1.
What is the most common method used for slide preparation after a Pap smear?
Correct Answer
C. ThinPrep
Explanation
ThinPrep: liquide-based medium sent to the lab, automates the preparation of the Pap smear slide so that the variability introduced by the clinician making the slide is no longer a factor
2.
Results from a 35 y/o patient's Pap smear cytology and HPV DNA test are positive, what is the next diagnostic modality?
Correct Answer
D. Colposcopy
Explanation
When a patient's Pap smear cytology and HPV DNA test are positive, the next diagnostic modality is typically colposcopy. Colposcopy is a procedure that allows the healthcare provider to closely examine the cervix, vagina, and vulva using a colposcope, a magnifying instrument. It helps in identifying any abnormal areas that may require further investigation or treatment. By performing colposcopy, the healthcare provider can determine if there are any precancerous or cancerous changes in the cervix and guide subsequent management decisions.
3.
What is the purpose of a cervical cone biopsy?
Correct Answer
C. Removal of the entire tranformation zone
Explanation
this is done after the cervical colposcopy reveals microinvasive cancer
4.
Which method of cervical cone biopsy is most used?
Correct Answer
C. LEEP
Explanation
The most commonly used method of cervical cone biopsy is LEEP (Loop Electrosurgical Excision Procedure). LEEP is a procedure that uses a thin wire loop heated by an electrical current to remove abnormal cervical tissue. It is a safe and effective method that allows for precise removal of the abnormal tissue while minimizing damage to the surrounding healthy tissue. LEEP is preferred over cold knife and laser methods due to its accuracy, ease of use, and lower risk of complications.
5.
Which is not viewed under colposcopy?
Correct Answer
A. Uterus
Explanation
Colposcopy is a procedure used to examine the cervix, vagina, and vulva for any abnormalities. The uterus is not viewed under colposcopy because it is located higher up in the reproductive system and cannot be directly visualized through this procedure.
6.
A 51 y/o postmenopausal patient comes for her annual Pap smear appointment with complaints of intermittent vaginal spotting. The results of the Pap smear are show no dysplasia or abnormal cells. What is the next step?
Correct Answer
C. Schedule her for a endometrial biopsy
Explanation
Endometrial biopsy is the most diagnostic test for abnormal uterine bleeding usually caused by endometrial cancer in postmenopausal women
7.
What procedure is included in the work-up of infertility?
Correct Answer
B. Hysterosalpingogram
Explanation
The procedure included in the work-up of infertility is a hysterosalpingogram. This is a diagnostic test that involves injecting a contrast dye into the uterus and fallopian tubes and then taking X-ray images to evaluate the shape and condition of these structures. It helps to identify any blockages or abnormalities that may be causing infertility.
8.
A 8 y/o female patient presents to Children's hospital with a CC of a sprained ankle. Upon inspection you notice bruising on the affected joint and continues up the medial calf and thigh. You have suspicion of more that just a sprained ankle and decide to order a rape kit. What gynecological instrument should you use?
Correct Answer
D. Vaginoscope
Explanation
Vaginoscopy is used for the examination of children usually to detect penetrating trauma
9.
What is a complication of hysterosalpingogram seen in 1-3% of patients?
Correct Answer
C. Peritonitis
Explanation
Pretreat with short course of doxycycline to prevent
10.
Which procedure is NOT a contraindication to a desired pregnant patient?
Correct Answer
D. Colposcopy
Explanation
Colposcopy is not a contraindication to a desired pregnant patient because it is a diagnostic procedure that allows for visualization and examination of the cervix, vagina, and vulva. It is commonly used to detect and evaluate abnormalities such as cervical dysplasia or cancer. Unlike D&C, hysteroscopy, and endometrial biopsy, colposcopy does not involve the removal or manipulation of the uterine lining or the uterus itself. Therefore, it is considered safe to perform during pregnancy as it does not pose a significant risk to the developing fetus.
11.
When should an inadequate Pap smear sample be repeated?
Correct Answer
C. 4 months
Explanation
Between 3-6 months preferably
12.
What is the most common type of cervical carcinoma?
Correct Answer
B. Squamous cell carcinoma
Explanation
Squamous cell carcinoma is the most common type of cervical carcinoma. This type of cancer originates in the squamous cells that line the outer surface of the cervix. Risk factors for squamous cell carcinoma include infection with high-risk strains of human papillomavirus (HPV), smoking, and a weakened immune system. It typically develops slowly over time and can be detected through regular cervical screenings. Treatment options for squamous cell carcinoma may include surgery, radiation therapy, and chemotherapy, depending on the stage and severity of the cancer.
13.
A 31 y/o female is examined for her annual Pap smear and during the exam you notice a waxy, yellowish irregular surface of the cervix. Results of the cytology are negative for intraepithelial lesions. What should be your next step?
Correct Answer
A. HPV DNA test
Explanation
From what I'm reading, HPV should be routinely done (so this is assuming one has not because it wasn't stated), but also a biopsy should always be done regardless of cytology results. Women over 30 most benefit from the HPV screening because these are usually the cancerous strains verses benign in sexually active women younger than 30 whose immune system usually clears.
14.
What is the follow-up for the previous patient if positive for HPV 16 &18?
Correct Answer
C. Cytology and HPV at 12 months
Explanation
Colposcopy would be if the results were on the 2nd Pap were still cytology normal and HPV positive.
15.
A 28 y/o woman diagnosed with carcinoma in situ (CIS) wishes to preserve her fertility. What is the recommended treatment?
Correct Answer
C. Cervical conization
Explanation
Cervical conization is the recommended treatment for a 28-year-old woman diagnosed with carcinoma in situ (CIS) who wishes to preserve her fertility. Cervical conization involves the removal of a cone-shaped piece of tissue from the cervix, which allows for both the diagnosis and treatment of CIS. This procedure aims to remove the abnormal cells while preserving the rest of the cervix, thus maintaining the woman's fertility. Hysterectomy, on the other hand, involves the surgical removal of the uterus and would result in the loss of fertility. Cervical biopsy and D&C are diagnostic procedures and do not provide definitive treatment for CIS.
16.
What is the absence of bother the cervix and upper part of the vagina?
Correct Answer
C. Complete cervical agenesis
Explanation
Complete cervical agenesis refers to the absence of both the cervix and the upper part of the vagina. This condition occurs when the cervix fails to develop properly during fetal development. It is a rare congenital anomaly that can lead to difficulties in menstruation, sexual intercourse, and fertility. Treatment options may include surgical interventions to create a functional cervix or alternative reproductive methods for individuals wishing to conceive.
17.
What is the treatment for asymptomatic Nabothian cyst?
Correct Answer
C. Nothing until patient discomfort
Explanation
The correct answer is "Nothing until patient discomfort." Asymptomatic Nabothian cysts are benign growths that occur on the cervix. They are usually harmless and do not require treatment unless they cause discomfort or other symptoms. In such cases, treatment options may include draining the cyst or removing it through electrocautery or LEEP (loop electrosurgical excision procedure). However, if the patient is not experiencing any discomfort, it is generally recommended to monitor the cyst and only intervene if necessary.
18.
Red or brownish/blacking areas called "powder burns" are characteristic of what type of lesions on the cervix?
Correct Answer
D. Endometriosis
Explanation
Red or brownish/black areas called "powder burns" are characteristic of endometriosis lesions on the cervix. Endometriosis is a condition where the tissue that normally lines the uterus grows outside of it, causing inflammation and the formation of lesions. These lesions can appear as red or brownish/black areas on the cervix, resembling powder burns. This characteristic feature helps in diagnosing endometriosis in the cervix.
19.
What is the appear of cherry red dots consisting of columnar epithelium surrounded by fibromuscular stroma?
Correct Answer
C. Adenosis
Explanation
Adenosis is the correct answer because it is a condition characterized by the presence of cherry red dots consisting of columnar epithelium surrounded by fibromuscular stroma. Warts, ulcers, and polyps do not exhibit this specific appearance.
20.
What is the most common sexually transmitted infection?
Correct Answer
B. Chlamydia
Explanation
Chlamydia is the most common sexually transmitted infection because it is highly contagious and can be easily transmitted through sexual contact. It is caused by the bacteria Chlamydia trachomatis and can affect both men and women. Chlamydia often does not show any symptoms, which makes it even more prevalent as people may not be aware that they are infected. If left untreated, it can lead to serious complications such as infertility and pelvic inflammatory disease. Regular testing and practicing safe sex are essential in preventing the spread of chlamydia.
21.
What is the most common sx of cervicitis?
Correct Answer
A. Purulent vaginal discharge
Explanation
Consistency of discharge varies with causative organism.
thick and creamy (gonorrhea)
greenish-white and punctuate hemorrhages (Trichomoniasis)
white and curd-like (candidiasis)
thin and gray, soapy water (bacterial Vaginosis)
22.
Chandiler's sign is positive exam finding for which STD?
Correct Answer
A. Pelvic inflammatory disease
Explanation
Chandelier's sign refers to the tenderness elicited during a bimanual examination of the cervix and uterus in cases of pelvic inflammatory disease (PID). This finding indicates that there is inflammation and infection present in the pelvic region. Chlamydia, herpes, and trichomoniasis can also cause PID, but Chandelier's sign specifically points towards PID as the correct answer.
23.
What is the most common finding of chlamydial infections in women?
Correct Answer
A. Asymptomatic
Explanation
Chlamydial infections in women are commonly asymptomatic, meaning that there are no noticeable symptoms present. This is a significant finding because it highlights the importance of regular screenings and testing for sexually transmitted infections, as individuals may not be aware that they are infected. Asymptomatic infections can lead to complications if left untreated, such as pelvic inflammatory disease, infertility, and chronic pelvic pain. Therefore, it is crucial to diagnose and treat chlamydial infections even in the absence of symptoms to prevent further health issues.
24.
What is the diagnostic measures for chlamydia and gonorrhea infections?
Correct Answer
B. Nucleic acid amplification test (NAAT)
Explanation
The correct answer is the nucleic acid amplification test (NAAT). This test is used to diagnose chlamydia and gonorrhea infections by detecting the genetic material (DNA or RNA) of the bacteria. It is a highly sensitive and specific test that can accurately identify the presence of these infections. Physical exam and pap smear are not specific diagnostic measures for chlamydia and gonorrhea, as they may not always detect these infections.
25.
What is the treatment for coverage of both chlamydia and gonorrhea infections?
Correct Answer
B. Doxycycline
Explanation
Doxycycline is the treatment for coverage of both chlamydia and gonorrhea infections. It is a broad-spectrum antibiotic that is effective against both bacteria. Penicillin is not effective against these infections, and levofloxacin is not recommended due to increasing resistance. Metronidazole is used for the treatment of certain parasitic and anaerobic bacterial infections, but it is not effective against chlamydia or gonorrhea.
26.
What is the diagnosis of Trichomoniasis?
Correct Answer
C. Wet mount
Explanation
Trichomoniasis is diagnosed through a wet mount test. This involves examining a sample of vaginal discharge under a microscope to look for the presence of Trichomonas vaginalis, the parasite that causes the infection. The wet mount test is a simple and effective method for diagnosing Trichomoniasis. Vaginal culture, PCR, and HPV test are not specific tests for Trichomoniasis and are used to diagnose other conditions.
27.
What disease is a finding of grouped vesicles with an erythematous background associated with regional adenopathy?
Correct Answer
D. Herpes genitalis
Explanation
Herpes genitalis is a sexually transmitted infection caused by the herpes simplex virus (HSV). It is characterized by the presence of grouped vesicles (blisters) on an erythematous (red) background. These vesicles are typically painful and can appear on the genitals, anus, or surrounding areas. Regional adenopathy, or swollen lymph nodes, is commonly seen with herpes genitalis due to the immune response to the infection. Condyloma acuminate, syphilis, and molluscum contagious are all different conditions with distinct clinical features and are not associated with the specific findings mentioned in the question.
28.
Which is an appropriate treatment for recurrent herpes genitalis?
Correct Answer
C. Valacyclovir 500 mg once a day
Explanation
Valacyclovir 500 mg once a day is an appropriate treatment for recurrent herpes genitalis. Valacyclovir is an antiviral medication that is effective in treating herpes infections. It helps to reduce the severity and duration of outbreaks, as well as prevent the recurrence of symptoms. The recommended dosage for recurrent herpes genitalis is 500 mg once a day.
29.
A patient has multiple painful genital ulcers. Presumptive diagnosis is chancroid. What other diagonstic STDs should be screened?
Correct Answer
B. Herpes and sypHilis
Explanation
In this case, the correct answer is herpes and syphilis. Chancroid is a sexually transmitted infection (STI) that causes painful genital ulcers. Since the patient has multiple painful genital ulcers, the presumptive diagnosis is chancroid. However, it is important to screen for other STIs that can present with similar symptoms. Both herpes and syphilis can cause genital ulcers, so it is necessary to test for these infections to confirm the diagnosis and provide appropriate treatment. Granuloma inguinale is also a possibility, but it is not as commonly associated with painful genital ulcers compared to herpes and syphilis.
30.
Which is not one of the Amsel's criteria for diagnosing bacterial vagninosis?
Correct Answer
B. Vaginal pH >4.5
Explanation
Amsel's criteria for diagnosing bacterial vaginosis include homogeneous vaginal discharge, amine odor when KOH is added, and clue cells on microscopy. Vaginal pH >4.5 is not one of Amsel's criteria for diagnosing bacterial vaginosis.
31.
What is the most common symptom associated with menopause?
Correct Answer
B. Vasomotor response
Explanation
aka hot flashes
32.
A 48 y/o female presents to her PCP with complaints of uncyclic vaginal bleeding. She states she has begun menopause over a year ago. What is should be the primary concern of her physician?
Correct Answer
B. Endometrial malignancy
Explanation
The primary concern of the physician should be endometrial malignancy because postmenopausal vaginal bleeding can be a symptom of this condition. Endometrial malignancy refers to cancer of the lining of the uterus, and it is more common in postmenopausal women. It is important to rule out this possibility through further evaluation and testing to ensure early detection and appropriate treatment if necessary.
33.
What is the management for simple endometrial hyperplasia?
Correct Answer
C. Progestin therapy
Explanation
Progestin therapy is the management for simple endometrial hyperplasia. This treatment involves the use of progestin, a synthetic hormone, to help regulate the growth of the endometrial lining. Progestin helps to counteract the effects of estrogen, which can contribute to the development of endometrial hyperplasia. By using progestin therapy, the growth of the endometrium can be controlled and the condition can be managed effectively. This approach is less invasive than D&C (dilation and curettage) or hysterectomy, making it a preferred option for treating simple endometrial hyperplasia.
34.
What is the first line therapy for osteroporosis?
Correct Answer
A. BispHospHonates
Explanation
Bisphosphonates are the first line therapy for osteoporosis because they are the most commonly prescribed medications for this condition. They work by slowing down the bone breakdown process, which helps to prevent further bone loss and reduce the risk of fractures. Bisphosphonates have been extensively studied and have shown to be effective in increasing bone density and reducing fracture risk in individuals with osteoporosis. They are also well-tolerated and have a good safety profile. Therefore, they are considered the initial treatment option for osteoporosis.
35.
What are the recommendations and indications for a DEXA scan?
Correct Answer
B. Women >60 yoa with risk factors
Explanation
A DEXA scan is recommended for women over 60 years of age who have risk factors for osteoporosis. This is because women in this age group are more likely to develop osteoporosis, and the scan can help detect bone density loss early on. Regular scans every 2 years are suggested to monitor changes in bone density and assess the effectiveness of any interventions. Women over 65 years of age without risk factors may not require a DEXA scan as frequently, with scans every 5 years being recommended instead.
36.
What is the definition of osteoporosis?
Correct Answer
A. T score less than -2.5
Explanation
Osteoporosis is a condition characterized by low bone density and deterioration of bone tissue, leading to increased risk of fractures. The T score is a measurement used to assess bone density, comparing an individual's bone density to that of a healthy young adult. A T score less than -2.5 indicates that the individual has significantly lower bone density compared to a healthy young adult, which is consistent with a diagnosis of osteoporosis.
37.
What are the result of the work-up for a postmenopausal woman?
Correct Answer
A. Estrogen low and FSH & LH high
Explanation
In postmenopausal women, the ovaries stop producing estrogen, resulting in low estrogen levels. Additionally, the pituitary gland increases the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in an attempt to stimulate the ovaries to produce estrogen. Therefore, in a postmenopausal woman, the result of the work-up would show low estrogen levels and high FSH & LH levels.
38.
What is the treatment for systemic symptoms of menopause in a woman without a hysterectomy?
Correct Answer
C. Combined therapy
Explanation
Combined therapy, which includes both estrogen and progesterone therapy, is the recommended treatment for systemic symptoms of menopause in a woman without a hysterectomy. Estrogen therapy alone is not recommended in women with an intact uterus, as it can increase the risk of endometrial cancer. Progesterone therapy is necessary to protect the uterus from the potential harmful effects of estrogen. Therefore, combined therapy is the appropriate choice to provide relief from menopausal symptoms while minimizing the risk of complications.