Block 15 Path Female Rep Sys Prt 2
Yakubovskyy. Pathology of Female Reproductive System - Part 2 "Yakubovskyy. Pathology of Female Reproductive System - PREGNANCY"
- 1.
The shown endometrial biopsy from a 42-year-old obese woman complaining of vaginal spotting represents- A.
Endometrial intraepithelial neoplasia
- B.
Keratinizing squamous cell carcinoma
- C.
Non-keratinizing squamous cell carcinoma
- D.
Endometrioid endometrial carcinoma
- E.
Choriocarcinoma
- F.
Hydatidiform mole
- G.
Leiomyosarcoma
- 2.
The shown endometrial biopsy from a 42-year-old obese woman complaining of vaginal spotting The most likely predisposing factor?
- A.
BRAC1 or BRAC2 mutation
- B.
P53 mutation
- C.
Endometriosis
- D.
HPV infection
- E.
Polycystic ovary syndrome
- 3.Presence of subnuclear vacuoles in the endometrial glands in an endometrial biopsy indicates
- A.
Proliferative phase
- B.
Early secretory phase
- C.
Mid-secretory luteal phase
- D.
Late secretory phase
- E.
Persistent proliferative phase
- 4.
A 33-year-old woman presents with a 3-year history of infertility. The microscopic appearance of the endometrium is shown for you evaluation. Which of the following is the most likely phase of the menstrual cycle at which the endometrial biopsy was taken?
- A.
Proliferative
- B.
Early secretory
- C.
Mid-secretory
- D.
Late secretory
- E.
Menstrual
- 5.Who of the following patients is more prone to serous endometrial adenocarcinoma?
- A.
A girl with precocious puberty
- B.
An obese young women with hirsutism and alopecia
- C.
A middle age woman with history of spontaneous abortions
- D.
A middle-age woman with an ovarian tumor
- E.
An elder women with osteoporosis
- 6.A young couple is evaluated for infertility. The wife, 28 years of age reports a long-standing history of oligomenorrhea alternating with amenorrhea. Physical examination reveals an obese woman with male escutcheon. She is at increased risk for
- A.
Ovarian carcinoma
- B.
Cervical carcinoma
- C.
Uterine leiomyosarcoma
- D.
Endometriod endometrial adenocarcinoma
- E.
Choriocarcinoma
- 7.Major source(s) of progesterone in a normal ovary
- A.
Ovum
- B.
Granulosa cells
- C.
Theca interna
- D.
Theca externa
- E.
Hilus cells
- F.
Fibrous stroma
- 8.
A 38-year-old Caucasian female presents with dysfunctional intrauterine bleeding. Physical examination reveals deep voice and hirsutism. Physical examination reveals enlargement of the left ovary. Oophorectomy is performed and subsequent examination of the specimen reveals the ovarian lesion shown for your evaluation. Histologic examination reveals diffuse growth of slightly pleomorphic and vacuolated theca cells. Which of the following is the most likely diagnosis?
- A.
Polycystic ovary syndrome
- B.
Fibroma
- C.
Thecoma
- D.
Dysgerminoma
- E.
Yolk sac tumor
- F.
Granulosa cell tumor
- G.
Sertoli-Leydig cell tumor
- 9.
A 43-year-old Hispanic female presents with intermittent lower abdominal pain. Physical examination with subsequent sonography reveals a cystic mass growing from the right ovary. Laparotomy with oophorectomy is performed and the removed ovary is shown for your evaluation. Histologic examination reveals small papillae and glands lined by stratified secreting columnar epithelium; neither cellular nor nuclear atypia is noticed. Which of the following is the most likely diagnosis?
- A.
Serous cystadenoma
- B.
Serous borderline tumor
- C.
Serous cystadenocarcinoma
- D.
Mucinous cystadenoma
- E.
Mucinous borderline tumor
- F.
Mucinous cystadenocarcinoma
- 10.
A 41-year-old woman presents with a 3-month history of intermittent lower abdominal pain. At pelvic examination, bilateral ovarian enlargement is found. Laparotomy with oophorectomy is performed and the gross appearance of one of the ovaries is shown for your evaluation. Histologic examination reveals multiple papillae covered by stratified pleomorphic epithelium single psammoma bodies are seen; mitotic activity is high. Which of the following is the most likely diagnosis?
- A.
Serous cystadenoma
- B.
Serous borderline tumor
- C.
Serous cystadenocarcinoma
- D.
Mucinous cystadenoma
- E.
Mucinous borderline tumor
- F.
Mucinous cystadenocarcinoma
- G.
Mature cystic teratoma
- 11.
A 45-year-old woman presents with an left ovarian mass. Oophorectomy is performed and microscopic examination of the resected material reveals the histologic structures shown for your evaluation. Elevation of which of the following serum markers you would expect in this patient before surgery?
- A.
Acid phosphatase
- B.
Alkaline phosphatase
- C.
Alpha-fetoprotein
- D.
Human chorionic gonatotropin
- E.
Prostate specific antigen
- 12.
A 28-year-old woman in her 12 weeks’ pregnancy presents to the Emergency Department with vaginal bleeding. Physical examination reveals an enlarged uterus. Ultrasound investigation detects snow-storm pattern of the distended uterine content; a fetus is not found. D&C is performed and the microscopic appearance of the specimen is shown for your evaluation. Which of the following is the most likely genetic background for the described pathology?
- A.
Fertilization of the normal ovum with two sperms
- B.
Reduplication of the ovum haplotype without fertilization
- C.
Fertilization of the normal ovum with one sperm
- D.
Fertilization of the empty ovum with two sperms
- E.
Fertilization of the normal ovum with one sperm with subsequent reduplication of sperm haplotype
- 13.
A 42-year-old African-American pregnant woman presents with vaginal bleeding. Physical examination reveals the uterus larger than predicted for her gestational age. Dilation and curettage is performed and histologic examination reveals the tissue shown for you evaluation. Which of the following is the most likely diagnosis?
- A.
Complete hydatidiform mole
- B.
Partial hydatidiform mole
- C.
Invasive hydatidiform mole
- D.
Choriocarcinoma
- E.
Endometrial carcinoma
- F.
Leiomyosarcoma
- 14.A 53-year-old Indian female presents with vaginal bleeding. On questioning, she reports her last menstrual period three months ago. She is not promiscuous and has lived in happy marriage with her husband over the past 30 years. She does not smoke, does not drink alcohol, and does not use recreational drugs. Ultrasound investigation reveals uterine pregnancy with a small hemorrhage between the placenta and uterine wall. Which of the following risk factors is most likely implicated in this case?
- A.
Chorioamnionitis
- B.
Smoking
- C.
Cocaine abuse
- D.
Advanced maternal age
- E.
All of above
- 15.A 32-year-old African American female in her 36 week of pregnancy is brought to the emergency department in comatose state. On questioning, the patient’s husband reports a history of elevated blood pressure and edema. Which of the following is the most likely cause of patient’s condition?
- A.
Fetal chromosomal abnormalities
- B.
Inadequate invasion of trophoblastic cells into the spiral arteries
- C.
A sexual transmitted disease with chorioamnionitis
- D.
A pelvic inflammatory disease with ectopic pregnancy
- E.
Inadequate decidua formation due to deficiency of pituitary gonadotropins
- F.
Too deep invasion of trophoblast into the underlying myometrium
- 16.
The image represents an endometrial biopsy obtained from a 28-year-old pregnant Asian woman with unexpectedly rapidly enlarging uterus. Which of the following chromosomal set is most likely to be found in the cells of this lesion?
- A.
46YY
- B.
46XX, both sets are paternal
- C.
69XXX, one set is maternal and two are paternal
- D.
69XXY, one set is paternal and two are maternal
- E.
46XY
- 17.
A 21-year-old African American woman acutely develops lower abdominal pain and vaginal bleeding. While in the bathroom she passes a cast of tissue composed of clot material. Histologic examination of the specimen reveals blood clots and endometrial tissue shown below for your evaluation. Which of the following conditions is most likely present in this patient?
- A.
Ectopic pregnancy
- B.
Aborted intrauterine pregnancy
- C.
Hydatidiform mole
- D.
Endometrial hyperplasia
- E.
Endometrioid endometrial carcinoma
- F.
Choriocarcinoma
.JPG "The shown endometrial biopsy from a 42-year-old obese woman complaining of vaginal spotting represents")
.JPG "A 33-year-old woman presents with a 3-year history of infertility. The microscopic appearance of the endometrium is shown for you evaluation. Which of the following is the most likely phase of the menstrual cycle at which the endometrial biopsy was taken?")
.JPG "A 38-year-old Caucasian female presents with dysfunctional intrauterine bleeding. Physical examination reveals deep voice and hirsutism. Physical examination reveals enlargement of the left ovary. Oophorectomy is performed and subsequent examination of the specimen reveals the ovarian lesion shown for your evaluation. Histologic examination reveals diffuse growth of slightly pleomorphic and vacuolated theca cells. Which of the following is the most likely diagnosis?")
.JPG "A 43-year-old Hispanic female presents with intermittent lower abdominal pain. Physical examination with subsequent sonography reveals a cystic mass growing from the right ovary. Laparotomy with oophorectomy is performed and the removed ovary is shown for your evaluation. Histologic examination reveals small papillae and glands lined by stratified secreting columnar epithelium; neither cellular nor nuclear atypia is noticed. Which of the following is the most likely diagnosis?")
.JPG "A 41-year-old woman presents with a 3-month history of intermittent lower abdominal pain. At pelvic examination, bilateral ovarian enlargement is found. Laparotomy with oophorectomy is performed and the gross appearance of one of the ovaries is shown for your evaluation. Histologic examination reveals multiple papillae covered by stratified pleomorphic epithelium single psammoma bodies are seen; mitotic activity is high. Which of the following is the most likely diagnosis?")
.JPG "A 45-year-old woman presents with an left ovarian mass. Oophorectomy is performed and microscopic examination of the resected material reveals the histologic structures shown for your evaluation. Elevation of which of the following serum markers you would expect in this patient before surgery?")
.JPG "A 28-year-old woman in her 12 weeks’ pregnancy presents to the Emergency Department with vaginal bleeding. Physical examination reveals an enlarged uterus. Ultrasound investigation detects snow-storm pattern of the distended uterine content; a fetus is not found. D&C is performed and the microscopic appearance of the specimen is shown for your evaluation.
Which of the following is the most likely genetic background for the described pathology?")
.JPG "A 42-year-old African-American pregnant woman presents with vaginal bleeding. Physical examination reveals the uterus larger than predicted for her gestational age. Dilation and curettage is performed and histologic examination reveals the tissue shown for you evaluation. Which of the following is the most likely diagnosis?")
.JPG "The image represents an endometrial biopsy obtained from a 28-year-old pregnant Asian woman with unexpectedly rapidly enlarging uterus.
Which of the following chromosomal set is most likely to be found in the cells of this lesion?")
.JPG "A 21-year-old African American woman acutely develops lower abdominal pain and vaginal bleeding. While in the bathroom she passes a cast of tissue composed of clot material. Histologic examination of the specimen reveals blood clots and endometrial tissue shown below for your evaluation. Which of the following conditions is most likely present in this patient?")
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