Pathology Of Female Reproductive System 2
.JPG "Pathology Of Female Reproductive System 2 - Quiz")
Questions and Answers
- 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
Correct Answer
D. Endometrioid endometrial carcinomaExplanation
The given endometrial biopsy from a 42-year-old obese woman complaining of vaginal spotting represents endometrioid endometrial carcinoma. This type of carcinoma is the most common form of endometrial cancer and is typically associated with obesity and hormonal imbalances. It is characterized by glandular structures resembling the lining of the uterus and is often accompanied by symptoms such as abnormal vaginal bleeding. Other options such as keratinizing and non-keratinizing squamous cell carcinoma, choriocarcinoma, hydatidiform mole, and leiomyosarcoma are not consistent with the histological features described in the question.Rate this question:
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- 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
Correct Answer
E. Polycystic ovary syndromeExplanation
Polycystic ovary syndrome (PCOS) is the most likely predisposing factor in this case. PCOS is a hormonal disorder that is commonly associated with obesity and can cause irregular menstrual cycles and abnormal uterine bleeding, such as vaginal spotting. PCOS is characterized by multiple cysts on the ovaries, hormonal imbalances, and insulin resistance. It is a common condition in women of reproductive age and can increase the risk of endometrial hyperplasia and endometrial cancer, which can cause vaginal spotting. Therefore, PCOS is the most likely explanation for the patient's symptoms.Rate this question:
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- 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
Correct Answer
B. Early secretory phaseExplanation
The presence of subnuclear vacuoles in the endometrial glands in an endometrial biopsy indicates the early secretory phase. During this phase, the endometrium undergoes changes to prepare for implantation of a fertilized egg. The subnuclear vacuoles are a characteristic feature of the early secretory phase and represent the secretory activity of the endometrial glands.Rate this question:
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- 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
Correct Answer
B. Early secretoryExplanation
The most likely phase of the menstrual cycle at which the endometrial biopsy was taken is the early secretory phase. This is suggested by the microscopic appearance of the endometrium, which shows glands that are elongated, tortuous, and branching. During the early secretory phase, the endometrium undergoes changes in preparation for potential implantation of a fertilized egg, including glandular development and increased vascularity. This phase typically occurs around days 19-23 of a 28-day menstrual cycle.Rate this question:
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- 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
Correct Answer
E. An elder women with osteoporosisExplanation
Elder women with osteoporosis are more prone to serous endometrial adenocarcinoma because there is a strong association between osteoporosis and endometrial cancer. Osteoporosis is linked to estrogen deficiency, which can lead to an imbalance in hormone levels and an increased risk of developing endometrial cancer. Additionally, older women are generally at a higher risk for endometrial cancer due to hormonal changes that occur with age.Rate this question:
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- 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
Correct Answer
D. Endometriod endometrial adenocarcinomaExplanation
The correct answer is Endometriod endometrial adenocarcinoma. The patient's history of oligomenorrhea alternating with amenorrhea and physical examination findings of obesity and male escutcheon are consistent with polycystic ovary syndrome (PCOS). PCOS is associated with chronic anovulation and unopposed estrogen exposure, which can lead to endometrial hyperplasia and an increased risk of endometriod endometrial adenocarcinoma. Ovarian carcinoma, cervical carcinoma, uterine leiomyosarcoma, and choriocarcinoma are not typically associated with PCOS.Rate this question:
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- 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
Correct Answer
B. Granulosa cellsExplanation
Granulosa cells are the major source of progesterone in a normal ovary. These cells are found in the ovarian follicles and are responsible for producing and releasing progesterone. Progesterone plays a crucial role in regulating the menstrual cycle and preparing the uterus for pregnancy. It helps in thickening the uterine lining and maintaining pregnancy by supporting the development of the embryo. Therefore, the granulosa cells are essential in the production of progesterone, making them the correct answer.Rate this question:
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- 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
Correct Answer
C. ThecomaExplanation
Thecomas or theca cell tumors are benign ovarian neoplasms composed only of theca cells. Histogenetically they are classified as sex cord-stromal tumours.
They are typically estrogen-producing and they occur in older women (mean age 59; 84% after menopause). (They can, however, appear before menopause.)
Sixty percent of patients present with abnormal uterine bleeding, and 20% have endometrial carcinoma.
Grossly, the tumour is solid and yellow.
Grossly and microscopically, it compress of the ovarian cortex.
Microscopically, the tumour cells have abundant lipid-filled cytoplasm.Rate this question:
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- 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
Correct Answer
E. Mucinous borderline tumorExplanation
Based on the given information, the most likely diagnosis is a mucinous borderline tumor. This is supported by the histologic examination findings of small papillae and glands lined by stratified secreting columnar epithelium, without any cellular or nuclear atypia. This is characteristic of a mucinous borderline tumor, which is a type of ovarian tumor that has the potential to progress to malignancy but is not yet invasive or metastatic.Rate this question:
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- 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
Correct Answer
C. Serous cystadenocarcinomaExplanation
The most likely diagnosis based on the given information is serous cystadenocarcinoma. This is indicated by the presence of multiple papillae covered by stratified pleomorphic epithelium, high mitotic activity, and the presence of psammoma bodies. Serous cystadenocarcinoma is a malignant tumor of the ovary characterized by these histologic features. The other options, such as serous cystadenoma and serous borderline tumor, do not typically exhibit the same level of cellular atypia and mitotic activity seen in serous cystadenocarcinoma.Rate this question:
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- 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
Correct Answer
C. Alpha-fetoprotein -
- 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
Correct Answer
D. Fertilization of the empty ovum with two spermsExplanation
The correct answer suggests that the most likely genetic background for the described pathology is fertilization of the empty ovum with two sperms. This is indicated by the presence of a snow-storm pattern of the distended uterine content on ultrasound, which is characteristic of a complete hydatidiform mole. In a complete mole, an empty ovum is fertilized by two sperms, resulting in a complete absence of fetal tissue and the presence of abnormal placental tissue. The microscopic appearance of the specimen would confirm this diagnosis.Rate this question:
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- 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
Correct Answer
B. Partial hydatidiform moleExplanation
The most likely diagnosis in this case is a partial hydatidiform mole. This is suggested by the patient's presentation of vaginal bleeding, an enlarged uterus, and the histologic examination revealing the tissue shown. A partial hydatidiform mole is a type of gestational trophoblastic disease characterized by abnormal growth of the placenta, with some fetal development. It is often associated with triploidy, which is an abnormal number of chromosomes. This diagnosis is more likely than a complete hydatidiform mole because a partial mole typically has some fetal tissue present, whereas a complete mole does not. The other options, such as invasive hydatidiform mole, choriocarcinoma, endometrial carcinoma, and leiomyosarcoma, are less likely based on the given information.Rate this question:
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- 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
Correct Answer
E. All of aboveExplanation
apparently middle aged Indian women are big coke heads!!!!!Rate this question:
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- 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
Correct Answer
B. Inadequate invasion of trophoblastic cells into the spiral arteriesExplanation
The most likely cause of the patient's condition is inadequate invasion of trophoblastic cells into the spiral arteries. This condition, known as preeclampsia, is characterized by elevated blood pressure and edema, which are reported by the patient's husband. Inadequate invasion of trophoblastic cells into the spiral arteries can lead to poor placental perfusion and oxygenation, resulting in maternal complications such as coma. Fetal chromosomal abnormalities, sexual transmitted diseases, pelvic inflammatory disease, inadequate decidua formation, and deep invasion of trophoblast into the myometrium are not consistent with the patient's clinical presentation.Rate this question:
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- 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
Correct Answer
C. 69XXX, one set is maternal and two are paternalExplanation
The presence of 69XXX indicates that there are three X chromosomes in the cells of this lesion. This suggests that there is an extra copy of the X chromosome, which is known as Triple X syndrome or Trisomy X. In this case, one set of X chromosomes is maternal (inherited from the mother) and two sets are paternal (inherited from the father). This condition can cause various symptoms and may be associated with an enlarged uterus, which aligns with the clinical presentation described in the question.Rate this question:
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- 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
Correct Answer
A. Ectopic pregnancyExplanation
The correct answer is ectopic pregnancy. Ectopic pregnancy refers to the implantation of a fertilized egg outside of the uterus, most commonly in the fallopian tube. The symptoms of lower abdominal pain, vaginal bleeding, and passing of tissue are consistent with ectopic pregnancy. The histologic examination of the specimen would reveal blood clots and endometrial tissue, further supporting the diagnosis.Rate this question:
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.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?")
Female Reproductive System Test! Trivia Facts Quiz
Female Reproductive System Test! Trivia Facts Quiz
Could you identify Female Internal Reproductive Organs?
Could you identify Female Internal Reproductive Organs?
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