Deck 13: Female Reproductive System

Question 1

Your 24-year-old female patient complains of tenderness at the entrance of the vagina on the right side. She cannot sit comfortably because of the soreness in the perineal area. On pelvic examination, there is a tender, inflamed, fluctuant cyst at the introitus on the right side. These signs and symptoms are indicative of:

A) Possible malignancy
B) Bartholin cyst
C) Nabothian cyst
D) Candidiasis

Answer 1

Bartholin cyst

Question 2

Which of the following findings on the bimanual examination of a female patient in early pregnancy requires further investigation?

A) Unilateral adnexal tenderness
B) Bluish colored cervix
C) Varicose veins of vaginal walls
D) None of the above

Answer 2

Unilateral adnexal tenderness

Question 3

Your patient who has a uterine fibroid complains of bleeding through up to 10 tampons per day. Excessive bleeding at the time of the menstrual cycle is termed:

A) Menorrhagia
B) Metrorrhagia
C) Dysmenorrhea
D) Premenstrual syndrome

Answer 3

Menorrhagia

Question 4

If amenorrhea is reported by the young female patient, the clinician should attribute this to _____________ until proven otherwise.

A) Pregnancy
B) Ovarian failure
C) Lack of progesterone
D) Menopause

Question 5

Your 24-year-old patient complains of vaginal discharge. When deciding what diagnostics to perform, what is most important to ascertain?

A) Color of the discharge
B) Timing of the menstrual cycle
C) Consistency of the discharge
D) Sexual activity and safe sex practices

Question 6

Which of the following infections can cause an eye infection in the newborn during vaginal delivery?

A) Candida vaginitis
B) Chlamydia trachomatis
C) Trichomonas vaginalis
D) vaginalis

Question 7

A 23-year-old female complains of a white-yellow vaginal discharge with a fishy odor for the last 2 days. A wet prep shows characteristic clue cells (epithelial cells embedded with bacteria). These findings are indicative of:

A) Chlamydia infection
B) Bacterial vaginosis
C) Vaginal candida
D) Gonorrhea

Question 8

In the health history, you ask a young adult female patient about safe sex and the use of contraception. The patient does not understand what you mean by safe sex. This is an indication for:

A) Patient teaching and counseling
B) Promotion of oral contraceptive use
C) Pregnancy testing and counseling
D) Sexually transmitted disease, HIV, and hepatitis testing

Question 9

It is important for the clinician to ask the female patient about multiple sexual partners. It is known that multiple sexual partners increases patient risk for:

A) Human papilloma virus infection
B) Endometriosis
C) Uterine cancer
D) Ovarian cysts

Question 10

A 38-year-old female complains of having trouble with conception. It is important to ask the patient to:

A) Schedule a date for pelvic examination and Pap smear
B) Chart at least three menstrual cycles
C) Take basal body temperature for three cycles
D) B and C

Question 11

A 65-year-old female complains of frequency and urgency of urination, and episodes of urinary incontinence. On pelvic examination, there is a smooth, soft bulge of the anterior vaginal wall that is more pronounced with straining. These findings are indicative of:

A) Rectocele
B) Cystocele
C) Uterine prolapse
D) Anteflexed uterus

Question 12

Which of the following findings on the bimanual examination of a female patient requires further investigation?

A) Retroverted uterus
B) Varicose veins in vaginal wall
C) Cervical motion tenderness
D) Anteflexed uterus

Question 13

During a pelvic examination, a clinician asks the patient to bear down to inspect the vaginal outlet for:

A) Cystocele
B) Rectocele
C) Prolapsed uterus
D) All of the above

Question 14

Your 35-year-old female patient complains of severe cramping with monthly menstrual flow. Painful menstrual periods are termed:

A) Menorrhagia
B) Metrorrhagia
C) Dysmenorrhea
D) Premenstrual syndrome

Question 15

When obtaining the health history of a 60-year-old female, it is important to ask:

A) The age of menopause
B) About any bleeding since menopause
C) About use of any hormone replacement treatment
D) All of the above

Question 16

In order to perform interventions or prescribe medication for the female patient, it is most important to obtain a complete health history. Which of the following is the most important question to ask female patients?

A) Age at menarche
B) Age at menopause
C) Last menstrual period
D) Number of pregnancies

Question 17

Your 16-year-old patient reports that she gets her period sometimes every month and sometimes she skips a month. If menstrual periods are irregular, the term for this condition is:

A) Menorrhagia
B) Metrorrhagia
C) Dysmenorrhea
D) Amenorrhea

Question 18

A 33-year-old female patient complains of white, thick vaginal discharge and severe pruritus of the outer genitalia. On pelvic examination, the vaginal introitus is red and swollen with a thin layer of white exudate. The bimanual examination is normal. A KOH prep is positive for hyphae. These findings are indicative of:

A) Vaginal candidiasis
B) Trichomonas infection
C) Chlamydia
D) Bacterial vaginosis

Question 19

A 32-year-old female reports normal monthly menstrual periods but complains of having trouble with conception. It is important to ask about history of:

A) Dysmenorrhea
B) Sexually transmitted disease
C) Menorrhagia
D) Pap smears

Question 20

A 20-year-old female complains of thin vaginal discharge and pruritus. On pelvic examination, there are "strawberry spots" on the vaginal walls. With this infection, it is important to:

A) Treat the patient's partner
B) Perform sexually transmitted disease and HIV testing
C) Look for characteristic clue cells
D) A and B

Question 21

A 55-year-old woman complains of amenorrhea and hot flashes for the last 3 months. Pregnancy test is negative. The clinician should recognize that menopause is defined as the absence of menses for:

A) 3 months
B) 6 months
C) 1 year
D) 18 months

Question 22

To confirm the diagnosis of amenorrhea due to menopause, blood should be drawn for hormones. Which are the changes that occur with menopause?

A) FSH rises
B) LH decreases
C) LH rises
D) A and C

Question 23

A 39-year-old female patient comes to the clinic for a pelvic examination and Pap smear. She reports that her partner is infected with Condyloma acuminata. In her history, she always has her partner use a condom. The external genitalia, vagina, and cervix appear normal on pelvic examination, but the Pap smear shows dysplasia. The patient is worried that she could be infected with human papilloma virus (HPV). The clinician should:

A) Assure the patient that safe sexual practices protect against HPV infection
B) Explain that there is no condyloma present, so HPV infection is improbable
C) Explain that HPV infection can be transmitted even in the presence of barrier contraception
D) Teach the patient about hysterectomy because she has cervical cancer

Question 24

Your 24-year-old female patient comes to the clinic for a routine pelvic examination and Pap smear. She has no history of abnormal Pap smears. It is recommended that a female of this age obtain a Pap smear:

A) Every year
B) Every 3 years
C) Every 5 years
D) None of the above

Question 25

Your postmenopausal 60-year-old female patient complains of vaginal irritation and pruritus of the external genitalia. She self-medicated with an over-the-counter anti-candida agent; however, the vaginal symptoms persist. The clinician should recognize that:

A) Over-the-counter medications do not treat all species of candida
B) Postmenopausal women are susceptible to trichomonas infection
C) Decreased estrogen makes vaginal mucosa susceptible to bacterial vaginosis
D) Irritation due to atrophic vaginal mucosa can mimic symptoms of candida

Question 26

Primary dysmenorrhea is pain with menses that occurs due to:

A) Rise in prostaglandins
B) Endometriosis
C) Fibroid tumor
D) Excessive estrogen

Question 27

To diagnose ovarian disorders, which of the following diagnostic studies is most helpful?

A) Transvaginal ultrasound
B) Pelvic computed tomography scan
C) Pelvic magnetic resonance imaging scan
D) Pap smear

Question 28

Your 45-year-old female patient complains of irregular menstrual cycles, severe pain with menses, and heavy bleeding every month for the last year. On examination, you palpate an enlarged uterus. Pregnancy test is negative. A recommended diagnostic test for this patient is:

A) Abdominal computed tomography scan
B) Kidney, ureter, bladder x-ray
C) Pelvic ultrasound
D) Abdominal magnetic resonance imaging

Question 29

Your 33-year-old female patient reports the development of a cold sore on her lower lip. She asks if this is the kind of sore that is transmitted during sex. The clinician should explain that:

A) The sore can be either herpes type 1 or 2, and both can be transmitted during oral sex
B) A cold sore in the oral region is caused by herpes type 1, and this is not contagious
C) Herpetic lesions on the lips and in the mouth are herpes type 2 and caused by oral sex
D) A blood test is done to determine the specific type of virus because treatments for herpes type 1 and 2 differ

Question 30

On pelvic examination, you observe a nontender, ulcerated, red lesion with raised borders on a patient's labia. Her inguinal lymph nodes are enlarged but nontender. The patient reports that her partner, who is HIV positive, has a similar lesion on his penis. The clinician should have a high suspicion of:

A) Herpes simplex 1
B) Herpes simplex 2
C) Condyloma acuminata
D) Syphilis

Question 31

The definitive diagnosis of endometriosis is made with:

A) Hysteroscopy
B) Pelvic computed tomography scan
C) Laparoscopy
D) Pelvic magnetic resonance imaging

Question 32

Pap smears assist in early diagnosis of endometrial cancer. The peak incidence of endometrial cancer occurs in:

A) Postmenopausal women aged 50 to 70 years old
B) Postmenopausal women aged 40 to 50 years old
C) Premenopausal women between 30 and 40 years old
D) Premenopausal women between 40 and 50 years old

Question 33

A 23-year-old female presents to the emergency room with fever, pelvic pain, vomiting, and dysuria. She reports having had an abortion yesterday in an urban birth control clinic. On physical examination, there is a bloody vaginal discharge, tenderness of the left lower quadrant of the abdomen, and cervical tenderness on pelvic examination. The following is a likely diagnosis:

A) Neisseria gonorrhoeae infection
B) Chlamydia trachomatis infection
C) Staphylococcal endometritis
D) Fulminant candidiasis

Question 34

Which of the following organisms can cause a syndrome that includes arthritis and conjunctivitis?

A) Neisseria gonorrhoeae
B) Chlamydia trachomatis
C) Trichomonas vaginalis
D) Gardnerella vaginalis

Question 35

A 17-year-old female patient complains of amenorrhea for the last 8 months, weight gain, excessive hair growth on the arms and chest, and development of acne. Pelvic examination is normal. The clinician should recognize these are signs of:

A) Ovarian cancer
B) Endometriosis
C) Hormonal imbalance
D) Stress-induced anovulation

Question 36

Your 26-year-old female patient reports a history of herpes simplex type 2 infection. On physical examination, you note red blisters over the vulva region. When questioned about sexual activity, she explains that her partner uses a condom whenever her infectious blisters are present. The clinician should recognize:

A) The herpes virus can be transmitted during the patient's asymptomatic periods
B) If the lesions are herpes simplex type 1, then the virus is not contagious
C) Only herpes simplex type 2 infects the genital region, and it is always contagious
D) When the blisters rupture, viral particles are transmitted to a sexual partner

Question 37

Your patient is a 63-year-old postmenopausal female with complaints of bloating, left lower quadrant abdominal pain, and feeling of abdominal fullness. On physical examination, the abdomen is nontender with shifting dullness and there are enlarged left sided inguinal lymph nodes. Pelvic examination reveals slight adnexal tenderness. The clinician should have a high index of suspicion of:

A) Endometriosis
B) Ovarian cancer
C) Uterine cancer
D) Ovarian cyst

Question 38

Which of the following infections often causes scarring of the fallopian tubes?

A) Chlamydia trachomatis
B) Pandida albicans
C) Trichomonas vaginalis
D) Gardnerella vaginalis

Question 39

Postmenopausal vaginal bleeding commonly indicates:

A) Hormonal imbalance
B) Endometrial cancer
C) Endometriosis
D) Atrophic vaginitis

Question 40

Which type of pelvic disorder has the highest rate of mortality in the United States?

A) Uterine cancer
B) Cervical cancer
C) Ovarian cancer
D) Pelvic inflammatory disease

Question 41

Your 61-year-old female patient complains of dyspareunia. On pelvic examination, you note atrophic vaginitis. The clinician should explain that these are most likely:

A) Signs of vaginismus
B) Postmenopausal symptoms
C) Signs of estrogen deficiency
D) B and C

Question 42

A 34-year-old female patient complains of lack of conception after unprotected sexual intercourse for 1 year. The patient has been keeping track of basal body temperature to plot ovulation. Pelvic examination is normal. The clinician should ask the patient if which of the following laboratory test(s) have been done?

A) TSH
B) FSH
C) LH
D) All of the above

Question 43

A 16-year-old female complains of sudden left-sided lower quadrant abdominal pain. Her last menstrual period was 2 weeks ago. On physical examination, the abdomen is nontender with no masses and no organomegaly. Bowel sounds are normal in four quadrants. Pelvic examination shows mild left lower quadrant tenderness. Pregnancy test is negative. These signs and symptoms are consistent with:

A) Ovarian cancer
B) Hydatidiform mole
C) Endometriosis
D) Follicular cyst

Question 44

A 19-year-old female complains of sudden severe left-sided lower quadrant abdominal pain, as well as nausea and vomiting for the last 2 weeks. Last menstrual period was 2 months ago. On physical examination, there is left sided lower quadrant abdominal tenderness and heel strike is positive. Pelvic examination reveals bluish discoloration of the cervix and left-sided adnexal tenderness. These signs and symptoms are consistent with:

A) Ovarian cyst
B) Ectopic pregnancy
C) Pelvic inflammatory disease
D) Follicular cyst