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GYNE LE # 3 / 2015 d) Vascular content of the urethral submucosal cavernous

1. Which of the following refers to the complaint of a sudden plexus

compelling desire to urinate that is difficult to postpone?
a) Urge 9. Pilocarpine, a parasympathomimetic alkaloid can have which of
b) Urgency the following actions?
c) Urinary incontinence a) Stimulates bladder contraction, relaxes urethral sphincter.
d) None of the above b) Relaxes detrusor muscle, contracts urethral sphincter.
c) Stimulates bladder contraction, contract urethral sphincter
2. Which of the following refers to the complaint of the involuntary d) Relaxes detrusor muscle and urethral sphincter.
loss of urine?
a) Urge 10. Terbutaline, a beta adrenergic stimulator, can have which of the
b) Urgency following actions?
c) Urinary incontinence a) Detrusor muscle relaxion
d) None of the above b) Detrusor muscle contraction
c) Urethral sphincter relaxation
3. Which of the following is the most common pathogen of cystitis in d) None of the above
a) Escherichia coli 11. Treatment of asymptomatic bacteriuria is recommended in which
b) Klebsiella pneumonia of the following conditions?
c) Staphylococcus saprophyticus a) A 65 years old woman with co-morbidities
d) Proteus mirabilis b) A 40 years old diabetic
c) A 28 year old at 26 weeks AOG
4. What is the origin of Loop I in the autonomic and somatic d) A 32 years old woman.
nervous system feedback loops in the act of voiding?
a) Brain stem 12. Persistent or recurrent cystitis following the initial infection with
b) Bladder wall the same organism is also termed as:
c) Urethra a) Relapse
d) Frontal Lobe b) Reinfection
c) Both a and b
5. What is the origin of Loop IV in the autonomic and somatic d) Neither a or b
nervous system feedback loops in the act of voiding?
a) Coordination 13. A patient came to your clinic due to dysuria. Physical examination
b) Detrusor muscle contraction to empty bladder showed urethra that is tender to palpation with pus expressed
c) Allows relaxation of urethral sphincter on synchrony with from it. Gram stain showed intracellular diplococci. What is your
detrusor action management for this patient?
d) Volitional content of striated external urethral sphincter a) Cephalexin 250 mg
b) Nitrofurantoin 50 mg TID
6. Parkinsons disease, brain tumors and trauma can have an effect c) Ceftriaxone 125 mg IM
on which feedback loop? d) Trimethoprim 100 mg
a) Loop I
b) Loop II 14. The following are methods of pelvic muscle strengthening
c) Loop III except?
d) Loop IV a) Kegel exercises
b) Biofeedback
7. Bladder detrusor contractility is stimulated by the activity of the c) Isometric with vaginal cones
parasympathetic nervous system mediated primarily by which d) Pessary use
a) Acetylcholine 15. What is the stage if the most distal portion of the prolapse is less
b) Norepinephrine than or equal to 1cm proximal or distal to the plane of the hymen?
c) Dopamine a) Stage 0
d) Histamine b) Stage I
c) Stage II
8. Intravesical pressure depends on which of the following factors? d) Stage III
a) Volume of fluid in the bladder
b) Smooth muscle fibers of the urethral submucosal 16. What is the stage if there is essentially complete aversion of the
cavernous plexus total length of the lower genital tract?
c) Passive elasticity of the urethral wall a) Stage II
b) Stage III

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c) Stage IV b) Hymen.
d) Stage V c) Perineal body.
d) Symphysis pubis.

17. Non operative management of urethra, and cystocele include

which of the following? 24. Differential diagnosis for cystocele and eretherocele includes the
a) Pessary following except
a) Use of tampons a) Bladder Tumor
b) Kegel exercises b) Bladder Diverticula
c) All of the above c) Urethral Diverticula
d) Urolithiasis
18. The following are inciting factors in pelvic organ prolapse except
a) Childbrith 25. Which of the following is a surgical management f a cystocele or
b) Nerve dosage Uretherocele?
c) Tissue absorption a) Anterior Colpoplasty
d) Gender b) Perinearhaphy
c) Posterior Colporhaphy
19. Patient ME, 45 years old G3P3 (2003) came fore consult due to d) Culdoplasty
falling out feeling in the vagina. She also complains of constipation
with a feeling of incomplete emptying of rectum at time of 26. Which surgical management of uterine prolapse should be
management. On pelvic examination, there is bulging of the rectum intended to younger women who wish to maintain their
into the vagina. On rectovaginal exam, the rectovaginal septum is reproductive abilities as they may lead to cervical incompetence
paper thin. Transillumination of the bulge showed small bowel a) Manchester operation
shadows within the sac. What is your diagnosis? b) Le Fort Colpo
a) Rectocele c) Anterior Colporhaphy
b) Urethrocele d) Vaginal Hysterectomy
c) Enterocele
d) Cystocele 27. Which of the following defines endometriosis
a) Presence and growth of stroma in lining of the uterus in an
20. Which of the following conditions has a high rate of recurrence aberrant or heteroectopic location
even after repair? b) Presence and growth of glands and stroma of the lining of
a) Rectocele the uterus in an aberrant heterotrophic location
b) Cystiocele c) Presence and growth of glands of the lining of the uterus in
c) Enterocele an aberrant or heterotrophic location
d) None of the above d) presence of growth of glands and stroma of lining of the
uterus into the uterine myometrium
21. Which of the following ligaments hold the uterus and upper
vagina in the proper location over the levator plane? 28. Adenomyosis is the growth of endometrial glands and stroma
a) Cardinal and uterosacral ligaments into the uterine myometrium to what depth?
b) Round and cardinal ligaments a) to a depth of at least 2.0 mm from the basalis layer of the
c) Broad and cardinal ligaments endometrium
d) Round and uterosacral ligaments b) in a depth of at least 2.5 mm from the basalis layer of the
22. Which of the following statements is true regarding the use of c) to a depth of at least 2.5 mm from the functionalis layer of
estrogen in pelvic organ prolapse? the endometrium
a) In older women, use of vaginal estrogen product may d) to a depth of at least 2.5 cm from the basalis layer of the
improve vaginal atrophy and patient comfort if the endometrium
prolapsed vaginal mucosa is irritated or ulcerated.
b) Evidence has shown that vaginal estrogen can treat POP. 29. Which of the following theories best explain why endometriosis
c) Evidence has shown that vaginal estrogen can prevent is frequently found in patients with outflow tract obstruction?
POP. a) Metaplasia
d) Vaginal estrogen should not be used in irritated vaginal b) Lymphatic and vascular metaplasia
mucosa. c) Retrograde menstruation
d) Immunological changes
23. Measurements in the quantitative description of the pelvic
prolapse are expressed in centimeters above or below which 30. Endometriosis has been discovered in prepubertal girls, women
structure? with congenital absence of uterus and very rarely in men, These
a) Genital hiatus examples support which theory od Endometriosis

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a) Metaplasia c) Fixed retroverted uterus with scarring and tenderness
b) Lymphatic and vascular metaplasia posterior to the uterus.
c) Retrograde menstruation d) Fixed retroverted uterus with narrowing of posterior vaginal
d) Immunologic changes fornix.

31. This theory helps explain rare and remote sites of endometriosis
such as spinal column and nose:
a) Metaplasia 39. Which of the following provides the best diagnostic tool for
b) Lymphatic and vascular metastasis endometriosis
c) Retrograde menstruation a) Ultrasound
d) Immunologic changes b) MRI
c) CT Scan
32. The 3 cardinal histologic features of endometriosis are d) X-ray
a) estrogenic endometrial glands, ectopic endometrial stroma
b) ectopic endometrial glands, ectopic endometrial stroma, 40. The average age of menopause among Filipina women is
presence if clue cells a) 51 years
c) endometrial growth, endometrial stroma, hemorrhage b) 43 years
within the endometrium c) 49.5 years
d) ectopic endometrial glands, hemorrhage into adjacent d) 47 and 48 years
tissue, hemorrhage within the endometrium.
41. The primary determinants of age of menopause?
33. The primary long term goal in management of endometrium is a) Body mass index
a) Relief of pain b) Age of menarche
b) Promotion of fertility c) Genetic
c) attempt to prevent progression and recurrence of disease d) Parity
d) achieve menstrual suppression 42. Premature ovarian failure or premature ovarian insufficiency is
hypergonadotropic ovarian failure occurring prior to age?
34. Medical therapy for endometriosis initiates the following, except a) 40
a) Danazol b) 45
b) Estradiol?? c) 30
c) GnRH agonists d) 35
d) GnRH antagonist
43. Circulation levels of these hormones decreases in
35. Which of the following is the most active phase of endometriosis postmenopausal women except
a) Red, blood filled lesions a) FSH
b) Clear vesicles b) DHEA
c) Black lesions c) Androstenedione
d) White lesions d) Testosterone

36. Which of the following in the most common site of endometrial 44. Levels of these hormones and gonadal proteins increases in
implant? postmenopausal women except
a) Peritoneum over the uterus a) Activing A
b) Round ligaments b) Luteinizing Hormone
c) Cervix c) FSH
d) Ovaries d) Estradiol

37. Which of the following are the classic sign of endometriosis? 45. The hallmark feature of declining estrogen status in the brain is
a) Cyclic pelvic pain and infertility a) Vasomotor episode
b) Abnormal bleeding and menorrhagia b) Cognitive decline
c) Intermittent constipation and diarrhea c) Memory loss
d) Dysuria and hematuria d) Depressed mood

38.Which of the following is a classic pelvic finding of endometriosis? 46. Which of the following is true of estrogen?
a) Anteverted uterus with narrowing of posterior vaginal fornix. a) It has a negative effect on collagen
b) Anteverted uterus with scarring and tenderness posterior to b) It has been shown to reduce recurrent urinary tract
the uterus. infections
c) It has no proven effect in wound healing

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d) It has no effect on growth functions
49. The following are used to prevent osteoporosis except
47. Estrogen deficiency results in which of the following? a) Conjugated Equine estrogens
a) Thick, paler vaginal mucosa b) Bisphosphonates
b) Higher moisture content of vaginal mucosa c) Tibolone
c) Increased ph of vaginal mucosa d) Testosterone
d) Increased vaginal blood loss
50. The following are possible causes of PCOS except
48. Which of the following statements is true of bone health in a) Classical Gonadal Dysgenesis
menopause? b) 17- Hydroxylase Deficiency
a) Loss of cortical bone is greater with estrogen deficiency c) Hypothyroidisms
than in loss of trabecular bone d) Chemotherapeutic Agents
b) Bone mass in substantially affected by sex steroids
c) Estrogen deficiency in most well established as cause of
bone loss
d) Postmenopausal bone loss is not a substantial health care

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