been shown based on studies to be associated with recurrent pregnancy loss, EXCEPT: A. Bacterial vaginosis B. chlamydia trachomatis C. ureaplasma urealyticum 7. 20% to 50% of recurrent pregnancy loss is attributed to be due to this factor: A. genetic B. anatomic C. endocrine D. immunologic E. infections D. A & C E. B & C 8. Mechanisms proposed by which antiphospholipid antibodies might mediate pregnancy loss include: A. increased thromboxane synthesis B. increased prostacyclin synthesis C. vascular constriction, platelet adhesion, placental infarction 9. The ff. tests are recommended for work-up of recurrent pregnancy loss, EXCEPT: A. parental peripheral blood karyotype B. hysterosalpingography C. test for antinuclear antibodies 10. The best method for monitoring in early pregnancy is: D. test for lupus anticoagulant E. test for anticardiolipin antibody D. herpes simplex D. mycoplasma D. hyperprolactinemia E. all of the above D. A & B E. B & C B. 30% C. balanced translocation D. insertions C. 40 to 50% D. 60% D. all of the above E. A & B

3. The risk for sub frequent pregnancy loss after 4 losses is: 4. Which congenital anomaly/ies demonstrate/s the strongest association/s with recurrent pregnancy

A. -HCG B. amniocentesis C. ultrasound ENUMERATION 1. Treatment for Bacterial Vaginosis (2)

D. MSAFP E. all of the above

2. Symptoms of Inflammatory vaginitis (2) 3. Signs of Atrophic vaginitis (2) 4. Presumptive diagnostic test for syphilis (2) 5. Treatment options for genital Herpes Simplex virus (2) Plating #6in Gynecology, 2/2/07 Identification:

1. The classic presentation is a moss symmetrically surrounding the urethra. The condition id known
as _____________

2. A young child can usually be examined best in a frog-leg position

3. 4. 5. 6. This is a considered in a prepubertal age group complaining of bloody or purulent foul smelling vaginal discharge ___________ Bleeding that occurs while taking oral contraceptive pills is know as ___________ The term ___________has been used to describe abnormal bleeding for which no specific cause has been found The most common cause of abnormal uterine bleeding in a postmenopausal women is :________ A. Menorrhagia B. Metrorrhagia C. Menometrorrhagia D. Hypermenorrhea E. Hypomenorrhea F. Oligomenorrhea Matching Type

___7. Regular interval, prolonged duration, excessive amount ___8.Infrequent or irregular interval, variable duration scanty in amount ___9.Irregular interval, prolonged duration, excessive in amount ___10.Regular interval, normal duration, excessive in amount Write Higher or Lower on the blank If the underlined number or value on each item should be higher or lower respectively Highter 11. If Day 3 FSH is 5mIU/ml there is reduced pregnancy rate in IVF Lower 12. Male fertility declines sharply after 55 y/o

Highter 13. 50% of couples should conceive after 12 months Highter 14. It takes 55 days for spermatogania to mature into a spermatozoa Lower 15. Optimal period of abstinence before semen analysis is 4-5 days Highter 16. For LH monitoring using the ovulation kit, ovulation occurs 10-12 hours after the onset of LH surge Lower 17. Post coital should be performed 3-4 days before the anticipated time of ovulation Highter 18. Tubal or peritoneal factor accounts for 5-10 % of cases as a cause of infertility Highyer 19. Semen is gelatinous, but liquefaction occurs in 5-10 minutes Lower 20. Luteal phase of defect is diagnosed when two endometrial biopsies show a delay of more than 5 days beyond the actual cycle day in histologic development of the endometrium Plating #7in Gynecology, 2/9/07 1. 2. 3. 4. 5. This is the portion of the cervix wherein the squamous epithelium meets the columnar epithelium Dysplastic cells which occupy the full thickness of the epithelium without crossing the basement membrane is defined as The cervical cell which form the basis of the Papanicolau smear is the Women positive for koilocyte have __________infection This is the physiologic change which occurs in the cervix in response to trauma or hormonal changes, wherein the normal columnar cell are covered by squamous cells

6. On Schillers test, normal cells become dark brown in color, while abnormal cell are pale. Give the
explanation for these changes

7. When acetic acid applied over the cervix, abnormal cells become white. Why does this happen?
8. 9. The form of management of CIN involves destroying cells by crystallizing the cells with ice In VAIN I, this part of the vaginal epithelium has abnormal changes

10. In VIN II, the main form of management is Choose the best answer 11. Indication for gonadotropin therapy A. As COH in IVF/ICSI B. Used for ovulation induction in gypogonadism or pituitary dysfunction C. For COH with IUI to treat unexplained infertility D. A and C only A. Undiagnosed AUB B. Pregnancy E. All of the above D. A and C only E. all of the above 12. Contraindications of gonadotropins for fertility treatment in women:

C. An organic intracranical lesion like pituitary tumor 13. For optimal pregnancy rate, IUI should be performed at : A. 12 hours after HCG administration B. 24 hours after HCG administration D. A and C only E. all of the above

C. 34 hours after HCG administration

14. Failure of management in unexplained infertility is considered only when: A. 3-6 cycles of COH with IUI are completed B. 4-5 cycles of COH with IUI are completed

C. 2-3 cycles of COH with IUI are completed

D. 6-8 cycles of COH with IUI are completed E. 9-10 cycles o f COH with IUI are completed 15. Complication of clomiphene citrate: A. Multiple gestation D. A and C only E. All of the above B. Thinning of the endometrium C. Thickening of cervical mucus 16. Drug of choice for PCOS: A. Clomiphene citrate B. Recombinant FSH(rFSH) D. Human Chrorionic Gonadatropin E. Ethinyl Estradial

C. Human Menopausal Gonadotriopin 17. The following are complications or ART: A. Twins and higher order of multiple gestation B. Increased risk for CA C. Ectopic pregnancies D. A and C only E. All of the above

18. The initial diagnostic procedure used is in evaluating the infertile couple is :
A. HSG B. Laparoscopy C. Ovulation assessment 19. The most constant step for all ART in the management of unexplained infertility is : A. Oocyte retrieval C. Superovulation by COH 20. HCG determination should be given when A. Follicular size is 18-19 mm B. Serum E2 level doubles in forty eight hours C. Serum E2 level doubles every 24 hors D. A and C only E. All of the above D. In vitro embryo culture B. Oocyte maturation using HSG E. None of the above D. Transvaginal ultrasound E. Serum E2 level determination