Dr.G.

Bhanu Prakash

1 Most important characteristic symptom of menopausal syndrome is

vasomotor disturbances (Hot flushes).
2 Osianders sign is seen in fibroid uterus, Pelvic inflammatory disease and
first trimester.
3 Weinbergs sign is seen in abdominal prignancy.
4 Carunculae myrintiformes are remnants are remnants of hymen(after
parturition)
5 1971 Schally & Gullemin discovered a decapeptide, now called
gonadotropin-releasing factor(gnRH)
6 Allen & Doisy disovered oestrogen.
7 Allen & Corner ...discovered progesterone.
8 Karl Ernst first identified mammalian ovum.
9 Mueller, Johannes described paramesonephric duct (Muellerian duct)
10 Ogino & Knaus opined that ovulation sually occurs 14 days before the
onset of the next menstrual period irrespective of the length of the menstrual
cycle.
11 Rock & Hertig have shown that the interval between ovulation and
nidation varies between five & eight days and have seen segmentation may
occur in vitro & vitro fertilization..
12 Implantation occurs at blastocyst stage.
13 Epithet helium of bladder trigone develops from mesoderm.
14 The clitoris, when compared to the penis, lacks the corpus spongiousm.
15 The vulval tissues respond to hormones (especially oestrogens) during the
child-bearing years.
16 Vulval lymphatics do not cross the libicrural fold.
17 Doderleins bacillus convert glycogen of vaginal epithelial cells into lactic
acid which has a protective function against bacterial invasion.
18 Follicular development starts in 20 primordial follicles per menstrual cycle.
19 FSH & LH are produced in basophilic cells where as prolactin is produced in
acidepholic cells.
20 Progesterone usually does not act independent of oestrogen.
21 Progesterone is absent or is in negligible amounts(extra ovarian sources) in
anvulatory cycles.
22 Granulose cells lack 17 o-hydroxylase necessary for oestrogen production:
and ovary lacks 21-hydroxylase & 11-hydroxylase enzymes necessary for

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 Dr.G.Bhanu Prakash

glucocorticoids & mineral corticoid production.

23 Puberty is brought about by the maturation of hypothalamus.
24 At puberty the body of uterus enlarges under the direct influence of ovarian
hormones.
25 Urinary gonadotrophins in young females usually appear 1 to2 years before
menarche.
26 FSH act only on granulose cells whereas LH acts both on theca and
granulose cells.
27 Earliest histopathological evidence of ovulation(36-48 hrs after ovulation) is
the appearance of sub-nuclear vacuoles in the endometrium.
28 Menstruasl bleeding is mainly arterial in character.
29 The menstrual blood does not clot for many hours.
30 Oestrogen is growth hormone for all tissues of the Mullerian system.
31 Hydrolysis of pregnanediol occurs in the interstine.
32 Progesterone has an anaesthetic effect.
33 The failure of milk production during the first 3 or 4 days of puerperium may
be due to the inhibition of the alveoli in the breast by oestrogen.(when
oestrogen levels fall after delivery, this inhibition is withdrawn & milk
begins to be produced).
34 The increase in breast size during pregnancy is due to hormonal stimuylation
by oestrogen, progester-one and HPL.
35 In pure form oxytocin has slight vaspressor and antidiuretic effects while in
pure synthetic form vasopressin has a slight oxytocic action.
36 When liver function is impaired. oestrogen in circulation results in excessive
menstrual bleeding.
37 Prolactin is chemically and antigenically related to GH & HPL.Q
38 The main androgen secreted by the ovarys stromal cells is Androstenedione.
39 HCG is most similar in its chemistry & biological action to LH.
40 Turners syndrome substitution therapy with oestrogen.
41 True hermaphroditismsurgical removal of contradictory organs &
Reconstruction of external genitalia.
42 Hirsutism without a specific cause Androgen antagonist.
43 A longitudinal hymenal incision for haematocolpos should be avoided
(otherwise urethra or rectum be opened accidentally).
44 Fusion of the labia majora occurs in pseudohermaphroditism.
45 Vaginal cysts representing vaginal adenosis due to diethylstilbestrol are
precursors of adenocarcinoma.
46 Endometriosis or adenomyosis is associated with congenital atresia of the
cervix.
47 Atresia of the oviducts may be a factor in infertility or may favour ectopic
pregnancy.
48 Removal of testes from a very young mammalian fetus will allow
development of female genitalia & cause regression of Wolffian ducts.
49 Urological anomalies are often associated with Mullerian duct dysplasia.
50 The K lebs classification depends upon the gondal structure.

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 Dr.G.Bhanu Prakash

51 Hysterosalpingography is the most useful method of diagnosing the different

varieties of uterine malformations.
52 Double vagina may accompany split pelvis & absence of one kidney.
53 Sex hormone binding globulin (SHBG) is a key factor in determining
androgen activity.
54 Well formed uterus is never associated with absence of the fallopian tubes.
55 Vaginal abnormalities are often associated with urgenital or urorectal defects
(Duplication of rectum & sigmoid colon with congenital rectovaginal
fistula).
56 the menstrual cycle is usually normal in uterus didelphys and uterus bicornis.
57 Uterus didelphys has the best kprognosis for pregnancy to viability whereas
septate & biocornuate uteri have the poorest progfnosis for pregnancy to
term.
58 The barr body first appears in trophoblast cells at about 12th day & in the
tissues of the fetus itself by 18th day.(Barr body is also detectable in the
nuclei of the cells of the amnion).
59 The development of an ovary depends not so much on an XX chromosome
complement but on the absence of Y.
60 Women who display the testicular feminization syndrome are immune to
virilism (no matter how large a dose of testosterone id administered to them).
61 The number of sex chromation bodies in one less than number of X
chromosomes.
62 Disorders due to consanguinity are most likely inherite according to
Autosomal recessive Mendelian principle.
63 IVP is the most important X-ray study in patients with genital anomalies.
64 The most effective therapy for khiusutism in a young woman with irregular
menstrual cycles is by birth control pills.
65 Peritoneal fluid in women wirth endometriosis contains higher
concentrations of more active macrophages, and higher concentrations of PG
s than normal.
66 Typical peritoneal endometriotic lesion is described as a powder burn, but
recently non-pigmented lesions have been described.
67 Prolapsed is benign except when third degree uterine prolapsed may be
associated with ureteric obstruction.
68 Surgery is the most usual form of treatment for prolapsed and should be
deferred until childbearing and vaginal delivery have been completed.
69 Anterior repair is a reliable cure for a cystourethrocele but is unreliable for
correction of stress incontinence.
70 Tele theraphy is used to treat large volumes.
71 Chemotherapy can be curative in trophoblastic disease and ovarian germ cell
temors.
72 Carboplatin, related to cisplatin but unlike it, does not have neuro or
nephrotoxicity but cause thrombocytopenia.
73 Four pitfalls in colposcopy arefalse squamocolummar junction (SCJ)
caused by abrasion; SCJ in the canal; previously treated cervix; glandular.

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 Dr.G.Bhanu Prakash

74 Most cases of vaginal intraepithetial neoplasia are seen after hysterectomy.

Surgical excision and intracavity radiotherapy are most effective.
75 Menstrual blood is rich in PGE1 PG F2-O,
76 In carcinoma cercvix with pregnancy, wertheims operation is done with abd.
Hysterotomy.
77 In ovarian tumor(symptomatic) with pregnancy, ovariotomy is to be done in
first half of pregnancy and following labour ovariotomy may be done
immediately.
78 Commonest cause of secondary amenorrhea(missing 3-cycles after normal
cycle ) is psychogenic leaving aside pregnancy and premature menopause.
79 Commonest congenital cause of primary amenorrhora is congenital adrenal
hyperplasia.
80 Cottle operation(presacral neurectomy) is done in dysmenorrheal.
81 Metrostaxis is irregular intermenstrual bleeding before puberty and after
menopause.
82 Use of oral contraceptive preparations is relatively contraindicated in
patients with amenorrhoea or oligomenorrhoea.
83 Clomiphene is not indicated unless the complaint is infertility as well as
amenorrhoea.
84 Overtreatment of infrequent menstruation or oligomenorrhoea should be
avoided, particularly in young girls in whom a spontaneous cure can be
expected.
85 Tuberculosis & malingnancy must be excluded in a case of dysfunctional
uterine bleeeing.
86 Curettage should precede hysterectomy in case of DUB.
87 Congenital adrenal hyperplasia is best treated with cortisone.
88 The best time to perform a curettage in a case of abnormal uterine bleeding is
secretory phase.
89 Pituitary adwrfs are deficient in growth factor but gonadotropic functions are
normal.
90 In loctational amenrrhoea, ovulation can occur in the absence of
menstruation.
91 Spasmodic variety of dysmenorrhoea is cured by kpregnancy.
92 Anovular cycles are painless in spasmodic dysmenorrhoea.
93 Progesterone diminishes uterine bleeding chiefly be chemical curettage.
94 Progestogens are more successful in the treatment of primary
dysmenorrhoea.
95 Herpes genitalis of vulva is treated with Local 5% acyclovir ointment.
96 Uncomplicated chronically infected Bartholins cyst is treated with simple
marsupialization.
97 Bowens disease of vulva is treated wwith Simple vulvectomy
98 Pagets disease of vulva is treated with through local vulvectomy(wide local
excision is the treatment of choice).
99 The most likely cause of simple acute ulcer of the vulva is Vincents
organisms.

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 Dr.G.Bhanu Prakash

100 Rete hyperplasia is important in the tissue diagnosis of Lymphogranloma

101 All the pigmented lesions of the vulva should have excisional biopsies.
102 Enlargement in the post menopausal patient should arouse a suspricion of
cancer in Bartholins duct cyst.
103 Pruriits vulvae or a mass in the presenting complaint in vulval carcinoma.
104 The urethral caruncle is best treated by fulgration.
105 Urethral carcinoma is usually treated by Radiation.
106 Breast tissue may be detected in the labia because they are located in the
milk line
107 Microinvasive lesions of vulva should always be regarded as invasive
cancer.
108 Basal cell carcinomas of vulva arise almost exclusively in the skin of labia
majora
109 Congenital angimota of the vulva usually regress
110 Improper use of vaginal tampons complication is Toxic shock syndrome.
111 G. vaginalis vagnitis results in purerperal morbidity, infection & septicemia
after abdominal hysterectomy, with gaseous crepitation in the abdominal
incision.
112 The blebs of emphysematous vaginitis contains CO2.
113 The maximal glycogen content of vaginal epithelium is found in the vaginal
fornices & is lowest in the lower thirdh.
114 Small cell carcinoma of vagina has poor prognosis.
115 Vaginal bleeding or blood discharge is the usual presenting complaint of
vaginal sarcoma.
116 Sarcoma botryoides is thought to arise primarily from vagina.
117 Trichomoniasis tends to be worse just after menstruation or during
pregnancy.
118 Menharbour the Trichomonas vaginalis in the urethra & postate.
119 Vagnitis emphysematosa is otherwise known as colpitis cystica .
120 The adenocarcinoma of vagina are associated with diethylstilbestrol
exdposure.
121 At the pelvic brim, the ureter passes anteriorly to the sacroiliac joints and
crosses the bifurcation of common iliac artery. Thus risk of injury during
oopherectomy.
122 Mullerian agenesis is the commonest cause for an absent vagina in girls.
123 Gondal dysgenesis can occur in an XX individual.
124 Wolffian system is dependent upon androgens for its development.
125 Although the second X-chromosome is usually inactivated. Both X-
chromosomes are required for fertility.
126 The mucous membrance of endocervix has anterior and posterior columns
from which folds radiate out the arbor vitae.
127 The primary concern in the management of congenital anomalies in
childhood is function of the bladder and3bowel.
128 If correction of cervical atresia is unsuccessful, hysterectomy should be
emjployed to avoid the potentially lethal peritonitis that may result.

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 Dr.G.Bhanu Prakash

129 Unilateral renal aplasia isfrequently associated wsith failure of mullerian

development in the same side since both are dependent on adequate of
mesonephric system.
130 Doderleins bacillus in important in maintaining the acid pH in vagina and
thus preventing vaginal infections.
131 There are no true anatomical sphinters to the urethra.
132 The round and ovarian ligaments together form the homologue to the
gubernacutum testis in the male.
133 The power density (PD) is the most important determinant of effects of the
lase upon (GTreater
134 Widespread pertitoneal metastasis occurs in state III ovarian cancer.
135 Vaginal ultrasound has a sensitivity and specificity in the diagnosis of
ectopic pregnancy and also plays ans important role in timing ovulation and
oocyst recovery.
136 Involuntary loss of urine is the most common symptom of cystocele.
137 Procidentia can cause acute angulation of the urethra and result in retention.
138 MRI accurately shows parametrial invasion of cervical cancer but does not
identity LN metastases reliably.
139 The hymen is a derivative of mullerian tubercle.
140 CT scanning may have a role in recurrent cervical cancer but is of limited
value in other gynaecological tumourts.
141 Dysmenorrhoea occurs in both endometriosis and adenomyosis.
142 Adenocarcinoma is the most common malignant tumour arising frm uterine
body.
143 Total abdominal hysterectomy with bilateral salpingo-oophorecttomy is the
treatment of choice in patients with stage I endometrial cancer.
144 Lymphangiography lacks precision in identifying nodal metastases.
145 Nabothian cysts are the features of chronic cervicitis.
146 IVp and chest X-ray are essential investigations in a patient with CA cervix.
147 The pudenda constitutes the female genitalia excluding the gas trointestinal
tract (Anus).
148 Almost all vitamins are found in Breast milk except cyancobalamin (Vit.
B12)
149 The karyotype of a complete hydatidiform mole is 46 XX.
150 Tuboscopy is used to study physiology and anatomy of the tuber and for
selection of patients for IVT.
151 Endometrial destruction is indicated in menorrhagia with a normal sized
uterus.
152 Steroids exert their action through intracellular receptors whereas trophic
hormones act through receptors located on cell membrance then through a
second messenger system within the cell.
153 Androgen, progesterone and glucocorticooid receptors are less precise than
oestrogen receptors in their binding affinity.
154 Synthetic progestogens can bnind to both androgen and progesterone
receptors reflecting the dual biological activities of progestogens.

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155 Due to amplification of hormone signals by the second messenger system,

only 1% of the cell receptors need to be evident.
156 LHRH controls the secretion of both FSH and LH with oavian sex steroids
playing the role in modulating it.
157 Oestrogens decreases Pulse amptitude of gonadtrophin secretion (more so of
FSH and LH) whereas progesterone reduces Pulse frequency of LH as
showing during luteal phase.
158 The role of lprostaglandian E (secreted on stimulation of NE nerve
terminals) in LHRH release may be and intracellular one.
159 There is no place of vulvectomy in the management of lichen sclerosis.
160 Schroeders disease is metropathica haemorrhagica (painless anvulotory
irregular heavy bleeding often preceded by history of amenorrhoea for 2-3
periodes). It constitutes 1/4 to 1/3 cases of DUB and there is cystic glandular
hyperplasia (Swiss cheese opearance)
161 Granulose cell tunor of ovary is important because of menorrhagia, DUB,
post menopausal bleeding and precocious puberty. Due to endometrial
hyperplasia. Carcinoma and endomertiosis may arise.
162 Virilizing tumors are arrhenoblastoma. Dysgerminoma, adrenal rest tumor,
hilus cell tumor and Brenners tumor, Luteoma of pregnancy whereas
feminizing tumor is Granulos cell tumor, thecoma, luteoma and embryonic
cell tumor.
163 For vaginal atresia, the tumor operations used ar --- McIndoes, Williams,
Baldwins, Shrodkars.
164 Absence of fructose in semen indicates blocked ejaculatory ducts.
165 Bonneys or Marchetts test is used instress incontinence.
166 First menstrual period is shortest menstrual cycle minus 18 or longest
menstrual cycle minus 11.
167 Ureterovaginal fistula (UVF) is commonest after Gynae operations (total
hysterectomy) whereas VVF is commonest after obstructed labour.
168 Downregulation by internalization of hormone receptors is a unique
mechanism for limiting polypeptide hormone activity.
169 Hormone replacement therapy is not contraindicated in postmenopausal
women with fibroids.
170 Oestrogen increases target tissue responsiveness to itself by increasing FSH
receptors.
171 The final step in the release of stored LH and FSH and subsequent induction
of further biosynthesis of both following LHRH stimulation involves Ca++,
Protein C, and cAMP.
172 The response of pituitary gland to LHRH depnds upon ovarian sex steroid
environment prevailing and the degree of LHRH stimulation.
173 Receptors for both oestrogen and progesterone are present in grater
concentrations in fibroids than in the adjacent myometrium but the role of
progesterone if any, is unclear.
174 Aetiology is unknown but fibroid growth is thought to be oestrogen
dependent.

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175 Factors contributing to menorrhagia in fibroid uterus includes a mechanical

obstruction to veous drainage; increased total prostaglandin synthesis and
metabolism.
176 Medical therapy with GnRH antagonists alone is unsutitable for long term
management because of hypooestrogenic side effects and regrowth of
fibroids following therapy discontinuation.
177 Asymptomatic benign ovarian cysts in young women often resolve
spontaneously.
178 Ultrasound can not reliably exclude ovarian malignancy.
179 Ovarian failure constitutes the largest single cause of delayed puberty.
180 The effect of danazol on reducing menstrual blood flow, length of period and
length of cycle is dose dependent.
181 The developing placenta (syncytiotrophoblast) begins producing AHCG as
soon as implantation occurs.
182 Ovarian cysts are very rarely malignant in womn below 35 years and if size
below 10 cm diameter.
183 ABO incompatibility is usually manifested by hyperbilirubinaemia in the
neonatal period.
184 There is evidence of rate of PGs in menorrhagea associated with adenmyosis,
uterine fibroid and presence of an IUCD.
185 Maternal cholesterol is the primary precursor of progesterone on the
pregnant lady.
186 Supine hypotension is characteristic of third trimester of Pregnancy.
187 Antifibrinolytic drugs and PG synthetase inhibitors are useful in
menorrhocgia, in those with DUB and IUCD.
188 The smallest distance in the midplane is the distance between the ischial
spines.
189 The distance between ischial tuberosities measures the pelvic outlet.
190 Almost all cases of hydatidiform mole have vaginal bleeding.
191 Eclampsia is frequently associated with renal shutdown and necrosis of the
renal cortex.
192 When the posterior parietal bone presents it is known as posterior
asynclitism. Similarly if anterior parietal presents it is called anterior
asynclitism.
193 HPL stimulates lactation.
194 Solid ovarian tumours are often malignant --- in young women these are
usually germ cel or sex cord stromal tumors.
195 Major oestrogen postmenopausally is oestrone produced by conversion of
adrenal androgens in a dipose tissue.
196 Fall in oestrogen levels lead to increase in LDL and increased chance of
ischaemic heart disease.
197 Oseoporosos that occurs postmenopausally results from loss of collagfen
matrix as the bone is normally calcified.
198 Virilization is very rarely seen without hirsutism (apart from in the neonate)
and is due to excess of androgen production.

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199 Sarcoma butyroides(embryonic sarcoma) is common in infants and children.

200 In nullipare, carcinoma is common in breast , uterus, tubes, vulva and also
benign ovarian cyst of ovary.

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