Imtiaz- Gynaecology

Concerning secondary amenorrhea, all the following are true except: A. May be due to thyrotoxicosis B. May be due to anorexia nervosa C. Investigations include prolactin levels D. Oral contraceptives can be used in treatment E. Clomiphene can be given as treatment

E* Clomiphene can be given as treatment 30

Regarding dysmenorrhea all of the following are true, except: A. It is a painful menstruation B. The spasmodic type is the primary C. The congestive type is the secondary D. Membranous dysmenorrhea is most uncommon E. D&C is the treatment of choice

E* D&C is the treatment of choice 46

Ovulation can be diagnosed by the following, except: A. Measuring day 14 serum progesterone B. Observing a rise in basal body temperature in the second half of the menstrual cycle C. Study of cervical mucus D. Endometrial biopsy E. Day 20 serum prolactin

E* Day 20 serum prolactin 94#

All of the following may cause primary amenorrhea, except: A. Cryptomenorrhea (imperforate hymen B. Testicular feminization syndrome C. Turner's syndrome D. Gonadal agenesis E. Dermoid cyst of the ovary

E* Dermoid cyst of the ovary 25

All of the following are contraindications for the use of combined oral contraceptive pills, except: A. Liver disease B. Secondary amenorrhea C. Thrombo-embolic disease D. Sickle cell disease E. Endometriosis

E* Endometriosis 76

Contraindications to birth control pills include all of the following, except: A. Migraine headache B. Deep vein thrombosis C. Hypertension D. Liver adenoma E. Hirsutism

E* Hirsutism 78

All of the following are side effects of oral contraceptives, except: A. Weight gain B. Hypertension C. Deep vein thrombosis D. Strike E. Hypoglycemia

E* Hypoglycemia 79

Ovulation can be diagnosed by all the following except one: Measuring day 14 serum progesterone Observing a rise in basal body temperature in the second half of the menstrual cycle Study of the cervical mucus Endometrial histology Mittle schmerz (midcyclic pain

1* Measuring day 14 serum progesterone 95

All of the following are true about vagina, except: A. The pH is 4 B. It contains no glands C. Whitish non-offensive discharge is normal finding D. Doderlein's bacilli is abnormal finding E. Posterior wall is longer than anterior wall

D* Doderlein's bacilli is abnormal finding 4

Laparoscopy is a useful investigation to diagnose one of the following conditions: A. Adenomyosis B. Congenital uterine abnormalities C. Premature ovarian failure D. Endometriosis E. Vaginal atresia

D* Endometriosis 3. Hysteroscopy. 22

The following statements are true regarding hematocolpos, except: A. It causes primary amenorrhea B. The patient may present with urine retention C. The patient may present with abdominal mass D. The treatment is incision of hymen E. Breasts atrophy may occur

E* Breasts atrophy may occur 28

The best support to the uterus is by: A. The broad ligaments B. Infundibulopelvic ligaments C. Round ligament D. Utero-ovarian ligament E. Cardinal ligament

E* Cardinal ligament 9

Regarding dysfunctional uterine bleeding all of following are true, except: A. It is an abnormal menstrual pattern B. There is no organic disease in the uterus C. It may cause menorrhagia D. It may cause prolonged period E. It is a pre-malignant condition of the endometrium

E* It is a pre-malignant condition of the endometrium 39

All the following are complications of ovulatory inducers, except: A. Multiple pregnancy B. Ectopic pregnancy C. Hypotension D. Ascites E. Hypoproteinemia

E* Hypoproteinemia 91

Induction of ovulation may be achieved by giving: A. Clomiphene citrate B. Cyproterone acetate C. Letrozole D. FSH and LH E. Tamoxifen

A* Clomiphene citrate 97

The following changes may occur in a fibroid, except: A. Cystic changes B. Sarcomatous changes C. Calcified called "womb stone" D. Acute fatty degeneration E. Hyaline degeneration

D* Acute fatty degeneration 66

Absence of vagina is common in: A. Congenital adrenal hyperplasia B. Turner's syndrome C. In Mullerian atresia with absent uterus D. With absent uterus in testicular feminization syndrome E. Drug induced masculinization

C* In Mullerian atresia with absent uterus 27

Concerning endometriosis, all the following are true except: A. Causes deep dyspareunia B. Is often asymptomatic C. Is frequently pre-malignant D. Often present as secondary dysmenorrhea E. Rare outside the pelvis

C* Is frequently pre-malignant 56

Absolute contraindication for oral contraceptive pills are the following, except: A. Carcinoma of the breast B. Heart disease C. Lactating mother D. Liver diseases E. Thrombo-embolic disease

C* Lactating mother 77

The most common tumor of the uterine corpus is: A. Adenocarcinoma B. Squamous carcinoma C. Leiomyoma D. Sarcoma E. Lymphoma

C* Leiomyoma 64

Contraindications of IUCD are the following, except: A. Pregnancy B. Pelvic infection C. Multigravida D. Dysfunctional uterine bleeding E. Patient with heart disease

C* Multigravida 87

Raised FSH levels are found in all of the following, except: A. Post menopausal woman B. Turner's syndrome C. Prepubertal girls D. Gonadal dysgenesis E. Kleinfelter's syndrome

C* Prepubertal girls 34

A 4 days old female healthy baby presented to your clinic with vaginal bleeding, the most appropriate action to do is: A. Refer to gynecologist B. Do PT and PTT C. Reassure the parents D. Do pelvic US E. Give vitamins and iron

C* Reassure the parents 43

All of the following may cause postmenopausal bleeding, except: A. Estrogen therapy B. Atrophic changes of the vagina C. Testosterone therapy D. Cervical malignancy E. Endometrial malignancy

C* Testosterone therapy 50

One of the following investigations is necessary in patients with primary amenorrhea: A. Serum TSH B. Serum prolactin C. Dilation and Curettage D. Chromosomal analysis E. Hysteroscopy

D* Chromosomal analysis 32

All of the following symptoms are associated with endometriosis, except: A. Dyspareunia B. Dysmenorrhea C. Menorrhagia D. Back pains E. Amenorrhea

E* Amenorrhea 58

The most effective contraceptive known is: A. Diaphragm B. Condom (Sheath C. Synthetic progestin D. Combined contraceptive pills (estrogen + progesterone E. Intrauterine device

D* Combined contraceptive pills (estrogen + progesterone 73

The most likely cause of abnormal genital bleeding in a 13 year old girl is: A. Uterine cancer B. Ectopic pregnancy C. Threatened abortion D. Cervical cancer E. Anovulation

E* Anovulation 38

All of the following are theories for causation of endometriosis except: A. Coelomic metaplasia B. Endometrial hyperplasia C. Retrograde menstruation D. Immunologic deficiency E. lymphatic spread of endometrial fragment

B* Endometrial hyperplasia 60

All of the following may cause secondary amenorrhea, except: A. Lactation (breast feeding B. Endometriosis C. Pituitary failure D. Early menopause E. Pregnancy

B* Endometriosis 31

Vaginal bleeding in the newborn female infant is most commonly due to: A. Trauma B. Estrogen withdrawal C. Infections D. Neoplasms E. Hemorrhagic disease of the newborn

B* Estrogen withdrawal 42

Concerning uterine fibroids the following are true, except: A. Rarely cause infertility B. They are not a cause of post menopausal bleeding C. May be asymptomatic during pregnancy D. May undergo red degeneration during pregnancy E. May cause antepartum hemorrhage

B* They are not a cause of post menopausal bleeding 63

All of the following are true for hemorrhagic metropathia, except: A. It is a condition of variable periods of amenorrhea B. It occurs more common with fibroid in the uterus C. Periods are heavy, continuous and painless D. It is found more common nearer the menopause E. It is a feature of anovular cycles in which estrogen levels are high

B* It occurs more common with fibroid in the uterus 40

The commonest type of bleeding encountered with uterine leiomyoma (fibroids is: A. Post coital bleeding B. Menorrhagia C. Metrorrhagia D. Postmenopausal bleeding E. Intra-abdominal bleeding

B* Menorrhagia 67

In a 42 years old female who has menorrhagia due to a uterine fibroid, the best treatment is: A. Radiotherapy B. Myomectomy C. Total abdominal hysterectomy D. Hormonal therapy E. Repeated D&C operations

B* Myomectomy 69

In secondary amenorrhea, elevated FSH over 40 nmol/u, indicates: A. Polycystic ovary syndrome B. Ovarian failure or resistance C. Pituitary failure D. Anorexia nervosa E. Hypothalamic amenorrhea

B* Ovarian failure or resistance 33

Regarding menstrual cycle, all the following are true except: A. Increasing levels of FSH from anterior pituitary gland B. FSH release is influenced by gonadotropin releasing hormone from hypothalamus C. FSH promotes follicular development in the ovary D. Ovulation occurs 14 days from 1st day of the cycle E. The endometrium undergoes proliferation during 1st half of the cycle

B* FSH release is influenced by GnRH from hypothalamus 16

The use of combined oral contraceptive pills may increase the risk of one of the following conditions: A. Fibrocystic breast disease B. Hepatic adenoma C. Salpingitis D. Ovarian cancer E. Endometrial cancer

B* Hepatic adenoma 82

Severe hyperstimulation syndrome associated with gonadotropin therapy may be manifested clinically by the following, except: A. Abdominal pain B. Ascites C. Follicular cysts D. Hypovolemic shock E. Thrombo-embolic episodes

A* Abdominal pain 18

Uterine fibroid may be associated with all of the following, except: A. Amenorrhea B. Menorrhagia C. Frequency of micturition D. Infertility E. Abdominal enlargement

A* Amenorrhea 68

Male sterilization (vasectomy causes: A. Azoospermia B. Loss of libido C. A decrease in the volume of the ejaculat D. Impotence E. Infection

A* Azoospermia 100

The most common side effect of low-dose oral contraceptive pills is: A. Breakthrough bleeding B. Dysmenorrhea C. Nausea D. Hypertension E. Breast pain

A* Breakthrough bleeding 83

Concerning Intrauterine Contraceptive Device IUCD, choose the correct answer: A. Failure rate 2-3 % women every year B. Increases the incidence of cervical erosion C. Increases the incidence of Candida infection D. Contraindicated in patients with cervical polyp E. Cryocautery to the cervix can be done while IUCD is in situ

A* Failure rate 2-3 % women every year 84

Intrauterine contraceptive devices (inert type prevent pregnancy by all of the possible mechanisms, except: A. Increase the motility of fallopian tubes B. Increase the contractility of the uterus C. Causing aseptic inflammatory reaction in the endometrium D. Increasing the potential space of uterine cavity E. Increasing the hostility of the cervical mucus to the spermatozoid

A* Increase the motility of fallopian tubes 85

Regarding oral contraceptive pills, one is true: A. Inhibit release of gonadotropic hormones B. May lead lo thinning of cervical mucus C. Lead to reduced platelet aggregation D. Lead lo increased antithrombin III E. Increase fallopian tube smooth muscle activity

A* Inhibit release of gonadotropic hormones 81

The most common method of contraception in Jordan is: A. Intrauterine device (IUCD B. Long acting progesterone injection (Depo-Provera C. Diaphragm D. Spermicidal cream E. Lactation

A* Intrauterine device (IUCD 89

One of the following drugs is commonly used for dysfunctional uterine bleeding DUB: A. Progesterone B. Testosterone C. Estrogen D. Epsilon aminocaproic acid E. Prostaglandin

A* Progesterone 44

The lining epithelium of the vagina is: A. Stratified squamous epithelium B. Simple columnar epithelium C. Tall columnar epithelium D. Transitional epithelium E. Ciliated columnar epithelium

A* Stratified squamous epithelium 6

In a normal menstrual cycle of 35 days duration, ovulation occurs: A. Two weeks before menstrual flow B. Mid cycle C. Time of maximum progesterone production D. Two weeks after the onset of the menstrual flow E. Time of maximum prolactin production

A* Two weeks before menstrual flow 17

Maximal number of germ cells in the ovary occurs at: A. 22 weeks of intrauterine life B. 30 weeks of intrauterine life C. Birth D. Menarche E. Age of 25 years

A*22 weeks of intrauterine life 14

Complication of Dilation and Curettage D&C include all of the following, except: A. Uterine perforation B. Injury of the urethra C. Cervical laceration D. Cervical stenosis E. Asherman's syndrome

B* Injury of the urethra 21

One of the following is contraindicated in combined oral contraceptive pills: A. Multiparity B. Chronic liver disease C. Primary dysmenorrhea D. Bronchial asthma E. Endometriosis

B* Chronic liver disease 75

In a 38 years old woman complaining of irregular and heavy periods, the first line of management is: A. Vitamin K injections B. Dilatation and curettage (D&C C. Hormone therapy D. Immediate hysterectomy E. Radiotherapy

B* Dilatation and curettage (D&C 20

The uterine artery is a branch of one of the following: A. External iliac artery B. Internal iliac artery C. Common iliac artery D. Middle sacral artery E. Obturator artery

B* Internal iliac artery 8

What percentage of couples in the reproductive age is unable to conceive after one year of coitus without contraception: A. 1-2% B. 15% C. 30% D. 50% E. 75%

B* 15% 92

One of the following is an absolute contraindication to Intrauterine Contraceptive Device IUCD: A. Uterine fibroids B. Bicornuate uterus C. Grand multi-parous woman D. Previous caesarian section E. Lactation

B* Bicornuate uterus 86

Post menopausal bleeding is managed primarily by: A. Hormonal replacement B. Papanicolau smear C. Dilatation and curettage (D&C D. Cervical biopsy E. Contraceptive pills

C* Dilatation and curettage (D&C 53

The most common cause of heavy bleeding in adolescent girls is: A. Uterine fibroid B. Endometriosis C. Dysfunctional uterine bleeding D. Cervical erosion E. Hypothyroidism

C* Dysfunctional uterine bleeding 41

Tests to detect ovulation include all of the following, except: A. Basal body temperature B. Endometrial biopsy C. Estrogen level D. Progesterone level E. Vaginal wall cytology

C* Estrogen level 96

All of the following are possible indications of ovulation, except: A. Increased plasma levels of progesterone in the second half of the cycle B. Increased basal temperature in the second half of the cycle C. Follicular stimulating hormone surge at the mid cycle D. Change in the cervical mucus E. Mid cycle abdominal pain

C* Follicular stimulating hormone surge at the mid cycle 93#

Postmenopausal bleeding is usually caused by all the following except one: A. Cervical lesions B. Vaginal lesions C. Hematologic disease D. Gastroenterological lesions E. Urinary lesions

C* Hematologic disease 54

Physiologic processes that are estrogen dependent in women include all the following except: A. Menses B. Vaginal cornification C. Hirsutism D. Appearance of axillary hair E. Production of cervical mucus

C* Hirsutism 19

The most common site of endometriosis externum is: A. The uterus B. The pouch of Douglas C. The ovaries D. The fallopian tubes E. The cervix

C* The ovaries 59

All of the following effects occur on the vagina by estrogen, except: A. The vagina becomes more vascular B. The vaginal epithelium grows C. The vaginal glands start to secret D. The epithelium cells become filled with glycogen E. The glycogen is broken by Doderlein's bacilli which cause lowering of vaginal pH

C* The vaginal glands start to secret 7

The following are characteristics of endometriosis, except: A. Period pain is congestive type B. Periods may be heavy C. There is intermenstrual bleeding D. May cause infertility E. May cause ovarian cysts

C* There is intermenstrual bleeding 57

The round ligament of the uterus terminates in one of the following: A. Symphysis pubis B. Iliac crest C. Upper portion of labium majus D. Upper portion of labium minus E. Upper portion of inguinal canal

C* Upper portion of labium majus 10

Ovarian failure causes atrophic changes in all of the following, except: A. Uterus B. Vagina C. Urethra D. Bone E. Rectum

C* Urethra . 15#

Causes of post menopausal bleeding are the following, except: A. Endometrial cancer B. Cervical cancer C. Urethral carbuncle D. Ovarian tumor E. Prolapse of the uterus

C*Urethral carbuncle 52

Amenorrhea in a 16 years old girl may result from all of the following conditions, except: A. Imperforate hymen B. Androgen insensitivity syndrome (testicular feminization syndrome C. Turner's syndrome D. Bicornuate uterus E. Pituitary tumor

D* Bicornuate uterus 26

Endometriosis is often associated with all the following except: Dysmenorrhea Dyspareunia Infertility Amenorrhea Pelvic pain

D* Amenorrhea 61

The following are contraindications for Hysterosalpingography, except: A. Uterine bleeding B. Active pelvic infection C. Suspected pregnancy D. Bicornuate uterus E. Active cervicitis

D* Bicornuate uterus 23

Intrauterine contraceptive device may be associated with following complications, except: A. Pelvic infection B. Uterine perforation C. Ectopic pregnancy D. Cervical erosion E. Menorrhagia

D* Cervical erosion 88

All of the following are true about spasmodic dysmenorrhea (primary, except: A. The pain occurs with the onset of menstruation B. The pain in colicky in nature C. It may associate with nausea and vomiting D. It is more common in multi parous women E. The pain may radiate from lower abdomen to the inner aspects of the thighs

D* It is more common in multi parous women 47

The left ovarian vein empties in one of the following: A. Vena cava inferior B. Left common iliac vein C. Left internal iliac vein D. Left renal vein E. Left external iliac vein

D* Left renal vein 12

The most common pelvic mass in postmenopausal women is: A. Follicular cyst B. Corpus luteum cyst C. Germ cell tumor D. Leiomyoma E. Endometrioma

D* Leiomyoma 70

All of the following structures are included in the term vulva, except: A. Clitoris B. Urethral orifice C. Labia minora D. Nabothian cysts E. Bartholin's glands

D* Nabothian cysts 2

Clomiphene citrate is contraindicated in one of the following: A. Endometrial hyperplasia B. Post pill amenorrhea C. Polycystic ovary (Stein-Leventhal syndrome D. Ovarian tumors E. Infrequent ovulation

D* Ovarian tumors 98

One of the following is associated with dysfunctional uterine bleeding: A. Uterine infection B. Placental polyp C. Cervical polyp D. Polycystic ovary E. Endometrial carcinoma

D* Polycystic ovary 3. Dysmenorrhea. 45

The normal vagina in the reproductive age is characterized by all of the following, except: A. Contains Doderlein's bacilli B. Lined by stratified squamous epithelium C. Has a pH of 4.5 D. The epithelium contains secretory cells E. Is divided by the cervix into four fornices

D* The epithelium contains secretory cells 5

The effectiveness of oral contraceptives is reduced following interaction with the following drugs, except: A. Ampicillin B. Phenobarbitone C. Phenytoin D. Thyroxine E. Carbamazepine

D* Thyroxine 80

All of the following may cause azoospermia, except: A. Blockage of the ducts B. Klinefelter syndrome C. Orchitis due to mumps D. Varicoceles E. Surgical trauma to the spermatic artery

D* Varicoceles 99

The most inner part of a mature Graafian follicle is: A. Theca interna B. Theca externa C. Granular cell layer D. Zona pellucida E. Ovarian stroma

D* Zona pellucida 13

An imperforate hymen in a girl may be associated with all of the following, except: A. Retention of urine B. Hematocolpos C. Periodical abdominal pain D. Amenorrhea E. Absent uterus

E* Absent uterus 29

Regarding lower uterine segment, all the following are true except: A. It represents isthmus in non pregnant uterus B. It lies between the anatomical and histological internal os C. It is a passive segment compared to the upper segment which is active D. In obstructed labor it can form Bandl's ring E. It is the least site of rupture in obstructed labor with no previous CS scar

E* It is the least site of uterus in obstructed labor with no previous CS scar 11

All of the following are true about effect of androgens on the external genitalia of a female fetus, except: A. Clitoral hypertrophy B. Labia fusion to form scrotum C. May give varying degrees of hypospadia D. It may cause adrenogenital syndrome E. It may cause closure of the Bartholin gland duct

E* It may cause closure of the Bartholin gland duct 35

The most common uterine neoplasm is: A. Sarcoma B. Adenocarcinoma C. Choriocarcinoma D. Adenomyosis E. Leiomyoma

E* Leiomyoma 71

About combined oral contraceptive pills one is true: A. Predispose to pelvic inflammatory disease (PID B. Predispose to breast tumors C. Predispose to ovarian cyst D. May be used in patient with heart lesion E. Less effective in patient with epilepsy on treatment

E* Less effective in patient with epilepsy on treatment 74

The following are causes of post menopausal bleeding, except: A. May be caused by estrogen therapy B. Atrophic vaginitis C. Endometrial malignancy D. Cervical carcinoma E. May be caused by non hormone-producing ovarian tumors

E* May be caused by non hormone-producing ovarian tumors 51

Concerning primary amenorrhea, all the following are true except: A. Investigations include serum FSH B. Is associated with karyotype 45 XO C. May be due to congenital adrenal virilism (hyperplasia D. May be due to Mullerian duct fusion failure E. May be due to granulous cell tumors of the ovary

E* May be due to granulous cell tumors of the ovary 24

A 27 years old woman has tried unsuccessfully for 5 months to become pregnant, The recommended investigation in this case would be: A. Hormonal assay B. Hysterosalpingogram (HSG C. Endometrial biopsy D. Laparoscopy E. None of the above

E* None of the above 90

Signs of virilism include all of the following, except: A. Excessive body hair B. Muscle development C. Deepening of the voice D. Clitoromegaly E. Occipital balding

E* Occipital balding 36

The most common pelvic mass associated with amenorrhea in a reproductive age woman is: A. Follicular cyst B. Corpus luteum cyst C. Benign cystic teratoma D. Leiomyoma E. Pregnancy

E* Pregnancy 2. Abnormal Uterine Bleeding. 37

Regarding post menopausal bleeding, all the following are true except: A. May be caused by estrogen therapy B. Can only occur six months after the cessation of menses C. May occur due to atrophic vaginitis D. Dilatation and curettage are mandatory E. Rarely is due to malignant changes in the endometrium

E* Rarely is due to malignant changes in the endometrium 49

All of the following complications are associated with intramural fibroid, except: A. Excessive uterine bleeding B. Red degeneration during pregnancy C. Fatty degeneration D. Hyaline degeneration E. Sarcomatous changes in 20% of cases

E* Sarcomatous changes in 20% of cases 65

Normal semen should have the following characteristics, except: A. Volume 2.5-5 cc B. Liquefaction in 30 minutes C. Motility 60-70% after 3 hours D. After 6 hours only 30% remain motile E. Sperm count the average normal specimen is 10-20 million per 1 cc

E* Sperm count the average normal specimen is 10-20 million per 1 cc 98

The nerve supply to the vulva is derived from all of the following nerves, except: A. The pudendal nerve B. The ileo-inguinal nerve C. The genito-femoral nerve D. The posterior cutaneous nerve to the thigh E. The inferior hemorrhoidal nerve

E* The inferior hemorrhoidal nerve 3

Regarding endometriosis all of the following are true, except: A. The endometrium is found in situation other than the uterine cavity B. It may be found in myometrium C. The principle feature is menorrhagia D. It may cause infertility E. The treatment of choice in young age is hysterectomy

E* The treatment of choice in young age is hysterectomy 55

The ideal method of contraception for a cardiac patient with mitral valve disease who desires no more children is by: A. Birth control pills B. IUCD (Intra Uterine Contraceptive Device C. Laparoscopic tubal ligation D. Immediate post partum tubal ligation E. Tubal ligation 40 days after delivery by laparotomy

E* Tubal ligation 40 days after delivery by laparotomy 2. Hormonal Methods. 72

Primary dysmenorrhea at the time of menstruation is caused by: A. Uterine atony B. Uterine ischemia C. Ovulation D. High level of estrogen E. Uterine hyper contractility due to prostaglandins release

E* Uterine hyper contractility due to prostaglandins release 4. Postmenopausal bleeding. 48

In adenomyosis the endometrial glands are localized at: A. Pelvic cavity B. Ovaries C. Fallopian tubes D. Bowels E. Uterine muscle

E* Uterine muscle 62