Gyn Flashcards
(32 cards)
Which of the followings is not progesterone effect? A) endometrial proliferation B) increase of basal body temperature C) development of breast acinars D) endometrial secretion
A) endometrial proliferation
EXPLANATION
Cyclic genital function in women is fundamentally influenced by estrogen and progesterone. Typical progesterone effects are basal body temperature elevation and endometrial secretion, whereas endometrial proliferation occurs in the first half of the cycle due to estrogen action.
The most frequent malignant tumor in adolescents is:
A) cervical cancer
B) clear cell adenocarcinoma of the vagina
C) ovarian cancer
D) rhabdomyosarcoma
C) ovarian cancer
EXPLANATION
Malignant tumors of female genital organs in adolescence are rarely seen. Endometrial cancer does not occur at all, cervical cancer is extremely rare at this age group, although the early start of sexual activity allows early HPV exposure in the latter group. Malignant ovarian tumors are the most common, but these are age-specific tumors (granulosa cell tumor, dysgerminomas, etc.), not characteristic for adults. The clear-cell adenocarcinoma of the vagina may occur where diethylstilbestrol treatment has been routinely used in cases of threatening abortion. Fortunately, in Hungary this therapy was not used.
Which of the following is not characteristic for Turner’s-syndrome?
A) pigmented nevus
B) hypoplastic fingernails and toenails
C) incidence is increasing in newborns with maternal age
D) high-arched roof of mouth
C) incidence is increasing in newborns with maternal age
EXPLANATION
In addition to the typical symptoms described by Turner in 1938, several other minor features can be found in the syndrome, such as pigmented nevus, hypoplastic nails and arcuated palate, but X-monosomy is the consequence of an abnormality in spermatogenesis, so the frequency with maternal age does not increase significantly.
Which of the followings is not characteristic for polycystic ovarian syndrome?
A) increased GnRH pulsatoric frequency
B) increased LH/FSH ratio
C) increased estradiol/estron ratio
D) increased DHEAS level (dehydroepiandrosterone-suphate)
C) increased estradiol/estron ratio
EXPLANATION
LH-hypersecretion is a diagnostic criteria in polycystic ovarian syndrome, while hyperandrogenism is responsible for hirsutism. Recent data have demonstrated increased GnRH pulsation frequency. Estradiol level is decreased in polycystic ovarian syndrome.
Which of the followings is frequently related to hematometra? A) polycystic ovarian syndrome B) hirsutism C) endometriosis D) adnexal torsion
C) endometriosis
Hematometra=retention of blood in uterus
Most common causes of cervicitis: 1) Neisseria gonorrhoeae 2) Trichomonas vaginalis 3) Chlamydia trachomatis 4) Candida albicans A) 1st, 2nd and 3rd answers are correct B) 1st and 3rd answers are correct C) 2nd and 4th answers are correct D) only 4th answer is correct E) all of the answers are correct
B) 1st and 3rd answers are correct
EXPLANATION
The most common cause of cervicitis is Chlamydia trachomatis and Neisseria gonorroeae, more rarely herpes simplex virus, Mycoplasma hominis, Ureaplasma urealyticum and group B streptococci. Their significance is pelvic inflammation that is caused by ascension and its subsequent consequences. In case of vulvovaginitis only local lesions occur, mainly due to changes in the endogenous flora of the vagina, two examples of them are Trichomonas vaginalis and Candida albicans infection.
Applicable medications to treat uncomplicated Chlamydia trachomatis infection: 1) doxycycline 2) erythromycin 3) azithromycin 4) clindamycin A) 1st, 2nd and 3rd answers are correct B) 1st and 3rd answers are correct C) 2nd and 4th answers are correct D) only 4th answer is correct E) all of the answers are correct
E) all of the answers are correct
EXPLANATION
For the treatment of uncomplicated Chlamydia trachomatis infection, doxycycline is usually the first line of therapy, while pregnant women should be treated with erythromycin. In addition to several other antibiotics, azithromycin and clindamycin are also suitable for the treatment.
Malignant ovarian tumors originated from germ cells include: 1) dysgerminoma 2) choriocarcinoma 3) endodermal sinus tumor 4) granulosa-cell tumor A) 1st, 2nd and 3rd answers are correct B) 1st and 3rd answers are correct C) 2nd and 4th answers are correct D) only 4th answer is correct E) all of the answers are correct
A) 1st, 2nd and 3rd answers are correct
EXPLANATION
Malignant epithelial ovarian cancer is rarely present in adolescence; most of the tumors are originated from germ cells. This includes dysgerminoma, choriocarcinoma, endodermal sinus tumor, malignant teratomas and gonadoblastoma. Granulosa cell tumors can be classified as a stromal tumor and is often associated with isosexual pubertal praecox.
Which is the most common cause of secondary amenorrhea? A) hypothalamo-hypophyseal B) ovarian C) uterine D) vaginal E) adrenal
A) hypothalamo-hypophyseal
EXPLANATIONThe most common cause of secondary amenorrhea is hypothalamo-hypophyseal with 61%, not included the hyperprolactinaemia, which represents further 18%. The uterine cause represents only 9%.
Management of abnormal uterine bleeding in adolescents:
A) it is a temporary condition, neither the excessive and prolonged bleeding require treatment
B) may be caused by neoplasms, in order to receive histologic diagnosis curettage needed to perform
C) continuous or cyclic progesterone therapy and oral contraceptives
D) in case of frequent and excessive bleeding, anticoagulants may be effective
E) all of the treatments are correct
C) continuous or cyclic progesterone therapy and oral contraceptives
EXPLANATION
The abnormal uterine bleeding in adolescents is usually due to hormonal disturbances, so curettage is not recommended. The initial treatment, especially in case of excessive and prolonged bleeding are cyclic progesterone therapy, ovulation induction or oral contraceptives,
Characteristics of dysmenorrhea, except:
A) The most characteristic symptom is the lower abdomen pain, other symptoms may include nausea and vomiting
B) The main symptom is nausea and vomiting, and the lower abdomen pain is an often co-occuring symptom
C) The symptoms may occur even after the first childbirth
D) The symptoms may occur after the menarche
E) The symptoms occur primarily in the anovulatory cycles
E) The symptoms occur primarily in the anovulatory cycles
EXPLANATION
The most characteristic symptom of dysmenorrhea is the lower abdomen pain, other symptoms may include headache, nausea and vomiting. It can be classified as either primary or secondary based on the absence or presence of an underlying cause. The most common cause of secondary dysmenorrhea is organic, it may occur even after the first childbirth. The symptoms does not occur in the anovulatory cycles because of the low prostaglandin level of the endometrium.
Which are the characteristic symptoms of the adenomyosis?
A) dysmenorrhea
B) hypermenorrhea
C) infertility is a main symptom
D) uterine enlargement
E) all of the symptoms are characteristic
F) A) and C) are correct
E) all of the symptoms are characteristic
EXPLANATION
Adenomyosis= The endometrial tissue infiltrates the myometrium deeply, causing dysmenorrhea and hypermenorrhea. The uterus is usually uniformly enlarged.
Which treatment is not recommended in menorrhagia?
A) Combined oral contraceptive pills
B) Intrauterine system that contains progestogen
C) NSAIDs
D) Endometrial resection
E) In case of unsuccessful initial treatment, surgery can be an effective second line treatment
F) Copper intrauterin device (IUD)
F) Copper intrauterin device (IUD)
EXPLANATION
In the treatment of menorrhagia, combined oral contraceptive pills have an efficiency of about 50-60%. The IUS has about 90%, and the NSAIDs have about 25% of efficiency. If the initial therapy is unsuccessful, endometrial ablation is recommended. Copper intrauterin devices can increase the amount of bleeding, therefore they are not recommended.
Possible causes of amenorrhoea, with withdrawal bleeding that is not responding to proper oestrogen treatment? A) uterus/endometrium dysfunction B) ovarium dysfunction C) ovarian cancer D) dysfunction of the hypophysis E) dysfunction of the hypothalamus
CLOSE ANSWER AND EXPLANATION ×CLOSE ANSWER AND EXPLANATION ×ANSWERA) uterus/endometrium dysfunctionEXPLANATIONDue to the effect of oestrogen the endometrium proceed to proliferation phase, the missing of withdrawl bleeding indicates the lack of responding endometrium.
What is metrorrhagia?
A) regular, heavy menstruational bleeding
B) elongated and heavy menses
C) irregular uterinal bleeding
D) normal menstruation with regular interval and cramps
E) withdrawl bleeding after the end of oestrogen and/or progesteron therapy
C) irregular uterinal bleeding
EXPLANATION
Metrhorrhagia is an irregular bleeding, which can last long. The other alternates are not correct, because the heavy or long bleeding is not metrhorrhagia (it is hypermenorrhea)
Does the GnRH puls frequency change in different parts of the normal menstruational period?
A) higher in follicular phase
B) higher in luteal phase
C) no difference
A) higher in follicular phase
EXPLANATION
The GnRH pulsfrequency is more frequent in the follical phase , unlike in the lutal phase, in which it is less frequen
Contraindication(s) of hysteroscopy: A) retroflected uterus B) uterinal septum C) heavy uterinal bleeding D) acut pelvic inflammatory diases E) All of them F) C and D answers are correct
F)
C and D answers are correct
EXPLANATION
Neither the retroflexion nor the uterine septum are not contraindications of hysteroscopy. Acute pelvic inflammation or heavy bleeding are contraindications
Side effect of chemical and barrier contraception methods, except: A) toxic shock syndrome B) urogenital infection C) pregnancy rate between 5–15% D) fetal congenital malformations E) salpingitis
E) salpingitis
EXPLANATION
The use of chemical spermicides or mechanical barriers can increase the risk of urogenital infection or nonmenstrual toxic shock syndrome. (Toxic shock syndrome is caused from intoxication by one of several related Staphylococcus aureus exotoxins, which colonized the vagina.) Due to the use of teratogenic chemicals may cause congenital malformation by the fetus. The efficacy of chemical or barrier contracpetion methods is not 100 %. Salpingitis do not occur with the use of barriers or spermicides.
Which is not the indication for intrauterine Insemination (IUI) A) unexplained infertility B) Cervical factor C) Ovulation dysfunction D) mild Oligozoospermy (<20 M/ml) E) Tubal occlusion both side
E) Tubal occlusion both side
EXPLANATION
Unexplained infertility, sperm abnormalities, ovulatory or cervical factors are the indication of intrauterine insemination. Tubal occlusion on the both side requires in –vitro fertilization. (IVF)
Absolute contraindications to the use of estrogen –containing contraceptives, except: A) endometrial cancer B) lupus erythematosus C) ulcerative colitis D) fibroid
C) ulcerative colitis
EXPLANATION
Fibroids have more estrogen receptors than has the nearby normal myometrium and estrogen can cause uterine fibroids to grow larger. Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia are absolute contraindication of OC use. Estrogen-containing hormonal contraceptives are contraindicated in patients with positive antiphospholipid antibodies (aPL) in systemic lupus erythematosus. Theres is no known association between OC use and ulcerative colitis progression.
Efficacy of contraception methods from high to low effective:
A) oral contraceptives, IUD, condom
B) condom, IUD, oral contraceptives
C) IUD, oral contraceptives, condom
D) all of them represents the same efficacy
A) oral contraceptives, IUD, condom
EXPLANATION
The highly effective methods are the combined hormonal methods of contraceptions and the last group includes all the barriers. From high to low: OCs-IUD-condom
Clomifen , an orally active antiestrogen is used for: 1) anovulation form of PCO 2) hypoprolactinaemia 3) luteal phase defect 4) abnormal cervical factor A) 1st, 2nd and 3rd answers are correct B) 1st and 3rd answers are correct C) 2nd and 4th answers are correct D) only 4th answer is correct E) all of the answers are correct
B) 1st and 3rd answers are correct
EXPLANATION
1., 3. Are true Clomiphen is an orally active antiestrogen. By inhibiting the negative feedback effect of endogenous estrogen, causes a rise of FSH and LH, stimulation of follicule maturation. Correction of the luteal phase defect is possible by use clomiphen (LH effect)
IVF treatment are recommended: 1) abnormal male coital factor 2) severe oligozoosperm 3) endometriosis 4) tubal occlusion on both sides A) 1st, 2nd and 3rd answers are correct B) 1st and 3rd answers are correct C) 2nd and 4th answers are correct D) only 4th answer is correct E) all of the answers are correct
C) 2nd and 4th answers are correct
EXPLANATION
2.,4. Are true. IVF procedure is preferable in cases of sever male factor infertility or in tubal occlusion. IVF is ineffective in the treatment of endometriosis or by coital abnormalities.
Complications of oral hormonal contraceptions:
1) post pill amenorrhea
2) pulmonary embolism
3) myocardiac infarction
4) bening hepatic tumors
A) 1st, 2nd and 3rd answers are correct B) 1st and 3rd answers are correct C) 2nd and 4th answers are correct D) only 4th answer is correct E) all of the answers are correct
E) all of the answers are correct
EXPLANATION
Complication of oral hormonal contraceptives could be deep vein thrombosis, pulmonary embolism, coronary vascular disease, cerebrovascular accident, post-pill amenorrhea and beging hepatic laesions. Fortunately serious complications are infrequent with the use of reduced hormonal doses.
