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Anatomy Review GY02-GY03.

1.Vulva.
***) All of the following structures are included in the term vulva, except:
A. Clitoris
B. Urethral orifice
C. Labia minora
D. Nabothian cysts
E. Bartholins glands
Answer: D* Nabothian cysts
***) The nerve supply to the vulva is derived from all of the following nerves,
except:
A. The pudendal nerve
B. The ileo-inguinal nerve
C. The genito-femoral nerve
D. The posterior cutaneous nerve to the thigh
E. The inferior hemorrhoidal nerve
Answer: E* The inferior hemorrhoidal nerve

2.Vagina.
***) All of the following are true about vagina, except:
A. The pH is 4
B. It contains no glands
C. Whitish non-offensive discharge is normal finding
D. Doderlein's bacilli is abnormal finding
E. Posterior wall is longer than anterior wall
Answer: D* Doderlein's bacilli is abnormal finding
***) The normal vagina in the reproductive age is characterized by all of the
following, except:
A. Contains Doderleins bacilli
B. Lined by stratified squamous epithelium
C. Has a pH of 4.5
D. The epithelium contains secretory cells
E. Is divided by the cervix into four fornices
Answer: D* The epithelium contains secretory cells
***) The lining epithelium of the vagina is:
A. Stratified squamous epithelium

B.
C.
D.
E.

Simple columnar epithelium


Tall columnar epithelium
Transitional epithelium
Ciliated columnar epithelium

Answer: A* Stratified squamous epithelium


***) All of the following effects occur on the vagina by estrogen, except:
A. The vagina becomes more vascular
B. The vaginal epithelium grows
C. The vaginal glands start to secret
D. The epithelium cells become filled with glycogen
E. The glycogen is broken by Doderlein's bacilli which cause lowering of
vaginal pH
Answer: C* The vaginal glands start to secret

3.Uterus.
***) The uterine artery is a branch of one of the following:
A. External iliac artery
B. Internal iliac artery
C. Common iliac artery
D. Middle sacral artery
E. Obturator artery
Answer: B* Internal iliac artery
***) The best support to the uterus is by:
A. The broad ligaments
B. Infundibulopelvic ligaments
C. Round ligament
D. Utero-ovarian ligament
E. Cardinal ligament
Answer: E* Cardinal ligament
***) The round ligament of the uterus terminates in one of the following:
A. Symphysis pubis
B. Iliac crest
C. Upper portion of labium majus
D. Upper portion of labium minus
E. Upper portion of inguinal canal
Answer: C* Upper portion of labium majus

***) Regarding lower uterine segment, all the following are true except:
A. It represents isthmus in non pregnant uterus
B. It lies between the anatomical and histological internal os
C. It is a passive segment compared to the upper segment which is active
D. In obstructed labor it can form Bandl's ring
E. It is the least site of rupture in obstructed labor with no previous CS scar
Answer: E* It is the least site of uterus in obstructed labor with no previous
CS scar

4.Ovaries.
***) The left ovarian vein empties in one of the following:
A. Vena cava inferior
B. Left common iliac vein
C. Left internal iliac vein
D. Left renal vein
E. Left external iliac vein
Answer: D* Left renal vein
***) The most inner part of a mature Graafian follicle is:
A. Theca interna
B. Theca externa
C. Granular cell layer
D. Zona pellucida
E. Ovarian stroma
Answer: D* Zona pellucida
***) Maximal number of germ cells in the ovary occurs at:
A. 20-22 weeks of intrauterine life
B. 30 weeks of intrauterine life
C. Birth
D. Menarche
E. Age of 25 years
Answer: A*20-22 weeks of intrauterine life
***) Ovarian failure causes atrophic changes in all of the following, except:
A. Uterus
B. Vagina
C. Urethra
D. Bone
E. Rectum

Answer: C* Urethra

Menstruation GY03-GY06.
1.Menstrual Cycle.
***) Regarding menstrual cycle, all the following are true except:
A. Increasing levels of FSH from anterior pituitary gland
B. FSH release is influenced by gonadotropin releasing hormone from
hypothalamus
C. FSH promotes follicular development in the ovary
D. Ovulation occurs 14 days from 1st day of the cycle
E. The endometrium undergoes proliferation during 1st half of the cycle
Answer: B* FSH release is influenced by GnRH from hypothalamus
***) In a normal menstrual cycle of 35 days duration, ovulation occurs:
A. Two weeks before menstrual flow
B. Mid cycle
C. Time of maximum progesterone production
D. Two weeks after the onset of the menstrual flow
E. Time of maximum prolactin production
Answer: A* Two weeks before menstrual flow
***) Severe hyperstimulation syndrome associated with gonadotropin
therapy may be manifested clinically by the following, except:
A. Abdominal pain
B. Ascites
C. Follicular cysts
D. Hypovolemic shock
E. Thrombo-embolic episodes
Answer: A* Abdominal pain
***) Physiologic processes that are estrogen dependent in women include all
the following except:
A. Menses
B. Vaginal cornification
C. Hirsutism
D. Appearance of axillary hair
E. Production of cervical mucus
Answer: C* Hirsutism

Common Procedures GY09-GY12.


1.Dilatation and Curettage.
***) In a 38 years old woman complaining of irregular and heavy periods, the
first line of management is:
A. Vitamin K injections
B. Dilatation and curettage (D&C)
C. Hormone therapy
D. Immediate hysterectomy
E. Radiotherapy
Answer: B* Dilatation and curettage (D&C)
***) Complication of Dilation and Curettage D&C include all of the following,
except:
A. Uterine perforation
B. Injury of the urethra
C. Cervical laceration
D. Cervical stenosis
E. Asherman's syndrome
Answer: B* Injury of the urethra

2.Laparoscopy.
***) Laparoscopy is a useful investigation to diagnose one of the following
conditions:
A. Adenomyosis
B. Congenital uterine abnormalities
C. Premature ovarian failure
D. Endometriosis
E. Vaginal atresia
Answer: D* Endometriosis

3.Hysteroscopy.
***) The following are contraindications for Hysterosalpingography, except:
A. Uterine bleeding
B. Active pelvic infection
C. Suspected pregnancy
D. Bicornuate uterus
E. Active cervicitis
Answer: D* Bicornuate uterus

Disorders of Menstruation GY12GY16.


1.Amenorrhea.
***) Concerning primary amenorrhea, all the following are true except:
A. Investigations include serum FSH
B. Is associated with karyotype 45 XO
C. May be due to congenital adrenal virilism (hyperplasia)
D. May be due to Mullerian duct fusion failure
E. May be due to granulous cell tumors of the ovary
Answer: E* May be due to granulous cell tumors of the ovary
***) All of the following may cause primary amenorrhea, except:
A. Cryptomenorrhea (imperforate hymen)
B. Testicular feminization syndrome
C. Turner's syndrome
D. Gonadal agenesis
E. Dermoid cyst of the ovary
Answer: E* Dermoid cyst of the ovary
***) Amenorrhea in a 16 years old girl may result from all of the following
conditions, except:
A. Imperforate hymen
B. Androgen insensitivity syndrome (testicular feminization syndrome)
C. Turner's syndrome
D. Bicornuate uterus
E. Pituitary tumor
Answer: D* Bicornuate uterus
***) Absence of vagina is common in:
A. Congenital adrenal hyperplasia
B. Turner's syndrome
C. In Mullerian atresia with absent uterus
D. With absent uterus in testicular feminization syndrome
E. Drug induced masculinization
Answer: C* In Mullerian atresia with absent uterus
***) The following statements are true regarding hematocolpos, except:
A. It causes primary amenorrhea
B. The patient may present with urine retention

C. The patient may present with abdominal mass


D. The treatment is incision of hymen
E. Breasts atrophy may occur
Answer: E* Breasts atrophy may occur
***) An imperforate hymen in a girl may be associated with all of the
following, except:
A. Retention of urine
B. Hematocolpos
C. Periodical abdominal pain
D. Amenorrhea
E. Absent uterus
Answer: E* Absent uterus
***) Concerning secondary amenorrhea, all the following are true except:
A. May be due to thyrotoxicosis
B. May be due to anorexia nervosa
C. Investigations include prolactin levels
D. Oral contraceptives can be used in treatment
E. Clomiphene can be given as treatment
Answer: E* Clomiphene can be given as treatment
***) All of the following may cause secondary amenorrhea, except:
A. Lactation (breast feeding)
B. Endometriosis
C. Pituitary failure
D. Early menopause
E. Pregnancy
Answer: B* Endometriosis
***) One of the following investigations is necessary in patients with primary
amenorrhea:
A. Serum TSH
B. Serum prolactin
C. Dilation and Curettage
D. Chromosomal analysis
E. Hysteroscopy
Answer: D* Chromosomal analysis
***) In secondary amenorrhea, elevated FSH over 40 nmol/u, indicates:
A. Polycystic ovary syndrome

B.
C.
D.
E.

Ovarian failure or resistance


Pituitary failure
Anorexia nervosa
Hypothalamic amenorrhea

Answer: B* Ovarian failure or resistance


***) Raised FSH levels are found in all of the following, except:
A. Post menopausal woman
B. Turner's syndrome
C. Prepubertal girls
D. Gonadal dysgenesis
E. Kleinfelter's syndrome
Answer: C* Prepubertal girls
***) All of the following are true about effect of androgens on the external
genitalia of a female fetus, except:
A. Clitoral hypertrophy
B. Labia fusion to form scrotum
C. May give varying degrees of hypospadia
D. It may cause adrenogenital syndrome
E. It may cause closure of the Bartholin gland duct
Answer: E* It may cause closure of the Bartholin gland duct
***) Signs of virilism include all of the following, except:
A. Excessive body hair
B. Muscle development
C. Deepening of the voice
D. Clitoromegaly
E. Occipital balding
Answer: E* Occipital balding
***) The most common pelvic mass associated with amenorrhea in a
reproductive age woman is:
A. Follicular cyst
B. Corpus luteum cyst
C. Benign cystic teratoma
D. Leiomyoma
E. Pregnancy
Answer: E* Pregnancy

2.Abnormal Uterine Bleeding.


***) The most likely cause of abnormal genital bleeding in a 13 year old girl
is:
A. Uterine cancer
B. Ectopic pregnancy
C. Threatened abortion
D. Cervical cancer
E. Anovulation
Answer: E* Anovulation
***) Regarding dysfunctional uterine bleeding all of following are true,
except:
A. It is an abnormal menstrual pattern
B. There is no organic disease in the uterus
C. It may cause menorrhagia
D. It may cause prolonged period
E. It is a pre-malignant condition of the endometrium
Answer: E* It is a pre-malignant condition of the endometrium
***) All of the following are true for hemorrhagic metropathia, except:
A. It is a condition of variable periods of amenorrhea
B. It occurs more common with fibroid in the uterus
C. Periods are heavy, continuous and painless
D. It is found more common nearer the menopause
E. It is a feature of anovular cycles in which estrogen levels are high
Answer: B* It occurs more common with fibroid in the uterus
***) The most common cause of heavy bleeding in adolescent girls is:
A. Uterine fibroid
B. Endometriosis
C. Dysfunctional uterine bleeding
D. Cervical erosion
E. Hypothyroidism
Answer: C* Dysfunctional uterine bleeding
***) Vaginal bleeding in the newborn female infant is most commonly due to:
A. Trauma
B. Estrogen withdrawal
C. Infections
D. Neoplasms
E. Hemorrhagic disease of the newborn

Answer: B* Estrogen withdrawal


***) A 4 days old female healthy baby presented to your clinic with vaginal
bleeding, the most appropriate action to do is:
A. Refer to gynecologist
B. Do PT and PTT
C. Reassure the parents
D. Do pelvic US
E. Give vitamins and iron
Answer: C* Reassure the parents
***) One of the following drugs is commonly used for dysfunctional uterine
bleeding DUB:
A. Progesterone
B. Testosterone
C. Estrogen
D. Epsilon aminocaproic acid
E. Prostaglandin
Answer: A* Progesterone
***) One of the following is associated with dysfunctional uterine bleeding:
A. Uterine infection
B. Placental polyp
C. Cervical polyp
D. Polycystic ovary
E. Endometrial carcinoma
Answer: D* Polycystic ovary

3.Dysmenorrhea.
***) Regarding dysmenorrhea all of the following are true, except:
A. It is a painful menstruation
B. The spasmodic type is the primary
C. The congestive type is the secondary
D. Membranous dysmenorrhea is most uncommon
E. D&C is the treatment of choice
Answer: E* D&C is the treatment of choice
***) All of the following are true about spasmodic dysmenorrhea (primary),
except:
A. The pain occurs with the onset of menstruation

B.
C.
D.
E.

The pain in colicky in nature


It may associate with nausea and vomiting
It is more common in multi parous women
The pain may radiate from lower abdomen to the inner aspects of the
thighs

Answer: D* It is more common in multi parous women


***) Primary dysmenorrhea at the time of menstruation is caused by:
A. Uterine atony
B. Uterine ischemia
C. Ovulation
D. High level of estrogen
E. Uterine hyper contractility due to prostaglandins release
Answer: E* Uterine hyper contractility due to prostaglandins release

4.Postmenopausal bleeding.
***) Regarding post menopausal bleeding, all the following are true except:
A. May be caused by estrogen therapy
B. Can only occur six months after the cessation of menses
C. May occur due to atrophic vaginitis
D. Dilatation and curettage are mandatory
E. Rarely is due to malignant changes in the endometrium
Answer: E* Rarely is due to malignant changes in the endometrium
***) All of the following may cause postmenopausal bleeding, except:
A. Estrogen therapy
B. Atrophic changes of the vagina
C. Testosterone therapy
D. Cervical malignancy
E. Endometrial malignancy
Answer: C* Testosterone therapy
***) The following are causes of post menopausal bleeding, except:
A. May be caused by estrogen therapy
B. Atrophic vaginitis
C. Endometrial malignancy
D. Cervical carcinoma
E. May be caused by non hormone-producing ovarian tumors
Answer: E* May be caused by non hormone-producing ovarian tumors

***) Causes of post menopausal bleeding are the following, except:


A. Endometrial cancer
B. Cervical cancer
C. Urethral carbuncle
D. Ovarian tumor
E. Prolapse of the uterus
Answer: C*Urethral carbuncle
***) Post menopausal bleeding is managed primarily by:
A. Hormonal replacement
B. Papanicolau smear
C. Dilatation and curettage (D&C)
D. Cervical biopsy
E. Contraceptive pills
Answer: C* Dilatation and curettage (D&C)
***) Postmenopausal bleeding is usually caused by all the following except
one:
A. Cervical lesions
B. Vaginal lesions
C. Hematologic disease
D. Gastroenterological lesions
E. Urinary lesions
Answer: C* Hematologic disease

Endometriosis GY16-GY17.
1.Endometriosis.
***) Regarding endometriosis all of the following are true, except:
A. The endometrium is found in situation other than the uterine cavity
B. It may be found in myometrium
C. The principle feature is menorrhagia
D. It may cause infertility
E. The treatment of choice in young age is hysterectomy
Answer: E* The treatment of choice in young age is hysterectomy
***) Concerning endometriosis, all the following are true except:
A. Causes deep dyspareunia
B. Is often asymptomatic
C. Is frequently pre-malignant
D. Often present as secondary dysmenorrhea

E. Rare outside the pelvis


Answer: C* Is frequently pre-malignant
***) The following are characteristics of endometriosis, except:
A. Period pain is congestive type
B. Periods may be heavy
C. There is intermenstrual bleeding
D. May cause infertility
E. May cause ovarian cysts
Answer: C* There is intermenstrual bleeding
***) All of the following symptoms are associated with endometriosis, except:
A. Dyspareunia
B. Dysmenorrhea
C. Menorrhagia
D. Back pains
E. Amenorrhea
Answer: E* Amenorrhea

***) The most common site of endometriosis externum is:


A. The uterus
B. The pouch of Douglas
C. The ovaries
D. The fallopian tubes
E. The cervix
Answer: C* The ovaries
***) All of the following are theories for causation of endometriosis except:
A. Coelomic metaplasia
B. Endometrial hyperplasia
C. Retrograde menstruation
D. Immunologic deficiency
E. lymphatic spread of endometrial fragment
Answer: B* Endometrial hyperplasia

???) Endometriosis is often associated with all the following except:


Dysmenorrhea
Dyspareunia
Infertility
Amenorrhea
Pelvic pain
Answer: D* Amenorrhea

Adenomyosis GY17-GY17.
1.Adenomyosis.
***) In adenomyosis the endometrial glands are localized at:
A. Pelvic cavity
B. Ovaries
C. Fallopian tubes
D. Bowels
E. Uterine muscle
Answer: E* Uterine muscle

Leiomyomata (Fibroids) GY17-GY19.


1.Leiomyomata.
***) Concerning uterine fibroids the following are true, except:
A. Rarely cause infertility
B. They are not a cause of post menopausal bleeding
C. May be asymptomatic during pregnancy
D. May undergo red degeneration during pregnancy
E. May cause antepartum hemorrhage
Answer: B* They are not a cause of post menopausal bleeding
***) The most common tumor of the uterine corpus is:
A. Adenocarcinoma
B. Squamous carcinoma
C. Leiomyoma
D. Sarcoma
E. Lymphoma
Answer: C* Leiomyoma

***) All of the following complications are associated with intramural fibroid,
except:
A. Excessive uterine bleeding
B. Red degeneration during pregnancy
C. Fatty degeneration
D. Hyaline degeneration
E. Sarcomatous changes in 20% of cases
Answer: E* Sarcomatous changes in 20% of cases
***) The following changes may occur in a fibroid, except:
A. Cystic changes
B. Sarcomatous changes
C. Calcified called "womb stone"
D. Acute fatty degeneration
E. Hyaline degeneration
Answer: D* Acute fatty degeneration
***) The commonest type of bleeding encountered with uterine leiomyoma
(fibroids) is:
A. Post coital bleeding
B. Menorrhagia
C. Metrorrhagia
D. Postmenopausal bleeding
E. Intra-abdominal bleeding
Answer: B* Menorrhagia
***) Uterine fibroid may be associated with all of the following, except:
A. Amenorrhea
B. Menorrhagia
C. Frequency of micturition
D. Infertility
E. Abdominal enlargement
Answer: A* Amenorrhea
***) In a 42 years old female who has menorrhagia due to a uterine fibroid,
the best treatment is:
A. Radiotherapy
B. Myomectomy
C. Total abdominal hysterectomy
D. Hormonal therapy
E. Repeated D&C operations

Answer: B* Myomectomy
***) The most common pelvic mass in postmenopausal women is:
A. Follicular cyst
B. Corpus luteum cyst
C. Germ cell tumor
D. Leiomyoma
E. Endometrioma
Answer: D* Leiomyoma
***) The most common uterine neoplasm is:
A. Sarcoma
B. Adenocarcinoma
C. Choriocarcinoma
D. Adenomyosis
E. Leiomyoma
Answer: E* Leiomyoma

Contraception GY19-GY22.
1.Contraception.
***) The ideal method of contraception for a cardiac patient with mitral valve
disease who desires no more children is by:
A. Birth control pills
B. IUCD (Intra Uterine Contraceptive Device)
C. Laparoscopic tubal ligation
D. Immediate post partum tubal ligation
E. Tubal ligation 40 days after delivery by laparotomy
Answer: E* Tubal ligation 40 days after delivery by laparotomy

2.Hormonal Methods.
***) The most effective contraceptive known is:
A. Diaphragm
B. Condom (Sheath)
C. Synthetic progestin
D. Combined contraceptive pills (estrogen + progesterone)
E. Intrauterine device
Answer: D* Combined contraceptive pills (estrogen + progesterone)
***) About combined oral contraceptive pills one is true:

A.
B.
C.
D.
E.

Predispose to pelvic inflammatory disease (PID)


Predispose to breast tumors
Predispose to ovarian cyst
May be used in patient with heart lesion
Less effective in patient with epilepsy on treatment

Answer: E* Less effective in patient with epilepsy on treatment


***) One of the following is contraindicated in combined oral contraceptive
pills:
A. Multiparity
B. Chronic liver disease
C. Primary dysmenorrhea
D. Bronchial asthma
E. Endometriosis
Answer: B* Chronic liver disease
***) All of the following are contraindications for the use of combined oral
contraceptive pills, except:
A. Liver disease
B. Secondary amenorrhea
C. Thrombo-embolic disease
D. Sickle cell disease
E. Endometriosis
Answer: E* Endometriosis
***) Absolute contraindication for oral contraceptive pills are the following,
except:
A. Carcinoma of the breast
B. Heart disease
C. Lactating mother
D. Liver diseases
E. Thrombo-embolic disease
Answer: C* Lactating mother
***) Contraindications to birth control pills include all of the following, except:
A. Migraine headache
B. Deep vein thrombosis
C. Hypertension
D. Liver adenoma
E. Hirsutism
Answer: E* Hirsutism

***) All of the following are side effects of oral contraceptives, except:
A. Weight gain
B. Hypertension
C. Deep vein thrombosis
D. Strike
E. Hypoglycemia
Answer: E* Hypoglycemia
***) The effectiveness of oral contraceptives is reduced following interaction
with the following drugs, except:
A. Ampicillin
B. Phenobarbitone
C. Phenytoin
D. Thyroxine
E. Carbamazepine
Answer: D* Thyroxine
***) Regarding oral contraceptive pills, one is true:
A. Inhibit release of gonadotropic hormones
B. May lead lo thinning of cervical mucus
C. Lead to reduced platelet aggregation
D. Lead lo increased antithrombin III
E. Increase fallopian tube smooth muscle activity
Answer: A* Inhibit release of gonadotropic hormones
***) The use of combined oral contraceptive pills may increase the risk of one
of the following conditions:
A. Fibrocystic breast disease
B. Hepatic adenoma
C. Salpingitis
D. Ovarian cancer
E. Endometrial cancer
Answer: B* Hepatic adenoma
***) The most common side effect of low-dose oral contraceptive pills is:
A. Breakthrough bleeding
B. Dysmenorrhea
C. Nausea
D. Hypertension
E. Breast pain

Answer: A* Breakthrough bleeding

3.Intrauterine Device.
***) Concerning Intrauterine Contraceptive Device IUCD, choose the correct
answer:
A. Failure rate 2-3 % women every year
B. Increases the incidence of cervical erosion
C. Increases the incidence of Candida infection
D. Contraindicated in patients with cervical polyp
E. Cryocautery to the cervix can be done while IUCD is in situ
Answer: A* Failure rate 2-3 % women every year
***) Intrauterine contraceptive devices (inert type) prevent pregnancy by all
of the possible mechanisms, except:
A. Increase the motility of fallopian tubes
B. Increase the contractility of the uterus
C. Causing aseptic inflammatory reaction in the endometrium
D. Increasing the potential space of uterine cavity
E. Increasing the hostility of the cervical mucus to the spermatozoid
Answer: A* Increase the motility of fallopian tubes
***) One of the following is an absolute contraindication to Intrauterine
Contraceptive Device IUCD:
A. Uterine fibroids
B. Bicornuate uterus
C. Grand multi-parous woman
D. Previous caesarian section
E. Lactation
Answer: B* Bicornuate uterus
***) Contraindications of IUCD are the following, except:
A. Pregnancy
B. Pelvic infection
C. Multigravida
D. Dysfunctional uterine bleeding
E. Patient with heart disease
Answer: C* Multigravida
***) Intrauterine contraceptive device may be associated with following
complications, except:
A. Pelvic infection

B.
C.
D.
E.

Uterine perforation
Ectopic pregnancy
Cervical erosion
Menorrhagia

Answer: D* Cervical erosion


***) The most common method of contraception in Jordan is:
A. Intrauterine device (IUCD)
B. Long acting progesterone injection (Depo-Provera)
C. Diaphragm
D. Spermicidal cream
E. Lactation
Answer: A* Intrauterine device (IUCD)

Infertility GY22-GY24.
1.Female Factors.
***) A 27 years old woman has tried unsuccessfully for 5 months to become
pregnant, The recommended investigation in this case would be:
A. Hormonal assay
B. Hysterosalpingogram (HSG)
C. Endometrial biopsy
D. Laparoscopy
E. None of the above
Answer: E* None of the above
***) All the following are complications of ovulatory inducers, except:
A. Multiple pregnancy
B. Ectopic pregnancy
C. Hypotension
D. Ascites
E. Hypoproteinemia
Answer: E* Hypoproteinemia
***) What percentage of couples in the reproductive age is unable to
conceive after one year of coitus without contraception:
A. 1-2%
B. 15%
C. 30%
D. 50%
E. 75%

Answer: B* 15%
***) All of the following are possible indications of ovulation, except:
A. Increased plasma levels of progesterone in the second half of the cycle
B. Increased basal temperature in the second half of the cycle
C. Follicular stimulating hormone surge at the mid cycle
D. Change in the cervical mucus
E. Mid cycle abdominal pain
Answer: C* Follicular stimulating hormone surge at the mid cycle
***) Ovulation can be diagnosed by the following, except:
A. Measuring day 14 serum progesterone
B. Observing a rise in basal body temperature in the second half of the
menstrual cycle
C. Study of cervical mucus
D. Endometrial biopsy
E. Day 20 serum prolactin
Answer: E* Day 20 serum prolactin
???) Ovulation can be diagnosed by all the following except one:
Measuring day 14 serum progesterone
Observing a rise in basal body temperature in the second half of the
menstrual cycle
Study of the cervical mucus
Endometrial histology
Mittle schmerz (midcyclic pain)
Answer: 1* Measuring day 14 serum progesterone
***) Tests to detect ovulation include all of the following, except:
A. Basal body temperature
B. Endometrial biopsy
C. Estrogen level
D. Progesterone level
E. Vaginal wall cytology
Answer: C* Estrogen level
***) Induction of ovulation may be achieved by giving:
A. Clomiphene citrate
B. Cyproterone acetate
C. Letrozole
D. FSH and LH

E. Tamoxifen
Answer: A* Clomiphene citrate
***) Clomiphene citrate is contraindicated in one of the following:
A. Endometrial hyperplasia
B. Post pill amenorrhea
C. Polycystic ovary (Stein-Leventhal syndrome)
D. Ovarian tumors
E. Infrequent ovulation
Answer: D* Ovarian tumors

2.Male Factors.
***) Normal semen should have the following characteristics, except:
A. Volume 2.5-5 cc
B. Liquefaction in 30 minutes
C. Motility 60-70% after 3 hours
D. After 6 hours only 30% remain motile
E. Sperm count the average normal specimen is 10-20 million per 1 cc
Answer: E* Sperm count the average normal specimen is 10-20 million per 1
cc
***) All of the following may cause azoospermia, except:
A. Blockage of the ducts
B. Klinefelter syndrome
C. Orchitis due to mumps
D. Varicoceles
E. Surgical trauma to the spermatic artery
Answer: D* Varicoceles
***) Male sterilization (vasectomy) causes:
A. Azoospermia
B. Loss of libido
C. A decrease in the volume of the ejaculate
D. Impotence
E. Infection
Answer: A* Azoospermia
***) All of the following are causes of abnormal spermatogenesis except:
A. Cryptorchidism
B. Genetic abnormality

C. Varicoceles
D. Cold environment
E. Drugs
Answer: D* Cold environment
***) All the following environmental factors might adversely affect
spermatogenesis except:
A. Prolonged sitting
B. Febrile illness
C. Hot bath
D. Swimming
E. Frequent saunas
Answer: D* Swimming

Polycystic ovarian syndrome GY24GY25.


1.PCOS.
***) Regarding polycystic ovary syndrome all are true, except:
A. Is best treated by clomiphene
B. Wedge resection is the treatment of choice
C. Absence of LH surge
D. Low or normal FSH
E. High testosterone level
Answer: A* Is best treated by clomiphene
***) Stein-Leventhal syndrome (polycystic ovary) is usually characterized by
all the following, except:
A. Hirsutism
B. Infertility
C. Menorrhagia
D. Obesity
E. Anovulation
Answer: C* Menorrhagia
***) All of the following problems may occur with an ovarian cyst, except:
A. May undergo torsion
B. May undergo rupture
C. May undergo hemorrhage
D. Retention of urine is common

E. May undergo malignant changes


Answer: D* Retention of urine is common
***) Primipara 20 weeks pregnant was found to have ovarian cyst 7x7 cm,
the proper treatment is:
A. Weekly assessment of the size of the cyst
B. Termination of pregnancy
C. Cystectomy after puerperium
D. Cesarean section and cystectomy after 37 completed weeks
E. Laparotomy and cystectomy as soon as discovered
Answer: E* Laparotomy and cystectomy as soon as discovered
***) A 65 years old woman was found to have ovarian cyst 6x6 cm, the
proper treatment is:
A. Observation
B. Laparoscopy
C. Laparotomy and cystectomy
D. Hysterectomy
E. Treatment no need
Answer: C* Laparotomy and cystectomy
***) Regarding polycystic ovaries all are true except:
A. Are associated with hirsutism
B. Are associated with infertility
C. Have an increased risk of malignant change in the ovaries
D. Are associated with obesity
E. Show dense thickening of the capsule
Answer: C* Have an increased risk of malignant change in the ovaries

Gynecological Infections GY25GY32.


1.Vulvovaginitis.
***) One of the following about childhood vulvovaginitis is true:
A. Is commonly due to staphylococcal infection
B. Is commonly due to monilial infection
C. Is caused by thread worms
D. Estrogen cream is of little help
E. Commonly requires treatment with systemic antibiotic

Answer: E* Commonly requires treatment with systemic antibiotic


***) Pruritus vulvae may be present in all of the following, except:
A. Monilial infection
B. Diabetes mellitus
C. Gonorrhea
D. Psychological problems
E. Leukoplakia (vulvar dystrophy)
Answer: E* Leukoplakia (vulgar dystrophy)
***) Which of the following conditions is the most likely cause of vulvovaginal
symptoms in children:
A. Foreign body
B. Lichen sclerosus
C. Physiologic leucorrhea
D. Trauma
E. Non-specific
Answer: E* Non-specific
***) The most common skin disease affecting the vulva is:
A. Psoriasis
B. Vulval cancer
C. Vulval injury
D. Vulval abscess
E. Contact dermatitis
Answer: E * Contact dermatitis
***) Which of the following is most likely to cause vulval pruritus:
A. Anemia
B. Leukemia
C. Heart failure
D. Hypertension
E. Personal hygiene products
Answer: E * Personal hygiene products
*** The most effective treatment of vulvar pruritus associated with atrophic
vulvitis is:
A. Antihistamines
B. Hydrocortisone
C. Alcohol injection
D. Tranquilizers
E. Topical estrogen therapy

Answer: E* Topical estrogen therapy


***) In a patient complaining of bad smelling, frothy and irritative vaginal
discharge, wet smear showed "clue cells", the causative organism is:
A. Candida albicans
B. Gardnerella vaginalis
C. Bacteroides
D. Mycoplasma
E. Trichomonas vaginalis
Answer: B* Gardnerella vaginalis
***) Profuse cream frothy vaginal discharge is characteristic of:
A. Moniliasis
B. Trichomoniasis
C. Gonorrhea
D. Tuberculosis
E. Syphilis
Answer: B* Trichomoniasis
***) Regarding vaginal candidiasis, all the following are true except:
A. Caused by yeast
B. Acid media in the vagina
C. Best treated by metronidazole
D. Commonly associated with vulvar pruritus
E. Patients partner may need treatment
Answer: C* Best treated by metronidazole
***) All of the following are predisposing factors for monilial infection, except:
A. Combined oral contraceptive pills
B. Diabetes mellitus
C. Pregnancy
D. Intrauterine contraceptive device
E. Patients on broad spectrum antibiotics
Answer: D* Intrauterine contraceptive device
***) The commonest cause of vaginal itching during pregnancy is:
A. Non specific vaginal infection
B. Trichomonal vaginal infection
C. Vaginal moniliasis
D. Gonorrhea
E. Cervical erosion

Answer: C* Vaginal moniliasis


***) Blood stained vaginal discharge occurs in the following, except:
A. Carcinoma of the cervix
B. Moniliasis
C. Cervical polyp
D. Senile vaginitis
E. Carcinoma of the body of the uterus
Answer: B* Moniliasis
***) The following might increase vaginal discharge during pregnancy except
one:
A. Bacterial vaginitis
B. Trichomonas vaginalis
C. Candida vaginitis
D. Simple ovarian cyst
E. Physiological
Answer: D* Simple ovarian cyst
***) In vulvo-vaginal hematoma, all the following are true except:
A. Usually related to child birth
B. Is usually painless purple colored swelling
C. Incision and evacuation is the treatment of choice
D. The bleeding is usually of arterial origin
E. Packing is rarely necessary
Answer: C* Incision and evacuation is the treatment of choice

2.Sexually Transmitted Infections.


***) Sexually transmitted diseases include all of the following except:
A. Trichomonas vaginalis
B. Type II herpes hominis
C. Condyloma acuminate
D. Chlamydial infections
E. Tuberculosis
Answer: E* Tuberculosis
***) All of the following are sexually transmitted diseases, except:
A. Trichomoniasis
B. Candidiasis (moniliasis)
C. Condyloma acuminate

D. Gonorrhea
E. Syphilis
Answer: B* Candidiasis (moniliasis)

***) Gonorrhea may affect all of the following, except:


A. Fallopian tubes
B. Urethra
C. Vagina
D. Cervix
E. Bartholin gland
Answer: C* Vagina
***) All the following are true about Neisseria gonorrhoeae, except:
A. Is a Gram-negative coccus
B. Is a Gram-negative bacillus
C. Occurs in pairs
D. Has a capsule
E. Sensitive to penicillin
Answer: B* Is a Gram-negative bacillus
***) Regarding Neisseria gonorrhea culture during pregnancy, the highest
positive culture is got from:
A. Urethra
B. Cervix
C. Vagina
D. Rectum
E. Throat
Answer: A* Urethra
***) Identification of donovan bodies in large mononuclear cells in Gimsastained from vulval lotion during pregnancy is diagnostic of:
A. Chancre
B. Chancroid
C. Granuloma inguinale
D. Lymphogranuloma venereum
E. Sarcoid

Answer: C* Granuloma inguinale


***) Sexually transmitted diseases include all of the following except:
A. Trichomonas vaginalis
B. Type II herpes hominis
C. Condyloma acuminate
D. Chlamydial infections
E. Type I herpes hominis
Answer: E* Type I herpes hominis
***) All of the following diseases are transmitted sexually, except:
A. Cytomegalovirus
B. Hepatitis B
C. Herpes simplex
D. Scabies
E. Granuloma annulare
Answer: D* Scabies
???) All of the following diseases are transmitted sexually, except:
Chancroid
Hepatitis B
AIDS
Gonorrhea
Pemphigoid
Answer: 5- Pemphigoid

3.Bartholin Gland Abscess.


***) In bartholin abscess, one of the following statements is true:
A. It occurs bilaterally in most cases
B. Treatment is by surgery (marsupialization)
C. It may cause infertility
D. The most common causing agent is staphylococcus
E. Antibiotic treatment is enough
Answer: B* Treatment is by surgery (marsupialization)

4.Pelvic Inflammatory Disease.


***) All of the following microorganisms may cause acute salpingitis, except:
A. Neisseria gonorrhea
B. Chlamydia
C. Bacteroids

D. Candida albicans
E. Gram negative streptococci
Answer: D* Candida albicans
***) All of the following conditions may be confused with acute salpingitis,
except:
A. Acute appendicitis
B. Tubal pregnancy
C. Acute pyelonephritis
D. Bartholin's abscess
E. Ruptured ovarian cyst
Answer: D* Bartholin's abscess
***) Management of septic pelvic thrombophlebitis usually will include:
A. Bed rest and analgesics alone
B. Antibiotics alone
C. Antibiotics and heparinization
D. Heparinization alone
E. Immediate vena cava ligation
Answer: C* Antibiotics and heparinization
***) Pelvic fallopian tube adhesions causing infertility may be due to all of the
following, except:
A. Appendicitis
B. A post abortion infection
C. A post puerperal sepsis
D. Adenomyosis
E. Pelvic endometriosis
Answer: D* Adenomyosis
***) Symptoms of PID include all of the following except:
A. Abdominal pain
B. Dyspareunia
C. Amenorrhea
D. Abnormal vaginal discharge
E. Fever and chills
Answer: C* Amenorrhea
***) PID differential diagnosis includes all of the following except:
A. Ectopic pregnancy
B. Endometriosis

C. Spontaneous abortion
D. Intrauterine pregnancy
E. Diverticulitis
Answer: D* Intrauterine pregnancy
***) About tuberculosis of the genital tract, all the following are true except:
A. Most commonly affects the fallopian tubes
B. It is transmitted by hematogenous spread
C. Causes infertility
D. Causes amenorrhea
E. Predisposes to endometrial carcinoma
Answer: E* Predisposes to endometrial carcinoma

Menopause GY33-GY35.
1.Menopause.
***) Concerning menopause the following are correct, except:
A. Serum androstenedione levels increase
B. The quantity of estrogens present increase by obesity
C. Therapy is rarely needed for more than 4 months
D. Combined estrogen and progesterone therapy is best
E. Withdrawal bleeding following combined therapy is not an indication for
curettage
Answer: C* Therapy is rarely needed for more than 4 months
***) During menopause one of the following is true:
A. Serum FSH only is elevated
B. Serum LH only is elevated
C. Both FSH and LH are elevated
D. Serum FSH is low
E. Serum FSH and LH are low
Answer: C* Both FSH and LH are elevated
***) All of the following may occur in menopausal women, except:
A. The breast tend to decrease in size
B. The uterus atrophies
C. The endometrium hyper-atrophies
D. The vaginal mucosa becomes thin
E. The pH of the vagina rises
Answer: C* The endometrium hyper-atrophies

***) All of the following symptoms are true for menopause, except:
A. Irritability
B. Headache
C. Vasomotor instability
D. Backache
E. Ovulation
Answer: E* Ovulation
***) Regarding the climacteric, all the following are true except:
A. Headache
B. Palpitation
C. Hot flushes
D. Low FSH
E. Sweating
Answer: D* Low FSH
***) Menopause is associated with all of the following, except:
A. Hot flushes
B. Insomnia
C. Decreased incidence of myocardial infarction
D. Osteoporosis
E. Loss of libido
Answer: C* Decreased incidence of myocardial infarction

Urogynecology GY35-GY37.
1.Pelvic Prolapse.
***) Symptoms of uterine prolapse are the following, except:
A. Retention of urine
B. Backache
C. Vaginal discharge
D. Vaginal bleeding
E. Heaviness in the vagina
Answer: A* Retention of urine

2.Urinary Incontinence.
***) Concerning stress urine incontinence the following are correct, except:
A. Can be caused by rectocele
B. Is more common in multi parous

C. Long term antibiotic therapy will not improve it


D. Can be treated by anterior colporrhaphy
E. Can be treated by colposuspension
Answer: A* Can be caused by rectocele

Gynecological Oncology GY37-GY51.


1.Uterus.
***) Risk factors of endometrial carcinoma include all of the following except:
A. Estrogen therapy
B. Early menopause
C. Obesity
D. Low parity
E. Adenomatous hyperplasia
Answer: B* Early menopause
***) A 47 year old woman complains of heavy post-coital bleeding. The most
likely origin of his bleeding would be:
A. Cervical polyp
B. Ectropion
C. Carcinoma
D. Nabothian cyst
E. Infection
Answer: C* Carcinoma
***) One of the following drugs causes endometrial hyperplasia:
A. Progesterone hormone
B. Clomiphene citrate
C. Estrogens
D. Combined oral contraceptive pills
E. Bromocriptine
Answer: C* Estrogens
***) The most common symptom of endometrial hyperplasia is:
A. Vaginal discharge
B. Vaginal bleeding
C. Amenorrhea
D. Pelvic pain
E. Abdominal distention
Answer: B* Vaginal bleeding

***) Endometrial carcinoma is most common in which of the following:


A. 10 to 25 years
B. 25 to 30 years
C. 30 to 40 years
D. 40 to 50 years
E. More than 60 years
Answer: E* More than 60 years
***) A 69 years old postmenopausal woman is being admitted for surgical
treatment of endometrial cancer. Which of the following is the best
preoperative test to look for metastasis:
A. Chest X-Ray
B. Hysterosalpingogram
C. Pelvic US
D. Intravenous pyelogram (IVP)
E. Barium enema
Answer: A* Chest X-Ray
***) The primary mode of treatment for endometrial carcinoma confined to
the uterine body is:
A. External beam radiation
B. Intracavitary radium
C. Hysterectomy
D. Chemotherapy
E. Progestin therapy
Answer: C* Hysterectomy
***) All of the following are estrogen actions on the uterus, except:
A. It causes an active development of the myometrium
B. The endometrium undergoes proliferation
C. Stimulates the growth of the glandular component
D. It causes increase of cervical mucus
E. Has no effect on enlargement of the uterus during pregnancy
Answer: E* Has no effect on enlargement of the uterus during pregnancy

2.Ovaries.
***) One of the following ovarian tumors is more likely to cause hirsutism:
A. Theca lutein cyst
B. Androblastoma
C. Krukenberg tumor

D. Serous cystadenoma
E. Follicular cyst
Answer: B* Androblastoma
***) One of the following ovarian tumors is malignant:
A. Follicular cyst
B. Luteal cyst
C. Dysgerminoma
D. Chocolate cyst
E. Dermoid cyst
Answer: C* Dysgerminoma
***) Concerning dermoid cysts the following are correct, except:
A. Are germ cell tumors
B. Are bilateral in 10% of cases
C. Are the commonest cysts defected during pregnancy
D. Are malignant in less than 5% of cases
E. Are frequently XY (karyotype)
Answer: E* Are frequently XY (karyotype)
***) Concerning malignant ovarian tumors, all the following are true except:
A. Are often bilateral
B. Often present as an asymptomatic mass
C. More common post menopause
D. Have a good prognosis after treatment
E. Are mostly hormone secreting
Answer: E* Are mostly hormone secreting
***) The most frequent diagnosed type of ovarian cancer is:
A. Epithelial
B. Germ cell
C. Specialized stromal cell
D. Non-specialized stromal cell
E. Metastatic disease to the ovary
Answer: A* Epithelial
***) The first line of treatment for ovarian cancer is:
A. Radiotherapy
B. Surgery
C. Chemotherapy
D. Radiotherapy and chemotherapy

E. Observation
Answer: B* Surgery
***) The primary lesion of Krukenberg ovarian tumor is commonly in:
A. Large bowels
B. Brain
C. Stomach
D. Bone
E. Liver
Answer: C* Stomach
***) A 65 years old woman was found to have ovarian cyst 6x6 cm, the
proper treatment is:
A. Observation
B. Laparoscopy
C. Laparotomy and cystectomy
D. Hysterectomy
E. Treatment no need
Answer: C* Laparotomy and cystectomy
***) Childhood neoplastic ovarian masses most commonly from:
A. Gonadal epithelium
B. Gonadal stromal
C. Germ cells
D. Sex cord
E. Metastatic disease
Answer: C* Germ cells
***) The most common complication of large cystic teratoma during the first
trimester is:
A. Torsion
B. Rupture
C. Intracystic hemorrhage
D. Solid degeneration
E. Luteinization
Answer: A* Torsion
***) A medium-size ovarian cyst may be subjected to the following except:
A. Torsion
B. Necrosis
C. Infection

D. Rupture
E. Malignant changes if she gets pregnant
Answer: E* Malignant changes if she gets pregnant
???) The commonest malignant tumors of the ovary are:
Germ cell tumors
Epithelial tumors
Metastases from other tumors
Stomal tumors
Knikenburg tumors
Answer: B* Epithelial tumors
???) Most common neoplastic ovarian masses in postmenopausal women
originate from:
Ovarian epithelium
Ovarian stroma
Ovarian germ cells
Ovarian sex cord
Metastatic disease
Answer: 1* Ovarian epithelium
???) Benign cystic teratoma (dermoid cyst) is characterized by one of the
following:
It occurs bilaterally in 50% of cases
It is formed of squamous epithelium only
It is formed of squamous epithelium and sebaceous glands only
It is formed of all three germ cell layers
The commonest ovarian tumor associated with pregnancy
Answer: 1* It occurs bilaterally in 50% of cases

3.Cervix.
***) Regarding carcinoma of the cervix, all the following are true except:
A. Cervical smear is a screening method
B. In the early stages of the disease there are no symptoms
C. Cervical cancer spreads only by direct spread
D. Post coital bleeding can be first sign
E. Adenocarcinoma of the cervix account for 5% of cases
Answer: C* Cervical cancer spreads only by direct spread
***) The lining of cervical erosion is:

A.
B.
C.
D.
E.

Squamous epithelium
Squamous epithelium with keratin
Columnar epithelium
Transitional epithelium
Cervical stroma

Answer: C* Columnar epithelium


***) The histologic differentiation between invasive carcinoma of the cervix
and carcinoma in situ depends upon one of the following:
A. The Papanicolau smear report
B. The basement membrane having been penetrated by abnormal epithelial
cells
C. The finding of cluecells in the basement membrane
D. The finding of increased eosinophilic cytoplasm in the surface epithelium
E. The surface epithelium taking up nils blue sulfate staining
Answer: B* The basement membrane having been penetrated by abnormal
epithelial cells
***) In case of cervical carcinoma in situ in 50 years old woman, the
treatment of choice is:
A. Hysterectomy
B. Cervical cryo-surgery
C. Cervical cone-biopsy
D. Selective biopsy under colposcopy
E. Radiotherapy
Answer: A* Hysterectomy
***) One of the following is recommended for cervical cancer screening:
A. Aspiration from the anterior fornix
B. Cervical canal curettage
C. Aspiration from the posterior fornix
D. Ultrasound to the genital tract
E. Papanicolau (pap) smear
Answer: E* Papanicolau (pap) smear
***) Asymptomatic cervical erosion in a pregnant patient is best managed by:
A. Heat cautery
B. Pap smear and follow up
C. Cone biopsy
D. Cryocautery
E. Cervical amputation

Answer: B* Pap smear and follow up


***) Invasive carcinoma of the cervix commonly present with all the
following, except:
A. Post coital bleeding
B. Intermenstrual bleeding
C. Vaginal discharge
D. Acyclic vaginal bleeding
E. Menorrhagia
Answer: E* Menorrhagia
***) The most common benign neoplasm of the cervix and endocervix is:
A. Leiomyoma
B. Endometriosis
C. Metastasis of uterine cancer
D. Metastasis of ovarian cancer
E. Polyps
Answer: E* Polyps
***) Often the first symptom of cervical cancer is:
A. Leg pain
B. Pain during intercourse
C. Vaginal bleeding
D. Weight loss
E. Vulvar pruritus
Answer: B* Pain during intercourse
???) Cervical smear is a method to detect early cancer of:
Ovarian
Endometrial
Vaginal
Cervical
Urethral
Answer: D* Cervical

4.Vulva.
***) The etiologic agent for vulvar cancer is:
A. Squamous cell hyperplasia
B. Atrophic dystrophy
C. Chronic granulomatous disease
D. Chronic irradiation

E. Unknown
Answer: E* Unknown
***) The most common symptom of vulvar cancer in elderly woman is:
A. Abnormal bleeding
B. Foul smell
C. Pruritus
D. Vulvar atrophy
E. Painful intercourse
Answer: C* Pruritus
***) A blue swelling on the vulva is most likely due to:
A. Melanoma
B. Varicosity
C. Endometriosis
D. Lipoma
E. Hemangioma
Answer: B* Varicosity

5.Vagina.
***) The most common histopathological finding in primary carcinoma of the
vagina is:
A. Clear cell carcinoma
B. Melanoma
C. Squamous cell carcinoma
D. Sarcoma
E. Choriocarcinoma
Answer: C* Squamous cell carcinoma