Deck 17: Female Reproductive System

Question 1

A 46 year old mother of three saw her GP who noticed a symmetrically enlarged uterus with no masses.A pregnancy test was negative.Since she already had three children,the woman elected to have a vaginal hysterectomy.A histological section from the myometrium is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenomyosis
B)Endometriosis
C)Endometrial polyp
D)Endometrioid carcinoma
E)Leiomyoma

Answer 1

Adenomyosis

Question 2

A 27 year old woman suspected she was pregnant,and performed a home pregnancy test,which was positive.However,a few weeks later,when she had her first ultrasound,no foetus was detected.Instead,the uterus was filled with round,grape-like masses.A dilation and curettage (D&C)was then performed.Tissue from the procedure was sent to surgical pathology,and a representative section from this material is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Endometrial carcinoma
B)Endocervical polyp
C)Endometrial polyp
D)Hydatidiform mole
E)Infection with hydatid tapeworm

Answer 2

Hydatidiform mole

Question 3

A 22 year old woman was seen by her GP for follow-up after an abnormal Pap smear.A biopsy of the cervix was done,and a representative section is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Endocervical polyp
B)Endometriosis
C)Human papilloma virus infection (HPV)
D)Herpes simplex virus infection
E)Severe dysplasia/carcinoma in situ

Answer 3

Human papilloma virus infection (HPV)

Question 4

A 20 year old woman consulted the Students' Health Service GP at her university because of an enlarging abdomen and abdominal fullness.Friends had been asking her if she was pregnant,but she was not sexually active.The physician palpated a large mass in the right ovary.She underwent an exploratory laparotomy (abdominal exploration),and an 8 cm tumour was removed,along with the right ovary.When sectioned,the tumour containing a mass of oily hair.A representative section is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Brenner tumour
B)Cystic teratoma
C)Mucinous cystadenoma
D)Mucinous cystadenocarcinoma
E)Serous cystadenoma
F)Serous cystadenocarcinoma

Question 5

A 41 year old woman consulted her GP because of abnormal bleeding in between menstrual periods.Examination disclosed a mass visible at the cervical os.An excisional biopsy was performed,and a representative section is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Endocervical polyp
B)Endometriosis
C)Human papilloma virus infection (HPV)
D)Herpes simplex virus infection
E)Severe dysplasia/carcinoma in situ

Question 6

A 38 year old woman is seen by her GP for increasing pelvic pain and abnormal uterine bleeding.The GP palpates several firm masses in the uterus.The patient is referred to a gynaecologist who recommends and eventually performs a vaginal hysterectomy.A representative section of the uterus is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenomyosis
B)Endometriosis
C)Leiomyoma
D)Leiomyosarcoma
E)Thrombus

Question 7

A 24 year old woman came to the emergency department with severe abdominal pain and vaginal bleeding.A physician palpated a mass in the right fallopian tube.A pregnancy test was positive.She was taken to the OR for emergency laparotomy (exploration of the abdomen)and the right fallopian tube and mass were removed.A representative section is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Acute salpingitis
B)Choriocarcinoma
C)Ectopic pregnancy
D)Endometrial carcinoma
E)Endometriosis
F)Tubo-ovarian abscess