Women's Health Exam 2

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  • 1/44 Questions

    Results from a 35 y/o patient's Pap smear cytology and HPV DNA test are positive, what is the next diagnostic modality?

    • Endometrial biopsy
    • D&C
    • Cervical conization
    • Colposcopy
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About This Quiz

Women's Health Exam 2 assesses key diagnostic procedures following Pap smears, including ThinPrep slide preparation, colposcopy, and cervical cone biopsies. It focuses on practical knowledge essential for gynecological health management.

Womens Health Exam 2 - Quiz

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  • 2. 

    What is the diagnosis of Trichomoniasis?

    • Vaginal culture

    • PCR

    • Wet mount

    • HPV test

    Correct Answer
    A. Wet mount
    Explanation
    Trichomoniasis is diagnosed through a wet mount test. This involves examining a sample of vaginal discharge under a microscope to look for the presence of Trichomonas vaginalis, the parasite that causes the infection. The wet mount test is a simple and effective method for diagnosing Trichomoniasis. Vaginal culture, PCR, and HPV test are not specific tests for Trichomoniasis and are used to diagnose other conditions.

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  • 3. 

    What is the most common sexually transmitted infection?

    • Gonorrhea

    • Chlamydia

    • Herpes virus

    • Syphilis

    Correct Answer
    A. Chlamydia
    Explanation
    Chlamydia is the most common sexually transmitted infection because it is highly contagious and can be easily transmitted through sexual contact. It is caused by the bacteria Chlamydia trachomatis and can affect both men and women. Chlamydia often does not show any symptoms, which makes it even more prevalent as people may not be aware that they are infected. If left untreated, it can lead to serious complications such as infertility and pelvic inflammatory disease. Regular testing and practicing safe sex are essential in preventing the spread of chlamydia.

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  • 4. 

    What disease is a finding of grouped vesicles with an erythematous background associated with regional adenopathy?

    • Condyloma acuminate

    • Syphilis

    • Molluscum contagious

    • Herpes genitalis

    Correct Answer
    A. Herpes genitalis
    Explanation
    Herpes genitalis is a sexually transmitted infection caused by the herpes simplex virus (HSV). It is characterized by the presence of grouped vesicles (blisters) on an erythematous (red) background. These vesicles are typically painful and can appear on the genitals, anus, or surrounding areas. Regional adenopathy, or swollen lymph nodes, is commonly seen with herpes genitalis due to the immune response to the infection. Condyloma acuminate, syphilis, and molluscum contagious are all different conditions with distinct clinical features and are not associated with the specific findings mentioned in the question.

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  • 5. 

    A 48 y/o female presents to her PCP with complaints of uncyclic vaginal bleeding. She states she has begun menopause over a year ago. What is should be the primary concern of her physician?

    • Ovarian cyst

    • Endometrial malignancy

    • Perimenopausal irregularity

    • Adenomyosis

    Correct Answer
    A. Endometrial malignancy
    Explanation
    The primary concern of the physician should be endometrial malignancy because postmenopausal vaginal bleeding can be a symptom of this condition. Endometrial malignancy refers to cancer of the lining of the uterus, and it is more common in postmenopausal women. It is important to rule out this possibility through further evaluation and testing to ensure early detection and appropriate treatment if necessary.

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  • 6. 

    What is the most common type of cervical carcinoma?

    • Adenocarcinoma

    • Squamous cell carcinoma

    Correct Answer
    A. Squamous cell carcinoma
    Explanation
    Squamous cell carcinoma is the most common type of cervical carcinoma. This type of cancer originates in the squamous cells that line the outer surface of the cervix. Risk factors for squamous cell carcinoma include infection with high-risk strains of human papillomavirus (HPV), smoking, and a weakened immune system. It typically develops slowly over time and can be detected through regular cervical screenings. Treatment options for squamous cell carcinoma may include surgery, radiation therapy, and chemotherapy, depending on the stage and severity of the cancer.

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  • 7. 

    What is the treatment for asymptomatic Nabothian cyst?

    • Electrocautery

    • LEEP

    • Nothing until patient discomfort

    • Cervical biopsy

    Correct Answer
    A. Nothing until patient discomfort
    Explanation
    The correct answer is "Nothing until patient discomfort." Asymptomatic Nabothian cysts are benign growths that occur on the cervix. They are usually harmless and do not require treatment unless they cause discomfort or other symptoms. In such cases, treatment options may include draining the cyst or removing it through electrocautery or LEEP (loop electrosurgical excision procedure). However, if the patient is not experiencing any discomfort, it is generally recommended to monitor the cyst and only intervene if necessary.

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  • 8. 

    Chandiler's sign is positive exam finding for which STD?

    • Pelvic inflammatory disease

    • Chlamydia

    • Herpes

    • Trichomoniasis

    Correct Answer
    A. Pelvic inflammatory disease
    Explanation
    Chandelier's sign refers to the tenderness elicited during a bimanual examination of the cervix and uterus in cases of pelvic inflammatory disease (PID). This finding indicates that there is inflammation and infection present in the pelvic region. Chlamydia, herpes, and trichomoniasis can also cause PID, but Chandelier's sign specifically points towards PID as the correct answer.

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  • 9. 

    What is the most common finding of chlamydial infections in women?

    • Asymptomatic

    • Dysuria

    • Urinary frequency

    • Dyspurenia

    Correct Answer
    A. Asymptomatic
    Explanation
    Chlamydial infections in women are commonly asymptomatic, meaning that there are no noticeable symptoms present. This is a significant finding because it highlights the importance of regular screenings and testing for sexually transmitted infections, as individuals may not be aware that they are infected. Asymptomatic infections can lead to complications if left untreated, such as pelvic inflammatory disease, infertility, and chronic pelvic pain. Therefore, it is crucial to diagnose and treat chlamydial infections even in the absence of symptoms to prevent further health issues.

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  • 10. 

    Which is not viewed under colposcopy?

    • Uterus

    • Vagina

    • Cervical os

    • Vulva

    Correct Answer
    A. Uterus
    Explanation
    Colposcopy is a procedure used to examine the cervix, vagina, and vulva for any abnormalities. The uterus is not viewed under colposcopy because it is located higher up in the reproductive system and cannot be directly visualized through this procedure.

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  • 11. 

    What is the diagnostic measures for chlamydia and gonorrhea infections?

    • Physical exam

    • Nucleic acid amplification test (NAAT)

    • Pap smear

    Correct Answer
    A. Nucleic acid amplification test (NAAT)
    Explanation
    The correct answer is the nucleic acid amplification test (NAAT). This test is used to diagnose chlamydia and gonorrhea infections by detecting the genetic material (DNA or RNA) of the bacteria. It is a highly sensitive and specific test that can accurately identify the presence of these infections. Physical exam and pap smear are not specific diagnostic measures for chlamydia and gonorrhea, as they may not always detect these infections.

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  • 12. 

    What procedure is included in the work-up of infertility?

    • Dilation and curettage

    • Hysterosalpingogram

    • Pap smear

    • Hysteroscopy

    Correct Answer
    A. Hysterosalpingogram
    Explanation
    The procedure included in the work-up of infertility is a hysterosalpingogram. This is a diagnostic test that involves injecting a contrast dye into the uterus and fallopian tubes and then taking X-ray images to evaluate the shape and condition of these structures. It helps to identify any blockages or abnormalities that may be causing infertility.

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  • 13. 

    Which procedure is NOT a contraindication to a desired pregnant patient?

    • D&C

    • Hysteroscopy

    • Endometrial biopsy

    • Colposcopy

    Correct Answer
    A. Colposcopy
    Explanation
    Colposcopy is not a contraindication to a desired pregnant patient because it is a diagnostic procedure that allows for visualization and examination of the cervix, vagina, and vulva. It is commonly used to detect and evaluate abnormalities such as cervical dysplasia or cancer. Unlike D&C, hysteroscopy, and endometrial biopsy, colposcopy does not involve the removal or manipulation of the uterine lining or the uterus itself. Therefore, it is considered safe to perform during pregnancy as it does not pose a significant risk to the developing fetus.

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  • 14. 

    Which method of cervical cone biopsy is most used?

    • Cold knife

    • Laser

    • LEEP

    Correct Answer
    A. LEEP
    Explanation
    The most commonly used method of cervical cone biopsy is LEEP (Loop Electrosurgical Excision Procedure). LEEP is a procedure that uses a thin wire loop heated by an electrical current to remove abnormal cervical tissue. It is a safe and effective method that allows for precise removal of the abnormal tissue while minimizing damage to the surrounding healthy tissue. LEEP is preferred over cold knife and laser methods due to its accuracy, ease of use, and lower risk of complications.

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  • 15. 

    A patient has multiple painful genital ulcers. Presumptive diagnosis is chancroid. What other diagonstic STDs should be screened?

    • Herpes and granuloma inguinale

    • Herpes and syphilis

    • Syphilis and granuloma inguinale

    Correct Answer
    A. Herpes and syphilis
    Explanation
    In this case, the correct answer is herpes and syphilis. Chancroid is a sexually transmitted infection (STI) that causes painful genital ulcers. Since the patient has multiple painful genital ulcers, the presumptive diagnosis is chancroid. However, it is important to screen for other STIs that can present with similar symptoms. Both herpes and syphilis can cause genital ulcers, so it is necessary to test for these infections to confirm the diagnosis and provide appropriate treatment. Granuloma inguinale is also a possibility, but it is not as commonly associated with painful genital ulcers compared to herpes and syphilis.

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  • 16. 

    What is the most common symptom associated with menopause?

    • Urinary frequency and urgency

    • Vasomotor response

    • Facial hair increas

    • Osteoporosis

    Correct Answer
    A. Vasomotor response
    Explanation
    aka hot flashes

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  • 17. 

    What is the first line therapy for osteroporosis?

    • Bisphosphonates

    • Hormone replacement therapy

    • Raloxifene

    • Calcitonin

    Correct Answer
    A. Bisphosphonates
    Explanation
    Bisphosphonates are the first line therapy for osteoporosis because they are the most commonly prescribed medications for this condition. They work by slowing down the bone breakdown process, which helps to prevent further bone loss and reduce the risk of fractures. Bisphosphonates have been extensively studied and have shown to be effective in increasing bone density and reducing fracture risk in individuals with osteoporosis. They are also well-tolerated and have a good safety profile. Therefore, they are considered the initial treatment option for osteoporosis.

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  • 18. 

    What is the treatment for systemic symptoms of menopause in a woman without a hysterectomy?

    • Estrogen therapy

    • Progesterone therapy

    • Combined therapy

    Correct Answer
    A. Combined therapy
    Explanation
    Combined therapy, which includes both estrogen and progesterone therapy, is the recommended treatment for systemic symptoms of menopause in a woman without a hysterectomy. Estrogen therapy alone is not recommended in women with an intact uterus, as it can increase the risk of endometrial cancer. Progesterone therapy is necessary to protect the uterus from the potential harmful effects of estrogen. Therefore, combined therapy is the appropriate choice to provide relief from menopausal symptoms while minimizing the risk of complications.

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  • 19. 

    What is the most common method used for slide preparation after a Pap smear?

    • Slide sampling

    • KOH prep

    • ThinPrep

    Correct Answer
    A. ThinPrep
    Explanation
    ThinPrep: liquide-based medium sent to the lab, automates the preparation of the Pap smear slide so that the variability introduced by the clinician making the slide is no longer a factor

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  • 20. 

    A 28 y/o woman diagnosed with carcinoma in situ (CIS) wishes to preserve her fertility. What is the recommended treatment?

    • Hysterectomy

    • Cervical biopsy

    • Cervical conization

    • D&C

    Correct Answer
    A. Cervical conization
    Explanation
    Cervical conization is the recommended treatment for a 28-year-old woman diagnosed with carcinoma in situ (CIS) who wishes to preserve her fertility. Cervical conization involves the removal of a cone-shaped piece of tissue from the cervix, which allows for both the diagnosis and treatment of CIS. This procedure aims to remove the abnormal cells while preserving the rest of the cervix, thus maintaining the woman's fertility. Hysterectomy, on the other hand, involves the surgical removal of the uterus and would result in the loss of fertility. Cervical biopsy and D&C are diagnostic procedures and do not provide definitive treatment for CIS.

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  • 21. 

    What is the management for simple endometrial hyperplasia?

    • D&C

    • Endometrial biopsy

    • Progestin therapy

    • Hysterectomy

    Correct Answer
    A. Progestin therapy
    Explanation
    Progestin therapy is the management for simple endometrial hyperplasia. This treatment involves the use of progestin, a synthetic hormone, to help regulate the growth of the endometrial lining. Progestin helps to counteract the effects of estrogen, which can contribute to the development of endometrial hyperplasia. By using progestin therapy, the growth of the endometrium can be controlled and the condition can be managed effectively. This approach is less invasive than D&C (dilation and curettage) or hysterectomy, making it a preferred option for treating simple endometrial hyperplasia.

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  • 22. 

    What is the treatment for coverage of both chlamydia and gonorrhea infections?

    • Penicillin

    • Doxycycline

    • Levofloxacin

    • Metronidzaone

    Correct Answer
    A. Doxycycline
    Explanation
    Doxycycline is the treatment for coverage of both chlamydia and gonorrhea infections. It is a broad-spectrum antibiotic that is effective against both bacteria. Penicillin is not effective against these infections, and levofloxacin is not recommended due to increasing resistance. Metronidazole is used for the treatment of certain parasitic and anaerobic bacterial infections, but it is not effective against chlamydia or gonorrhea.

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  • 23. 

    What is the most common sx of cervicitis?

    • Purulent vaginal discharge

    • Dysuria

    • Dyspurenia

    • Urinary frequency

    Correct Answer
    A. Purulent vaginal discharge
    Explanation
    Consistency of discharge varies with causative organism.

    thick and creamy (gonorrhea)
    greenish-white and punctuate hemorrhages (Trichomoniasis)
    white and curd-like (candidiasis)
    thin and gray, soapy water (bacterial Vaginosis)

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  • 24. 

    What is the definition of osteoporosis?

    • T score less than -2.5

    • T score less than 2.5

    • T score less than -1.5

    • T score less than 1.5

    Correct Answer
    A. T score less than -2.5
    Explanation
    Osteoporosis is a condition characterized by low bone density and deterioration of bone tissue, leading to increased risk of fractures. The T score is a measurement used to assess bone density, comparing an individual's bone density to that of a healthy young adult. A T score less than -2.5 indicates that the individual has significantly lower bone density compared to a healthy young adult, which is consistent with a diagnosis of osteoporosis.

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  • 25. 

    What is the absence of bother the cervix and upper part of the vagina?

    • Cervical hypoplasia

    • Partial cervical agenesis

    • Complete cervical agenesis

    Correct Answer
    A. Complete cervical agenesis
    Explanation
    Complete cervical agenesis refers to the absence of both the cervix and the upper part of the vagina. This condition occurs when the cervix fails to develop properly during fetal development. It is a rare congenital anomaly that can lead to difficulties in menstruation, sexual intercourse, and fertility. Treatment options may include surgical interventions to create a functional cervix or alternative reproductive methods for individuals wishing to conceive.

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  • 26. 

    What is the purpose of a cervical cone biopsy?

    • Removal of the cervix

    • Removal of the macroinvasive cervical carcinoma

    • Removal of the entire tranformation zone

    • Diagnosis abnormal uterine bleeding

    Correct Answer
    A. Removal of the entire tranformation zone
    Explanation
    this is done after the cervical colposcopy reveals microinvasive cancer

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  • 27. 

    What are the result of the work-up for a postmenopausal woman?

    • Estrogen low and FSH & LH high

    • Estrogen low and FSH & LH low

    Correct Answer
    A. Estrogen low and FSH & LH high
    Explanation
    In postmenopausal women, the ovaries stop producing estrogen, resulting in low estrogen levels. Additionally, the pituitary gland increases the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in an attempt to stimulate the ovaries to produce estrogen. Therefore, in a postmenopausal woman, the result of the work-up would show low estrogen levels and high FSH & LH levels.

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  • 28. 

    What are the recommendations and indications for a DEXA scan?

    • Women >60 yoa every 2 years

    • Women >60 yoa with risk factors

    • Women >65 yoa with risk factors

    • Women >65 yoa every 5 years

    Correct Answer
    A. Women >60 yoa with risk factors
    Explanation
    A DEXA scan is recommended for women over 60 years of age who have risk factors for osteoporosis. This is because women in this age group are more likely to develop osteoporosis, and the scan can help detect bone density loss early on. Regular scans every 2 years are suggested to monitor changes in bone density and assess the effectiveness of any interventions. Women over 65 years of age without risk factors may not require a DEXA scan as frequently, with scans every 5 years being recommended instead.

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  • 29. 

    What is a complication of hysterosalpingogram seen in 1-3% of patients?

    • Abdominal cramping

    • Postcoital bleeding

    • Peritonitis

    • Infertility

    Correct Answer
    A. Peritonitis
    Explanation
    Pretreat with short course of doxycycline to prevent

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  • 30. 

    What is the follow-up for the previous patient if positive for HPV 16 &18?

    • Blood work in 6 months

    • Colposcopy

    • Cytology and HPV at 12 months

    • D&C

    Correct Answer
    A. Cytology and HPV at 12 months
    Explanation
    Colposcopy would be if the results were on the 2nd Pap were still cytology normal and HPV positive.

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  • 31. 

    A 51 y/o postmenopausal patient comes for her annual Pap smear appointment with complaints of intermittent vaginal spotting. The results of the Pap smear are show no dysplasia or abnormal cells. What is the next step?

    • Reassure her that the bleeding is normal the first 2 years after menopause begins

    • Schedule her for a colposcopy

    • Schedule her for a endometrial biopsy

    • Ask her to come in for blood work

    Correct Answer
    A. Schedule her for a endometrial biopsy
    Explanation
    Endometrial biopsy is the most diagnostic test for abnormal uterine bleeding usually caused by endometrial cancer in postmenopausal women

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  • 32. 

    Red or brownish/blacking areas called "powder burns" are characteristic of what type of lesions on the cervix?

    • Polyps

    • Leiomyomas

    • Ulcers

    • Endometriosis

    Correct Answer
    A. Endometriosis
    Explanation
    Red or brownish/black areas called "powder burns" are characteristic of endometriosis lesions on the cervix. Endometriosis is a condition where the tissue that normally lines the uterus grows outside of it, causing inflammation and the formation of lesions. These lesions can appear as red or brownish/black areas on the cervix, resembling powder burns. This characteristic feature helps in diagnosing endometriosis in the cervix.

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  • 33. 

    What is the appear of cherry red dots consisting of columnar epithelium surrounded by fibromuscular stroma?

    • Warts

    • Ulcers

    • Adenosis

    • Polpys

    Correct Answer
    A. Adenosis
    Explanation
    Adenosis is the correct answer because it is a condition characterized by the presence of cherry red dots consisting of columnar epithelium surrounded by fibromuscular stroma. Warts, ulcers, and polyps do not exhibit this specific appearance.

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  • 34. 

    A 31 y/o female is examined for her annual Pap smear and during the exam you notice a waxy, yellowish irregular surface of the cervix. Results of the cytology are negative for intraepithelial lesions. What should be your next step?

    • HPV DNA test

    • Colposcopy

    • Cervical cone biopsy

    • Nothing the results are normal

    Correct Answer
    A. HPV DNA test
    Explanation
    From what I'm reading, HPV should be routinely done (so this is assuming one has not because it wasn't stated), but also a biopsy should always be done regardless of cytology results. Women over 30 most benefit from the HPV screening because these are usually the cancerous strains verses benign in sexually active women younger than 30 whose immune system usually clears.

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  • 35. 

    Which is an appropriate treatment for recurrent herpes genitalis?

    • Acyclovir 200 mg twice a day

    • Famciclovir 250 mg twice a day

    • Valacyclovir 500 mg once a day

    • Acyclovir 500 mg once a day

    Correct Answer
    A. Valacyclovir 500 mg once a day
    Explanation
    Valacyclovir 500 mg once a day is an appropriate treatment for recurrent herpes genitalis. Valacyclovir is an antiviral medication that is effective in treating herpes infections. It helps to reduce the severity and duration of outbreaks, as well as prevent the recurrence of symptoms. The recommended dosage for recurrent herpes genitalis is 500 mg once a day.

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  • 36. 

    Which is not one of the Amsel's criteria for diagnosing bacterial vagninosis?

    • Homongenous vaginal discharge

    • Vaginal pH >4.5

    • Amine odor when KOH is added

    • Clue cells on microscopy

    Correct Answer
    A. Vaginal pH >4.5
    Explanation
    Amsel's criteria for diagnosing bacterial vaginosis include homogeneous vaginal discharge, amine odor when KOH is added, and clue cells on microscopy. Vaginal pH >4.5 is not one of Amsel's criteria for diagnosing bacterial vaginosis.

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  • 37. 

    A 8 y/o female patient presents to Children's hospital with a CC of a sprained ankle. Upon inspection you notice bruising on the affected joint and continues up the medial calf and thigh. You have suspicion of more that just a sprained ankle and decide to order a rape kit. What gynecological instrument should you use?

    • Small Pedersen speculum

    • Small Graves speculum

    • Coloscope

    • Vaginoscope

    Correct Answer
    A. Vaginoscope
    Explanation
    Vaginoscopy is used for the examination of children usually to detect penetrating trauma

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  • 38. 

    When should an inadequate Pap smear sample be repeated?

    • One year

    • 6 months

    • 4 months

    • 2 months

    Correct Answer
    A. 4 months
    Explanation
    Between 3-6 months preferably

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  • Dec 06, 2023
    Quiz Edited by
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