Uterine disorders

Question 1

Mucous retention cyst of endocervical columnar cells occurring when a cleft has been covered by squamous metaplasia

Answer 1

Nabothian cyst

Question 2

Most common lesion of the cervix, assoc w/ intermenstrual or postcoital bleeding

Answer 2

Cervical polyps

Question 3

HPV types involved in Cervical dysplasia

Answer 3

16,18,31,33

Question 4

Current classification system in reporting cervical cytology

Answer 4

Bethesda system

Question 5

Histology of endocervix

Answer 5

Columnar glandular cells

Question 6

Histology of ectocervix

Answer 6

Stratified squamous epithelium

Question 7

Screening recommendation of pap smear

Answer 7

3 yrs after onset of sexual activity

Age 21 yrs

Question 8

Frequency of pap smear in less than 30 y/o

Answer 8

annually in conventional method

every 2 yrs in liquid-based method

Question 9

Intervention for ASCUS pap smear result

Answer 9

Colposcopy and biopsy

Question 10

Test used using iodine for cervical squamous cells to contrast for biopsy

Answer 10

Schiller’s test

Question 11

Test used when T-zone cannot be evaluated

Answer 11

Diagnostic conization

Question 12

Grade 1: very mild-mild dysplasia

Answer 12

Low Grade SIL

Question 13

Grade 2-3: mod to cancer-in-situ (mitotic figures contained in epith)

Answer 13

High-grade SIL

Question 14

Mgt for CIN I

Answer 14

Observe, repeat pap smear in 3 mos

Question 15

CIN 2-3 tx

Answer 15

Ablative therapy (cryotx, CO2 laser)
Excisional procedure (LEEP or cold knife conization)
Hysterectomy (if fertility is undesired)

Question 16

FIGO stage I of cervical Ca

Answer 16

confined to the cervix

Question 17

Most common stage of presentation in cervical cancer

Answer 17

Stage III

Question 18

Mainstay tx for cervical Ca

Answer 18

Chemoradiation

Question 19

FIGO stage II

Answer 19

beyond uterus but not to the pelvic wall or to the lower 3rd of the vagina

Question 20

FIGO Stage III

Answer 20

Causes hydronephrosis, involves lower third of vagina

Question 21

Most common cause of death in cervical ca

Answer 21

Uremia

Question 22

HPV type in genital warts

Answer 22

6, 11

Question 23

Only carcinoma that is staged clinically

Answer 23

Cervical cancer

Question 24

Vaccine sched for Quadrivalent HPV vaccine

Answer 24

0-2-6 mos

Question 25

Most common anatomic mullerian anomaly

Answer 25

Category 5: Septate

Question 26

2 Categories of Mullerian anomalies assoc w/ 2nd trimester loss

Answer 26

2: Unicornuate 4: Bicornuate

Question 27

Most common type of myoma/ fibroid

Answer 27

intramural

Question 28

Most common type of myoma assoc with heavy and prolonged bleeding

Answer 28

Submucous myoma

Question 29

What drug is assoc with endometrial polyps

Answer 29

tamoxifen

Question 30

When do you order for biopsy in a patient with endometrial polyp instead of simple UTZ only?

Answer 30

> 35 y/o with AUB

Question 31

Presence of glands and stroma in abberant location

Answer 31

Endometriosis

Question 32

Most common site of endometriosis

Answer 32

Ovaries

Question 33

4 etiology of endometriosis

Answer 33

Retrograde menstruation Coelemic metaplasia Lymphatic / vascular metastasis Iatrogenic dissemination

Question 34

3 cardinal histo features of endometriosis

Answer 34

Ectopic endometrial glands Ectopic endometrial stroma Hemorrhage on adjacent tissues (hemosiderin-laden macrophages)

Question 35

Definitive diagnostic procedure for endometriosis

Answer 35

Laparoscopy

Question 36

Growth of endometrial glands and stroma into the uterine myometrium to a depth of at least 2.5 mm from basalis layer

Answer 36

Adenomyosis

Question 37

Definitive tx for endometriosis

Answer 37

TAHBSO

Question 38

Treatment for ovarian endometriosis >2 cm and adnexal enlargements >8cm

Answer 38

Surgical (TAHBSO)

Question 39

>35 y/o, mostly asymptomatic, but in multiparous, with dysmenorrhea and menorrhagia, diffusely enlarged uterus (2-3x bigger)

Answer 39

Adenomyosis

Question 40

Diagnostic exam for endometrial hyperplasia

Answer 40

``` Endometrial sampling (Cytologic aplasia -most impt determinant for premalignant potential) ```

Question 41

Histo with the highest risk of progression to endometrial cancer

Answer 41

Complex with atypia

Question 42

Pathophy of endometrial hyperplasia

Answer 42

Chronic unopposed estrogen exposure

Question 43

After tx of endometrial hyperplasia, how many months should the biopsy be repeated?

Answer 43

6 mos

Question 44

Most common cause of postmenopausal bleeding

Answer 44

Endometrial atrophy

Question 45

Precursor of endometrial carcinoma

Answer 45

Atypical complex hyperplasia

Question 46

Most common subtype of endometrial cancer

Answer 46

Endometroid

Question 47

Double cervix arising from uterine didelphys with double vagina

Answer 47

Bicollis