Question 1

A 55-year-old woman who has diabetes mellitus complains of genital itching. Examination shows whitish plaques on the mucosa of the vulva and vagina. Which of the following infectious agents most likely caused these changes?

Accepted Answer

A)   Human papillomavirus
B)   Herpes simplex virus type 2
C)   Trichomonas vaginalis
D)   Gardnerella vaginalis
E)   Candida albicans E

Question 2

A 25-year-old woman had a workup for infertility. During the laparoscopic examination, the gynecologist found foci of endometriosis. Such foci are most often seen on which of the following sites?

Accepted Answer

A)   Ovary
B)   Uterine ligaments
C)   Rectovaginal septum
D)   Pelvic peritoneum
E)   Appendix A

Question 3

Which of the following genital lesions is associated with a greater than expected risk of carcinoma of the vulva?

Accepted Answer

A)   Condyloma acuminatum
B)   Condyloma latum
C)   Lichen simplex chronicus
D)   Lichen sclerosus
E)   Papillary hydradenoma D

Question 4

This uterus was removed from a 58-year-old woman who complained of metrorrhagia. Most likely this lesion is pathogenetically related to

Accepted Answer

A)   herpesvirus infection
B)   human papillomavirus infection
C)   hyperestrinism
D)   multiparity
E)   endometriosis

Question 5

BRCA1 and BRCA2 genes that are mutated in 25% of all women who have familial breast cancer encode proteins. Which of the following functions do these proteins serve?

Accepted Answer

A)   Cell surface receptors for growth factors
B)   Growth factors
C)   Cytoplasmic signaling molecules
D)   DNA repair enzymes
E)   Nuclear hormone receptors

Question 6

A high level of expression of the tumor suppressor gene PTEN will most likely be found in which of the following?

Accepted Answer

A)   Normal proliferative phase endometrium
B)   Uterine ligaments
C)   Complex atypical endometrial hyperplasia
D)   Endometrial intraepithelial neoplasia
E)   Adenocarcinoma of the endometrium

Question 7

This biopsy specimen was taken from an excoriated and oozing nipple of a 50-year-old woman. These histologic findings are most consistent with the diagnosis of

Accepted Answer

A)   eczema
B)   psoriasis
C)   Paget disease of the breast
D)   medullary carcinoma of the breast
E)   fibrocystic change of the breast

Question 8

This breast tumor was removed from a 60-year-old woman. On gross examination, the tumor was found to be

Accepted Answer

A)   rubbery and yellow
B)   white and gritty
C)   calcified
D)   necrotic and caseous
E)   soft and gelatinous

Question 9

Comedocarcinoma of the breast is a type of which of the following carcinomas?

Accepted Answer

A)   Ductal carcinoma in situ
B)   Medullary carcinoma
C)   Invasive ductal carcinoma
D)   Invasive lobular carcinoma
E)   Tubular carcinoma

Question 10

Which of the following nonneoplastic breast lesions is associated with the highest risk of mammary cancer?

Accepted Answer

A)   Apocrine cysts
B)   Sclerosing adenosis
C)   Complex sclerosing lesion
D)   Small duct papillomas
E)   Atypical ductal hyperplasia

Question 11

This pelvic tumor most likely originated from the

Accepted Answer

A)   prostate
B)   rectum
C)   urinary bladder
D)   ovary
E)   uterus

Question 12

Elevated 17-ketosteroid excretion, masculinization, and hirsutism are found in a woman who has a tumor of the ovary. The tumor is composed of polygonal cells with abundant eosinophilic cytoplasm and occasional Reinke crystals. Which of the following is the most likely classification of this tumor?

Accepted Answer

A)   Thecoma
B)   Granulosa cell tumor
C)   Hilar tumor of the ovary
D)   Sertoli-Leydig cell tumor
E)   Brenner tumor

Question 13

The solitary nodular lesion in this uterus removed from a 55-year-old woman is most likely composed of

Accepted Answer

A)   benign endometrial glandular cells
B)   malignant endometrial glandular cells
C)   benign smooth muscle cells
D)   malignant smooth muscle cells
E)   foci of adenomyosis

Question 14

These ovaries were removed from an infertile, obese, slightly hirsute 30-year-old woman with persistent menstrual irregularities. The cystic spaces seen in the ovaries represent

Accepted Answer

A)   foci of endometriosis
B)   foci of endosalpingiosis
C)   corpora lutea
D)   corpora albicantia
E)   dilated follicles filled with fluid

Question 15

Assuming that a vaccination will be discovered for the human papillomavirus in women, it is expected that the vaccination will reduce the incidence of carcinoma at which of the following sites?

Accepted Answer

A)   Clitoris
B)   Vagina
C)   Cervix
D)   Endometrium
E)   Ovary

Question 16

A physical examination of a 5-year-old girl shows a grape-like polypoid mass protruding from the vagina. Histologic examination reveals that the mass has a myxoid stroma that contains small oval-shaped cells. Some of these cells have pink cytoplasm and resemble tennis rackets. These cells reacted positively upon immunohistochemical staining with the antibodies to desmin. Which of the following is the most likely diagnosis?

Accepted Answer

A)   Squamous cell carcinoma
B)   Clear cell adenocarcinoma of the cervix
C)   Leiomyosarcoma
D)   Rhabdomyosarcoma
E)   Malignant melanoma

Question 17

A 50-year-old woman sees her physician because she has noticed a bloody discharge from the left nipple. Upon physical examination, there are no palpable masses in the breast. Which of the following is the most likely cause of this discharge?

Accepted Answer

A)   Solitary cyst
B)   Fibrocystic change
C)   Acute mastitis
D)   Intraductal papilloma
E)   Carcinoma

Exam 18: Female Genital System and Breast