Subjective Gynaecology Quiz

44 Questions | Total Attempts: 27

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Subjective Gynaecology Quiz

Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system. Almost all modern gynaecologists are also obstetricians. In many areas, the specialities of gynaecology and obstetrics overlap. This is the best subjective Gynaecology quiz there is! Take this quiz to know more


Questions and Answers
  • 1. 
    1 A 25-year-old man presents 1 week after discovering that his left testicle is twice the normal size. Physical examination reveals a nontender, testicular mass that cannot be transilluminated. Serum levels of alpha-fetoprotein and human chorionic gonadotropin are normal. A hemiorchiectomy is performed, and histologic examination of the surgical specimen shows embryonal carcinoma. Compared to normal adult somatic cells, this germ cell neoplasm would most likely show high levels of expression of which of the following proteins?
    • A. 

      (A) Desmin

    • B. 

      (B) Dystrophin

    • C. 

      (C) Cytochrome c

    • D. 

      (D) P selectin

    • E. 

      (E) Telomerase

  • 2. 
    2 A 25-year-old woman presents for a gynecologic examination. The cervical Pap smear shows “koilocytic atypia” characterized by perinuclear halos and wrinkled nuclei (shown in the image). A cervical biopsy reveals invasive squamous cell carcinoma. Molecular tests for human papillomavirus (HPV) in the tumor cells are positive. Which of the following mechanisms of disease best explains the role of HPV in the pathogenesis of neoplasia in this patient?
    • A. 

      (A) Activation of cellular oncogenes

    • B. 

      B) Enhanced transcription of telomerase gene

    • C. 

      (C) Episomal viral replication

    • D. 

      (D) Inactivation of tumor suppressor proteins

    • E. 

      (E) Insertional mutagenesis

  • 3. 
    3 The patient described in Question 2 undergoes a hysterectomy. In addition to a focus of invasive carcinoma, the pathologist identifi es dysplastic squamous cells occupying the entire thickness of the cervical epithelium, with no evidence of epithelial maturation. The basal membrane in these areas appears intact. Which of the following terms best describes this cervical lesion?
    • A. 

      (A) Atypical hyperplasia

    • B. 

      (B) Carcinoma in situ

    • C. 

      (C) Carcinomatosis

    • D. 

      (D) Complex hyperplasia

    • E. 

      (E) Koilocytic atypia

  • 4. 
    4 A 62-year-old woman presents with a breast lump that she discovered 6 days ago. A breast biopsy shows lobular carcinoma in situ. Compared to normal epithelial cells of the breast lobule, these malignant cells would most likely show decreased expression of which of the following proteins?
    • A. 

      (A) Desmin

    • B. 

      (B) E-cadherin

    • C. 

      (C) Lysyl hydroxylase

    • D. 

      (D) P selectin

    • E. 

      (E) Telomerase

  • 5. 
    5 An 80-year-old man complains of lower abdominal pain, increasing weakness, and fatigue. He has lost 16 lb (7.3 kg) in the past 6 months. The prostate-specifi c antigen test is elevated (8.5 ng/mL). Rectal examination reveals an enlarged and nodular prostate. A needle biopsy of the prostate discloses invasive prostatic adenocarcinoma. Histologic grading of this patient’s carcinoma is based primarily on which of the following criteria?
    • A. 

      (A) Capsular involvement

    • B. 

      (B) Extent of regional lymph nodes involvement

    • C. 

      (C) Pulmonary metastases

    • D. 

      (D) Resemblance to normal tissue of origin

    • E. 

      (E) Volume of prostate involved by tumor

  • 6. 
    6 A 50-year-old woman presents with a lump in her breast. A 4-cm firm and fixed mass is noted on breast examination. Excisional biopsy reveals malignant cells that form glandlike structures and solid nests, surrounded by a dense collagenous stroma. A connective tissue stain (trichrome) of the biopsy is shown in the image. Which of the following descriptive terms best describes the blue areas observed in this specimen?
    • A. 

      (A) Colloid carcinoma

    • B. 

      (B) Comedocarcinoma

    • C. 

      (C) Desmoplastic change

    • D. 

      (D) Medullary carcinoma

  • 7. 
    7 A 65-year-old man complains of muscle weakness and a dry cough for 4 months. He has smoked two packs of cigarettes daily for 45 years. A chest X-ray shows a 4-cm central, left lung mass. Laboratory studies reveal hyperglycemia and hypertension. A transbronchial biopsy is diagnosed as small cell carcinoma. Metastases to the liver are detected by CT scan. Which of the following might account for the development of hyperglycemia and hypertension in this patient?
    • A. 

      (A) Adrenal metastases

    • B. 

      (B) Paraneoplastic syndrome

    • C. 

      (C) Pituitary adenoma

    • D. 

      (D) Pituitary metastases

    • E. 

      (E) Thrombosis of the renal artery

  • 8. 
    8 A 60-year-old man presents with a 4-month history of increasing weight loss, wheezing, and shortness of breath. He has smoked two packs of cigarettes a day for 40 years. His past medical history is signifi cant for emphysema and chronic bronchitis. A chest X-ray shows a 10-cm mass in the left lung. Bronchoscopy discloses obstruction of the left main stem bronchus. A biopsy is obtained (shown in the image). Immunohistochemical studies of this biopsy specimen would most likely show strong expression of which of the following tumor markers?
    • A. 

      (A) Alpha-fetoprotein

    • B. 

      (B) Calretinin

    • C. 

      (C) Carcinoembryonic antigen

    • D. 

      (D) Cytokeratins

    • E. 

      (E) Synaptophysin

  • 9. 
    9 Which of the following potent carcinogens was most likely involved in the pathogenesis of lung cancer in the patient described in Question 8?
    • A. 

      (A) Afl atoxin B1

    • B. 

      (B) Asbestos

    • C. 

      (C) Azo dyes

    • D. 

      (D) Polycyclic aromatic hydrocarbons

    • E. 

      (E) Vinyl chloride

  • 10. 
    10 A 33-year-old woman discovers a lump in her left breast on self-examination. Her mother and sister both had breast cancer. A mammogram demonstrates an ill-defi ned density in the outer quadrant of the left breast, with microcalcifi cations. Needle aspiration reveals the presence of malignant, ductal epithelial cells. Genetic screening identifi es a mutation in BRCA1. In addition to cell cycle control, BRCA1 protein promotes which of the following cellular functions?
    • A. 

      (A) Apoptosis

    • B. 

      (B) Cell adhesion

    • C. 

      (C) DNA repair

    • D. 

      (D) Gene transcription

    • E. 

      (E) Transmembrane signaling

  • 11. 
    11 A 60-year-old man who worked for 30 years in a chemical factory complains of blood in his urine. Urine cytology discloses dysplastic cells. A bladder biopsy demonstrates transitional cell carcinoma. Which of the following carcinogens was most likely involved in the pathogenesis of bladder cancer in this patient?
    • A. 

      (A) Aniline dyes

    • B. 

      (B) Arsenic

    • C. 

      (C) Benzene

    • D. 

      (D) Cisplatinum

    • E. 

      (E) Vinyl chloride

  • 12. 
    12 A 60-year-old man presents with an ulcerated, encrusted, and infi ltrating lesion on the sun-exposed dorsal aspect of a fi nger (shown in the image). A biopsy reveals squamous cell carcinoma. The metastatic potential of this neoplasm would be enhanced by upregulation of the gene for which of the following proteins?
    • A. 

      (A) Collagen type IV

    • B. 

      (B) Desmin

    • C. 

      (C) E-cadherin

    • D. 

      (D) Glutathione peroxidase

    • E. 

      (E) Plasminogen activator

  • 13. 
    13 A 45-year-old man presents with a 9-month history of a reddish nodule on his foot. Biopsy of the nodule discloses a poorly demarcated lesion composed of fi broblasts and endothelial-like cells lining vascular spaces. Further work-up identifi es similar lesions in the lymph nodes and liver. The tumor cells contain sequences of human herpesvirus-8 (HHV-8). This patient most likely has which of the following diseases?
    • A. 

      (A) Acquired immunodefi ciency

    • B. 

      (B) Ataxia telangiectasia

    • C. 

      (C) Li-Fraumeni syndrome

    • D. 

      (D) Neurofi bromatosis type I

    • E. 

      (E) Xeroderma pigmentosum

  • 14. 
    14 During a routine checkup, a 50-year-old man is found to have blood in his urine. He is otherwise in excellent health. An abdominal CT scan reveals a 2-cm right renal mass. You inform the patient that staging of this tumor is key to selecting treatment and evaluating prognosis. Which of the following is the most important staging factor for this patient?
    • A. 

      (A) Histologic grade of the tumor

    • B. 

      (B) Metastases to regional lymph nodes

    • C. 

      (C) Proliferative capacity of the tumor cells

    • D. 

      (D) Somatic mutations in the p53 tumor suppressor gene

    • E. 

      (E) Tumor cell karyotype (aneuploidy)

  • 15. 
    15 A 68-year-old man who has worked in a shipyard and manufacturing plant all his adult life complains of a 4-month history of chest discomfort, malaise, fever, night sweats, and weight loss. A chest X-ray reveals a large pleural effusion. The patient dies 5 months later of cardiorespiratory failure. The lung at autopsy is shown in the image. This malignant neoplasm is associated with environmental exposure to which of the following carcinogens?  
    • A. 

      (A) Afl atoxin B1

    • B. 

      (B) Asbestos

    • C. 

      (C) Beryllium

    • D. 

      (D) Ionizing radiation

    • E. 

      (E) Silica

  • 16. 
    16 A 58-year-old woman with colon cancer presents with 3 months of increasing shortness of breath. A chest X-ray reveals numerous, bilateral, round masses in both lungs. Histologic examination of an open-lung biopsy discloses malignant gland-like structures, which are nearly identical to the colon primary. Which of the following changes in cell behavior was the fi rst step in the process leading to tumor metastasis from the colon to the lung in this patient?
    • A. 

      (A) Arrest within the circulating blood or lymph

    • B. 

      (B) Exit from the circulation into a new tissue

    • C. 

      (C) Invasion of the underlying basement membrane

    • D. 

      (D) Penetration of vascular or lymphatic channels

    • E. 

      (E) Stimulation of angiogenesis within the pulmonarymetastases

  • 17. 
    17 A 68-year-old man complains of recent changes in bowel habits and blood-tinged stools. Colonoscopy reveals a 3-cm mass in the sigmoid colon. Biopsy of the mass shows infi ltrating malignant glands. These neoplastic cells have most likely acquired a set of mutations that cause which of the following changes in cell behavior?
    • A. 

      (A) Decreased cellular motility

    • B. 

      (B) Enhanced stem cell differentiation

    • C. 

      (C) Increased cell-cell adhesion

    • D. 

      (D) Increased susceptibility to apoptosis

    • E. 

      (E) Loss of cell cycle restriction point control

  • 18. 
    18 A 35-year-old woman complains of nipple discharge and irregular menses of 5 months duration. Physical examination reveals a milky discharge from both nipples. MRI shows an enlargement of the anterior pituitary. Which of the following is the most likely histologic diagnosis of this patient’s pituitary tumor?
    • A. 

      (A) Adenoma

    • B. 

      (B) Choristoma

    • C. 

      (C) Hamartoma

    • D. 

      (D) Papilloma

    • E. 

      (E) Teratoma

  • 19. 
    19 A 52-year-old woman presents with a 1-year history of upper truncal obesity and moderate depression. Physical examination shows hirsutism and moon facies. A CT scan of the thorax displays a hilar mass. A transbronchial lung biopsy discloses small cell carcinoma. Electron microscopy of this patient’s lung tumor will most likely reveal which of the following cytologic features?
    • A. 

      (A) Councilman bodies

    • B. 

      (B) Hyperplasia of endoplasmic reticulum

    • C. 

      (C) Mitochondrial calcifi cation

    • D. 

      (D) Myelin fi gures in lysosomes

    • E. 

      (E) Neuroendocrine granules

  • 20. 
    20 Cytogenetic studies in a 40-year-old woman with follicular lymphoma demonstrate a t(14;18) chromosomal translocation involving the bcl-2 gene. Constitutive expression of the protein encoded by the bcl-2 gene inhibits which of the following processes in this patient’s transformed lymphocytes?
    • A. 

      (A) Apoptosis

    • B. 

      (B) DNA excision repair

    • C. 

      (C) G1-to-S cell cycle progression

    • D. 

      (D) Oxidative phosphorylation

    • E. 

      (E) Protein (N-linked) glycosylation

  • 21. 
    21 A 60-year-old man presents with a 6-month history of increasing weight loss and fatigue. Physical examination reveals conspicuous hepatomegaly. An abdominal CT scan reveals multiple “canon ball” nodules in the liver (shown in the image). A CTguided biopsy reveals a mucous-secreting adenocarcinoma. This patient’s metastatic liver cancer most likely originated in which of the following anatomic locations? 
    • A. 

      (A) Adrenal medulla

    • B. 

      (B) Bone marrow

    • C. 

      (C) Brain

    • D. 

      (D) Pancreas

    • E. 

      (E) Urinary bladder

  • 22. 
    22 A 59-year-old woman presents with increasing pigmentation of the skin. Physical examination shows hyperkeratosis and hyperpigmentation of the axilla, neck, fl exures, and anogenital region. Endocrinologic studies reveal normal serum levels of adrenal corticosteroids and glucocorticoids. If this patient’s skin pigmentation represents a paraneoplastic syndrome, the primary tumor would most likely be found in which of the following anatomic locations?
    • A. 

      (A) Bladder

    • B. 

      (B) Cervix

    • C. 

      (C) Esophagus

    • D. 

      (D) Pleura

    • E. 

      (E) Stomach

  • 23. 
    23 A 65-year-old man dies after a protracted battle with metastatic colon carcinoma. At autopsy, the liver is fi lled with multiple nodules of cancer, many of which display central necrosis (umbilication). Which of the following best explains the pathogenesis of tumor umbilication in this patient?
    • A. 

      (A) Biphasic tumor

    • B. 

      (B) Chronic infl ammation

    • C. 

      (C) Granulomatous infl ammation

    • D. 

      (D) Ischemia and infarction

    • E. 

      (E) Stimulation of angiogenesis

  • 24. 
    24 A 59-year-old man complains of progressive weakness. He reports that his stools are very dark. Physical examination demonstrates fullness in the right lower quadrant. Laboratory studies show iron defi ciency anemia, with a serum hemoglobin level of 7.4 g/dL. Stool specimens are positive for occult blood. Colonoscopy discloses an ulcerating lesion of the cecum. Which of the following serum tumor markers is most likely to be useful for following this patient after surgery?
    • A. 

      (A) Alpha-fetoprotein

    • B. 

      (B) Carcinoembryonic antigen

    • C. 

      (C) Chorionic gonadotropin

    • D. 

      (D) Chromogranin

    • E. 

      (E) Coagulation factor VIII

  • 25. 
    25 Laboratory studies of the surgical specimen obtained from the patient described in Question 24 demonstrate hypermethylation of the p53 gene. Which of the following best characterizes this biochemical change in the neoplastic cells?  
    • A. 

      A) Epigenetic modifi cation

    • B. 

      (B) Gene amplifi cation

    • C. 

      (C) Insertional mutagenesis

    • D. 

      (D) Nonreciprocal translocation

    • E. 

      (E) Protooncogene mutation

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