Deck 17: Female Genital Organs

Question 1

A 71-year-old woman who has never been pregnant and always had normal Pap tests notices spotty vaginal bleeding. A workup is performed and a biopsy reveals cancer. Which is she most likely to have?

A) Stage I endometrial carcinoma
B) Stage IV cervical carcinoma
C) Stage I ovarian cancer
D) Stage III endometrial carcinoma
E) Stage I vulvar carcinoma

Answer 1

The most common test for detecting infections of the uterine cervix is known as the Papanicolaou test (Pap test). It allows detection of the human papillomavirus infection and the neoplastic lesions that are occurring on the vaginal surfaces and their secretions. These diseases can also be visualized by the examination of the smears of the abnormal vaginal secretions.
Biopsy can also be used to predict the nature of lesions in the genital tract of the females. In this, the cervix is biopsied by studying the visible lesion on the surface of the vagina that also considered as a suggestive Pap test. Cervix gets stained with suitable agents that reflect premalignant lesions and thus, studying at higher magnification results into selecting the most appropriate biopsy sites.
So, a 71-year old woman is assumed to likely to have Stage 1 endometrial carcinoma, Stage IV cervical carcinoma, Stage I ovarian cancer and Stage III endometrial carcinoma.
Hence, the options A, B, C and D are incorrect.
In this case study, a 71-year old woman has never been pregnant and reported normal Pap tests by noticing heavy vaginal bleeding. A standard biopsy tests has been done that detects cancer. Thus, she was most likely to have Stage I vulvar carcinoma. It has been reported that in postmenopausal woman, the vulvar lesions have been commonly reported that malignates and spread with a high potential.
Hence, the correct answer is option .

Question 2

A 35-year-old woman attends a routine prenatal exam in her 32nd week of pregnancy complaining of recent severe headaches and swelling of her feet. Her blood pressure is 160/90 mm Hg and urinalysis shows markedly elevated protein. What is her diagnosis?

A) These changes are normal for pregnancy
B) Preeclampsia
C) Gestational hypertension
D) Eclampsia
E) Gestational diabetes

Answer 2

Gestational hypertension , also known as pregnancy-induced hypertension (PIH) , refers to the development of new kind of hypertension that shows after 20 weeks of gestation period in a pregnant woman. It is characterized by the presence of urinal proteins or shows other sign of preeclampsia.
Eclampsia refers to the onset of convulsions or seizures in a pregnant woman with signs of preeclampsia. It also refers to the pregnancy disorder that is characterized by a high blood pressure and large amounts of proteins in the urine. It leads to severe complications such as cerebral hemorrhage, cardiac arrest, aspiration pneumonia and kidney failure.
Gestational diabetes , also known as gestational diabetes mellitus (GDM) , refers to a condition in which the pregnant woman exhibits high blood glucose sugar that is caused by dysfunction of insulin responses. It is generally caused by some pregnancy factors such as the presence of human placental lactogen that strongly competes with insulin receptors that in turn, causes elevated blood sugar levels.
Hence, the options A, C, D and E are incorrect.
In this case study, a 35-year old woman had a routine prenatal exam in her 32nd week of pregnancy having complaining of severe headaches and swelling of feet. Her blood pressure is 160/90 mmHg and urinalysis shows distinctly elevated protein levels. So, the most likely diagnosis was the presence of Preeclampsia.
Preeclampsia refers to life-threatening disease that is characterized by hypertension and maternal endothelial dysfunction. It occurs in total 5% of pregnancies and accounts for almost 20% of deaths that result from severe complications during childbirth and pregnancy. It also leads to hypertension, edema and proteinuria.
Hence, the correct answer is option .

Question 3

Molar pregnancy refers to

A) a teratoma in which teeth have formed.
B) growth of a placenta derived only from paternal chromosomes.
C) a rapidly fatal malignancy of the placenta.
D) growth of a fetus with an abnormal placenta derived only from paternal chromosomes.
E) a pregnancy developing outside the uterus.

Answer 3

Molar pregnancy refers to a drastic form of pregnancy in which a non-viable fertilized egg begins to implant in the uterus that ultimately grows into a mass in the uterus by appearing like a swollen chorionic villi. These villi will grow in multiple clusters that resemble grapes like structure. It can also develop when a fertilized egg does not contain an original maternal nucleus.
It is featured by the presence of a hydatidiform mole or hydatid mole that is simply used to denote a mass of growing tissue. In some hydatidiform moles, the abnormal chorionic villi deeply invade into the myometrium. If it is left untreated, it will leads to a spontaneous abortion that resulted into miscarriage.
Molar pregnancies are rare in the United States. Hydatidiform moles generally occur in only 1 in 1000-2000 pregnancies. It also refers to not such a type of pregnancy conditions in which a teratoma is formed by forming teeth, growth of placenta derived from only paternal chromosomes, fatal malignancy of the placenta takes place and a pregnancy developing outside the uterus.
Hence, the options A, B, C and E are incorrect.
Molar pregnancy refers to that type of pregnancy in which the growth of fetus takes place with an abnormal kind of placenta that is derived from paternal chromosomes. It will result into gestational trophoblastic neoplasms that collectively known as hydatidiform mole that ensures the probability of having molar pregnancy.
Hence, the correct answer is option .

Question 4

Which of the following tests or procedures can confirm the presence of an ovarian cyst?

A) Chorionic gonadotropin levels
B) Speculum examination
C) Pap test
D) Ultrasound
E) Bimanual examination

Question 5

The term for painful menstruation is

A) menorrhagia.
B) dysmenorrhea.
C) menarche.
D) metrorrhagia.
E) menopause.

Question 6

Which of the following diseases is not associated with a venereally transmitted infection?

A) Cervical cancer
B) Pelvic inflammatory disease
C) Candidiasis
D) Trichomoniasis
E) Secondary syphilis

Question 7

Permanent cessation of menstruation

A) occurs around the age of 60 years.
B) is best treated with oral estrogen supplementation.
C) rarely causes symptoms in women in the United States.
D) is associated with accelerated osteoporosis and cardiovascular disease.
E) does not cause symptoms outside the female genital tract.