Female GU & Breast

Question 1

A 35-year old woman received a report from her gynecologist indicating that she had a human papillomavirus (HPV) infection. This is important, because HPV is a risk factor for cancer of the:

Answer 1

Cervix (squamous cell carcinoma)

Question 2

A 35-year old woman complained of heaviness in the abdomen and frequent urge to urinate. Gynecologic examination revealed an enlarged, bulky uterus. What is the probable diagnosis?

Answer 2

Leiomyoma (fibroid)

Question 3

A 28-year old woman had vague lower abdominal pain that intensified at the time of menstruation. What is the possible cause of this pain?

Answer 3

Endometriosis

Question 4

A postmenopausal 52-year old woman who had cessation of menstruation suddenly noted a bloody vaginal discharge. Pap smear was normal, but endometrial biopsy revealed a malignancy. The most appropriate histological diagnoses is:

Answer 4

Endometrial adenocarcinoma following endometrial hyperplasia

Question 5

A 70-year old woman noted abdominal swelling. The doctor diagnosed ascites and requested a gynecologic consultation. What findings might be expected on gynecologic examination?

Answer 5

Ovarian cancer

Question 6

A 30-year old woman stopped menstruating and developed chest hair. Such virilization could be caused by:

Answer 6

Polycystic ovary syndrome

Question 7

A pregnant woman presented to the emergency room 5 months after her last menstrual period complaining of spotting. An enlarged uterus, corresponding to a 7-month pregnancy was noted. No fetal movement was evident. What is the most likely diagnosis?

Answer 7

Hydatidiform mole

Question 8

A 3-cm breast mass was found in a 20-year old woman. What is the most likely diagnosis?

Answer 8

Fibroadenoma

Question 9

Painful, small nodules in both breasts were noted in a 40-year old woman. What is the most likely diagnosis?

Answer 9

Fibrocystic change of the breast

Question 10

A 3-cm mass was palpated in the breast of a 45-year old woman. What is the most likely diagnosis?

Answer 10

Invasive ductal carcinoma (adenocarcinoma)

Question 11

A viral induced, benign, squamous lesion that occurs on the vulva, perianal region, perineum, vagina, and cervix. A characteristic finding is the koilocyte, an epithelial cell with a perinuclear halo that contains human papilloma virus (HPV):

Answer 11

Condyloma

Question 12

a common cause of sexually-transmitted genital infections. After an incubation period of 1 to 3 weeks, small vesicles develop on the vulva and erode into painful ulcers:

Answer 12

Herpes simplex type 2

Question 13

An infection of the pelvic organs that follows the extension of microorganisms beyond the uterus:

Answer 13

Pelvic inflammatory disease

Question 14

The most common cancer of the vulva:

Answer 14

Squamous cell carcinoma

Question 15

Replacement of the normal squamous epithelium of the vagina by a glandular epithelium (metaplasia). Exposure to diethylstilbestrol during prenatal life is associated with this disease:

Answer 15

Vaginal adenosis

Question 16

Generally a disease of the vaginal tissue of older women:

Answer 16

Squamous cell carcinoma

Question 17

A spectrum of epithelial changes that begin with minimal atypia and progress to invasive squamous cell carcinoma:

Answer 17

Cervical intraepithelial neoplasia (CIN)

Question 18

Implicated in the pathogenesis of cervical cancer:

Answer 18

HPV

Question 19

The presence of endometrial glands and stroma deep within the myometrium. Patients with this disease frequently present with pelvic pain, dysfunctional uterine bleeding, dysmenorrhea, and dyspareunia:

Answer 19

Adenomyosis

Question 20

The presence of benign endometrial glands and stroma outside the uterus. Early foci on the ovary or peritoneum appear as red/bluish (“mulberry”) nodules. Causes dysmenorrhea. Infertility is the chief compliant in one third of women with this disease.

Answer 20

Endometriosis

Question 21

Abnormal bleeding during or between menstrual periods, in which the cause lies outside the uterus. Most cases are related to an endocrine disturbance:

Answer 21

Dysfunctional uterine bleeding

Question 22

Inflammation of the fallopian tube typically resulting from ascending infections. Infertility is a complication:

Answer 22

Salpingitis

Question 23

Persistent anovulation, small ovarian cysts, and clinical manifestations related to the secretion of excess androgens. Patients typically present with amenorrhea, hirsutism (excess body hair), obesity, and infertility:

Answer 23

Polycystic ovary syndrome

Question 24

The second most frequent gynecologic malignancy after endometrial cancer. In the US it carries a higher mortality rate than all other genital cancers combined:

Answer 24

Ovarian cancer

Question 25

The ovarian counterpart of testicular seminoma and is composed of activated germ cells. Extremely sensitive to radiation:

Answer 25

Disgerminoma

Question 26

A tumor of germ cell origin that shows differentiation toward somatic structures:

Answer 26

Teratoma

Question 27

A rare germ cell tumor that mimics trophoblast of the placental villi. Human chorionic gonadotropin is a serum marker:

Answer 27

Choriocarcinoma

Question 28

_______ is a complex of symptoms, including hypertension, proteinuria, and pathologic edema. It occurs in 6% of pregnant women during the last trimester (more commonly with the first child). If convulsive seizures appear, the disorder is termed _______:

Answer 28

Preeclampsia Eclampsia

Question 29

The spectrum of trophoblastic disorders characterized by abnormal proliferation and maturation of trophoblast.

Answer 29

Gestational trophoblastic disease

Question 30

A gestational trophoblastic disease in which the uterus fills with placental tissue containing swollen chorionic villi. There is no embryo. Results from the fertilization of an ovum that lacks functional DNA.

Answer 30

Complete hydatidiform mole

Question 31

Has 69 chromosomes (triploidy) and results from fertilization of a normal ovum with two spermatozoa. Fetal parts are present:

Answer 31

Partial hydatidiform mole

Question 32

A malignant tumor derived from fetal trophoblast. It is a tumor allograft and thus unique among human cancers. May evolve from complete hydatidiform mole.

Answer 32

Gestational choriocarcinoma

Question 33

Women exposed to diethylstibesterol (DES) in utero have an increased risk of developing which tumor of the female reproductive system?

Answer 33

Clear cell adenocarcinoma

Question 34

Name a benign germ cell tumor of the ovary:

Answer 34

Dermoid cyst

Question 35

Name the tumor that originates in the bladder, cervix, vagina, and vulva, but is rare in the ovary:

Answer 35

Squamous cell carcinoma