GYNECOLOGY (OBGYN) MOD
1-5 FINAL EXAM
QNS & ANS
2023/2024
,1. Which of the following is NOT correct of pelvic endometriosis?
A. Most commonly found during the reproductive years
B. Aberrant endometrial tissue grows under the cyclic influence of ovarian hormones
C. Particularly estrogen dependent
D. This is not responsive to medical treatment
2. Which is not a hallmark of chronic pelvic pain?
A. Hypersensitive response to nociceptive stimuli
B. Signs of depression
C. Altered family ties
D. Non-debilitating pelvic pain lasting more than 6 months
3. Mrs. A is a G8P8(8008), recently diagnosed with a cystocele and a rectocele. Based on this finding, what level of support was
weakened?
A. Level II
B. Level IV
C. Level
D. Level Ill
4. It is also sometimes termed internal endometriosis
A. Endometriotic cyst
B. Pelvic inflammatory disease
C. Deep infiltrating endometriosis
D. Adenomyosis
5. Sensitizing mediators are released into affected tissues and lower the conduction threshold of nociceptors. This is termed as:
A. Nociception
B. Neuropathic pain
C. Central sensitization
D. Peripheral sensitization
,6. The most popular theory of pelvic endometriosis:
A. Retrograde menstruation
B. latrogenic
C. Coelomic metaplasia
D. Immunologic
7. Which of the following progestins is a NOT suitable option to treat a woman recently diagnosed with stage I endometriosis who
has associated pain but is not currently seeking conception?
A. Depot medroxyprogesterone acetate
B. Levonorgestrel-releasing intrauterine system
C. Drosperinone
D. Norethindrone acetate
8. Sonographically, endometriomas are typically described by which of the following?
A. Solid with diffuse internal low-level echoes
B. Cystic with focal hyperechoic internal echoes
C. Cystic with diffuse internal low-level echoes
D. Solid with intracystic blood flow
9. Which is the most common condition assigned as an etiology to pelvic pain?
A. Sexual abuse
B. Pelvic congestion
C. Pelvic adhesions
D. Ovarian remnant syndrome
10. Antiepileptic drugs used in chronic pelvic pain do NOT include:
A. Pregabalin
B. Gabapentin
C. Desipramine
D. Lamotrigine
11. Which best describes normal pelvic anatomy?
A. Arcus tendinous fascia pelvis supports midportion anterior vagina
B. In the standing position the lower two thirds of vagina is directly over the levator plate
C. Intraabdominal & pelvic contents directed towards the muscles and the fascia
D. Pelvic inlet is tilted backward
12. Which is NOT a cardinal feature of endometriosis?
A. Endometrial glands and stroma within the myometrium
B. Ectopic endometrial glands
C. Ectopic endometrial stroma
D. Hemorrhage into adjacent tissues
13. Which of the following is an inciting factor for POP?
A. Vaginal birth
B. Obesity
C. Menopause
D. Constipation
14. Which of the following statements is NOT true of Pelvic Congestion Syndrome?
A. Pelvic Congestion Syndrome results from chronic pelvic ache, pressure and heaviness
B. Progesterone is implicated in pelvic congestion syndrome in that it acts as a venous dilator
C. Varicosities in the thigh, buttocks, perineum, or vagina may be associated
D. Affected women may describe pelvic ache or heaviness that may worsen premenstrually
15. What structure serves as a reference in the POP-Q?
A. Cervix C. Hymen
B. Posterior fornix D. Clitoris
, 16. Which of the following procedures is most needed to perform for apical prolapse?
A. Anterior colporrhaphy
B. Sacrospinous ligament suspension
C. Anterior and Posterior colporrhaphy
D. Posterior colporrhaphy
17. In patients with combined urinary and chronic pelvic pain symptoms, which of the following tests is typically advised?
A. Abdominopelvic computed tomography
B. Retrograde cystourethrography
C. Cystometrics
D. Cystoscopy
18. In patients for whom specific pathology is not identified, medical management of chronic pelvic pain can be directed toward
alleviation of dominant symptoms. This may not involve the use of which of the following?
A. Hormonal suppression
B. Analgesics such as nonsteroidal anti-inflammatory drugs
C. Tranexamic acid
D. Antidepressants and anticonvulsants
19. Which of the following statements does NOT describe the dynamics of the levator ani muscle and endopelvic fascia?
A. Form a "bowl shape" configuration
B. Provide a stable platform for pelvic organ’s
C. lliococcygeus serves as supportive "backstop" behind the pelvic organs
D. Pubococcygeus and the puborectalis sling around the urethra, vagina and the anorectum to pull them towards the
symphysis pubis
20. A 33-year-old married nulligravid with chronic low back pain, with a long history of dysmenorrhea, and failure to conceive, now
complains of dyspareunia. Which of the following would NOT be an expected examination finding in this case?
A. Nodular rectovaginal septum
B. Anteverted uterus
C. Obliterated cul-de-sac
D. Thickened uterosacral ligaments
21. Which of the following is a suitable gonadotropin- releasing hormone agonist choice for treatment of endometriosis?
A. Goserelin as a 10.8-mg, 3-month subcutaneous implant
B. Goserelin 3.6 mg, 3-month, subcutaneous implant
C. Leuprolide acetate as a 11.25-mg, 3-month intra- muscular injection
D. Nafarelin as a 200-mg twice daily nasal spray
22. Although no definition is universally accepted, chronic pelvic pain is often defined as which of the following?
A. Cyclic pain less than 6 months
B. Noncyclic pain that persists or 6 or more months
C. Pain that localizes to the anatomic pelvis, to the anterior abdominal wall at or below the umbilicus, or to the lumbosacral
back or buttocks
D. Pain sufficiently severe to cause functional disability or lead to medical intervention
1-5 FINAL EXAM
QNS & ANS
2023/2024
,1. Which of the following is NOT correct of pelvic endometriosis?
A. Most commonly found during the reproductive years
B. Aberrant endometrial tissue grows under the cyclic influence of ovarian hormones
C. Particularly estrogen dependent
D. This is not responsive to medical treatment
2. Which is not a hallmark of chronic pelvic pain?
A. Hypersensitive response to nociceptive stimuli
B. Signs of depression
C. Altered family ties
D. Non-debilitating pelvic pain lasting more than 6 months
3. Mrs. A is a G8P8(8008), recently diagnosed with a cystocele and a rectocele. Based on this finding, what level of support was
weakened?
A. Level II
B. Level IV
C. Level
D. Level Ill
4. It is also sometimes termed internal endometriosis
A. Endometriotic cyst
B. Pelvic inflammatory disease
C. Deep infiltrating endometriosis
D. Adenomyosis
5. Sensitizing mediators are released into affected tissues and lower the conduction threshold of nociceptors. This is termed as:
A. Nociception
B. Neuropathic pain
C. Central sensitization
D. Peripheral sensitization
,6. The most popular theory of pelvic endometriosis:
A. Retrograde menstruation
B. latrogenic
C. Coelomic metaplasia
D. Immunologic
7. Which of the following progestins is a NOT suitable option to treat a woman recently diagnosed with stage I endometriosis who
has associated pain but is not currently seeking conception?
A. Depot medroxyprogesterone acetate
B. Levonorgestrel-releasing intrauterine system
C. Drosperinone
D. Norethindrone acetate
8. Sonographically, endometriomas are typically described by which of the following?
A. Solid with diffuse internal low-level echoes
B. Cystic with focal hyperechoic internal echoes
C. Cystic with diffuse internal low-level echoes
D. Solid with intracystic blood flow
9. Which is the most common condition assigned as an etiology to pelvic pain?
A. Sexual abuse
B. Pelvic congestion
C. Pelvic adhesions
D. Ovarian remnant syndrome
10. Antiepileptic drugs used in chronic pelvic pain do NOT include:
A. Pregabalin
B. Gabapentin
C. Desipramine
D. Lamotrigine
11. Which best describes normal pelvic anatomy?
A. Arcus tendinous fascia pelvis supports midportion anterior vagina
B. In the standing position the lower two thirds of vagina is directly over the levator plate
C. Intraabdominal & pelvic contents directed towards the muscles and the fascia
D. Pelvic inlet is tilted backward
12. Which is NOT a cardinal feature of endometriosis?
A. Endometrial glands and stroma within the myometrium
B. Ectopic endometrial glands
C. Ectopic endometrial stroma
D. Hemorrhage into adjacent tissues
13. Which of the following is an inciting factor for POP?
A. Vaginal birth
B. Obesity
C. Menopause
D. Constipation
14. Which of the following statements is NOT true of Pelvic Congestion Syndrome?
A. Pelvic Congestion Syndrome results from chronic pelvic ache, pressure and heaviness
B. Progesterone is implicated in pelvic congestion syndrome in that it acts as a venous dilator
C. Varicosities in the thigh, buttocks, perineum, or vagina may be associated
D. Affected women may describe pelvic ache or heaviness that may worsen premenstrually
15. What structure serves as a reference in the POP-Q?
A. Cervix C. Hymen
B. Posterior fornix D. Clitoris
, 16. Which of the following procedures is most needed to perform for apical prolapse?
A. Anterior colporrhaphy
B. Sacrospinous ligament suspension
C. Anterior and Posterior colporrhaphy
D. Posterior colporrhaphy
17. In patients with combined urinary and chronic pelvic pain symptoms, which of the following tests is typically advised?
A. Abdominopelvic computed tomography
B. Retrograde cystourethrography
C. Cystometrics
D. Cystoscopy
18. In patients for whom specific pathology is not identified, medical management of chronic pelvic pain can be directed toward
alleviation of dominant symptoms. This may not involve the use of which of the following?
A. Hormonal suppression
B. Analgesics such as nonsteroidal anti-inflammatory drugs
C. Tranexamic acid
D. Antidepressants and anticonvulsants
19. Which of the following statements does NOT describe the dynamics of the levator ani muscle and endopelvic fascia?
A. Form a "bowl shape" configuration
B. Provide a stable platform for pelvic organ’s
C. lliococcygeus serves as supportive "backstop" behind the pelvic organs
D. Pubococcygeus and the puborectalis sling around the urethra, vagina and the anorectum to pull them towards the
symphysis pubis
20. A 33-year-old married nulligravid with chronic low back pain, with a long history of dysmenorrhea, and failure to conceive, now
complains of dyspareunia. Which of the following would NOT be an expected examination finding in this case?
A. Nodular rectovaginal septum
B. Anteverted uterus
C. Obliterated cul-de-sac
D. Thickened uterosacral ligaments
21. Which of the following is a suitable gonadotropin- releasing hormone agonist choice for treatment of endometriosis?
A. Goserelin as a 10.8-mg, 3-month subcutaneous implant
B. Goserelin 3.6 mg, 3-month, subcutaneous implant
C. Leuprolide acetate as a 11.25-mg, 3-month intra- muscular injection
D. Nafarelin as a 200-mg twice daily nasal spray
22. Although no definition is universally accepted, chronic pelvic pain is often defined as which of the following?
A. Cyclic pain less than 6 months
B. Noncyclic pain that persists or 6 or more months
C. Pain that localizes to the anatomic pelvis, to the anterior abdominal wall at or below the umbilicus, or to the lumbosacral
back or buttocks
D. Pain sufficiently severe to cause functional disability or lead to medical intervention
