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Questions and Answers
Which statement about mature cystic teratomas is true?
Which statement about mature cystic teratomas is true?
Which tumor antigen is correctly paired with its ovarian tumor?
Which tumor antigen is correctly paired with its ovarian tumor?
Which clinical criterion should prompt referral to a gynecologic oncologist?
Which clinical criterion should prompt referral to a gynecologic oncologist?
Which of the following is NOT a side effect of aromatase inhibitors?
Which of the following is NOT a side effect of aromatase inhibitors?
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Which condition is commonly diagnosed among causes of chronic pelvic pain?
Which condition is commonly diagnosed among causes of chronic pelvic pain?
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Which patient complaints are NOT suggestive of interstitial cystitis?
Which patient complaints are NOT suggestive of interstitial cystitis?
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What is the typical lesion diagnostic of interstitial cystitis during cystoscopy called?
What is the typical lesion diagnostic of interstitial cystitis during cystoscopy called?
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Which statement is FALSE regarding the development of the hypothalamic–pituitary-ovarian axis in female fetuses?
Which statement is FALSE regarding the development of the hypothalamic–pituitary-ovarian axis in female fetuses?
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What is the most likely mechanism for urinary frequency and incomplete bladder emptying in a woman with large fibroids?
What is the most likely mechanism for urinary frequency and incomplete bladder emptying in a woman with large fibroids?
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What is the initial management for a woman presenting with irregular bleeding and anemia due to uterine fibroids?
What is the initial management for a woman presenting with irregular bleeding and anemia due to uterine fibroids?
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What is the most suitable treatment for a 35-year-old woman with heavy bleeding and multiple fibroids who prefers minimally invasive options?
What is the most suitable treatment for a 35-year-old woman with heavy bleeding and multiple fibroids who prefers minimally invasive options?
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What is the best initial management for a pregnant woman diagnosed with a large intramural fibroid during her first trimester?
What is the best initial management for a pregnant woman diagnosed with a large intramural fibroid during her first trimester?
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Which of the following is NOT a use of magnetic resonance imaging in gynecologic malignancies?
Which of the following is NOT a use of magnetic resonance imaging in gynecologic malignancies?
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Early pregnancy loss is most common in women with which condition?
Early pregnancy loss is most common in women with which condition?
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Sonographically, endometriomas are typically described as which of the following?
Sonographically, endometriomas are typically described as which of the following?
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Mature ovarian cystic teratomas account for what approximate proportion of ovarian neoplasms?
Mature ovarian cystic teratomas account for what approximate proportion of ovarian neoplasms?
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What is the most likely diagnosis for a woman with heavy menstrual bleeding, pelvic pressure, and a well-defined uterine wall mass?
What is the most likely diagnosis for a woman with heavy menstrual bleeding, pelvic pressure, and a well-defined uterine wall mass?
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For a woman with prolonged heavy periods and frequent urination due to a large submucosal fibroid, what is the best initial treatment option?
For a woman with prolonged heavy periods and frequent urination due to a large submucosal fibroid, what is the best initial treatment option?
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In evaluating a case of infertility where a mass distorts the uterine cavity, which condition should be included in the differential diagnosis?
In evaluating a case of infertility where a mass distorts the uterine cavity, which condition should be included in the differential diagnosis?
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What is the most likely complication for a patient with sudden-onset pelvic pain, fever, and a tender mass, who has a history of uterine fibroids?
What is the most likely complication for a patient with sudden-onset pelvic pain, fever, and a tender mass, who has a history of uterine fibroids?
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What is the next best step to confirm the diagnosis in a woman with heavy menstrual bleeding and an irregularly enlarged uterus?
What is the next best step to confirm the diagnosis in a woman with heavy menstrual bleeding and an irregularly enlarged uterus?
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What is the most appropriate treatment option for a woman with severe menstrual pain and multiple fibroids who wishes to preserve her fertility?
What is the most appropriate treatment option for a woman with severe menstrual pain and multiple fibroids who wishes to preserve her fertility?
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Which of the following presentations is most characteristic of pelvic inflammatory disease?
Which of the following presentations is most characteristic of pelvic inflammatory disease?
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What is a common symptom associated with uterine fibroids, especially when they are submucosal?
What is a common symptom associated with uterine fibroids, especially when they are submucosal?
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What is the most appropriate management of a 4.2-cm simple right ovarian cyst in a neonate?
What is the most appropriate management of a 4.2-cm simple right ovarian cyst in a neonate?
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Which statement is true regarding polycystic ovarian syndrome (PCOS)?
Which statement is true regarding polycystic ovarian syndrome (PCOS)?
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Which of the following is NOT a component of the Rotterdam criteria for diagnosing PCOS?
Which of the following is NOT a component of the Rotterdam criteria for diagnosing PCOS?
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What is the most common endocrine disorder affecting reproductive-aged women?
What is the most common endocrine disorder affecting reproductive-aged women?
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Which hormone has higher circulating levels in first-degree male relatives of women with PCOS?
Which hormone has higher circulating levels in first-degree male relatives of women with PCOS?
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In PCOS, altered GnRH pulsatility leads to what predominant change in hormone levels?
In PCOS, altered GnRH pulsatility leads to what predominant change in hormone levels?
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What characterizes the clinical presentation of an 18-year-old nulligravida with primary amenorrhea who has vaginal bleeding following a progesterone withdrawal test?
What characterizes the clinical presentation of an 18-year-old nulligravida with primary amenorrhea who has vaginal bleeding following a progesterone withdrawal test?
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Which of the following conditions is most likely to present with amenorrhea in a young woman?
Which of the following conditions is most likely to present with amenorrhea in a young woman?
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Flashcards
Mature cystic teratomas: Torsion vs. rupture
Mature cystic teratomas: Torsion vs. rupture
Mature cystic teratomas are benign tumors that often undergo torsion, but cyst rupture is rare.
Mature solid teratomas: Malignant nature
Mature solid teratomas: Malignant nature
Solid teratomas are malignant tumors that arise from the proliferation of multiple germ cell lines.
CA19-9 association
CA19-9 association
Cancer antigen 19-9 (CA19-9) is a tumor antigen associated with mucinous epithelial ovarian carcinoma.
AFP association
AFP association
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β-hCG association
β-hCG association
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LDH association
LDH association
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Referral criteria for pelvic mass
Referral criteria for pelvic mass
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Hunner ulcer
Hunner ulcer
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Myomectomy
Myomectomy
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Hysterectomy
Hysterectomy
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Uterine artery embolization
Uterine artery embolization
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Endometrial ablation
Endometrial ablation
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Compression of the bladder by fibroid
Compression of the bladder by fibroid
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Iron supplementation and hormonal therapy
Iron supplementation and hormonal therapy
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Uterine artery embolization
Uterine artery embolization
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Conservative observation
Conservative observation
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Uterine Fibroid
Uterine Fibroid
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Neonatal Ovarian Cyst
Neonatal Ovarian Cyst
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GnRH Agonists
GnRH Agonists
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Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome (PCOS)
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Submucosal Uterine Fibroid
Submucosal Uterine Fibroid
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Polycystic appearing ovaries
Polycystic appearing ovaries
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Oligoovulation or anovulation
Oligoovulation or anovulation
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Degenerating Fibroid
Degenerating Fibroid
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Pelvic Ultrasound
Pelvic Ultrasound
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Clinical or biochemical signs of hyperandrogenism
Clinical or biochemical signs of hyperandrogenism
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Dehydroepiandrosterone sulfate (DHEAS)
Dehydroepiandrosterone sulfate (DHEAS)
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Follicle-stimulating hormone (FSH)
Follicle-stimulating hormone (FSH)
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Progestins
Progestins
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Luteinizing hormone (LH)
Luteinizing hormone (LH)
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Study Notes
Menstrual Cycle
- Average duration: 28 days (other options include 21, 35, and 40 days)
- Ovulation hormone: Luteinizing hormone (LH)
- Endometrial thickening phase: Luteal phase
- Estrogen's role: Promotes endometrial growth
- Phase after ovulation: Luteal phase
- Progesterone levels (no fertilization): Decrease, leading to menstruation
- Follicle development hormone: Follicle-stimulating hormone (FSH)
Ovarian Tumors
- Most common benign tumor: Serous cystadenoma
- Typical symptom: Abdominal bloating and pelvic pain
- Imaging for ovarian tumors: Pelvic ultrasound
- Most likely malignant tumor type: Epithelial tumors
- Tumor marker for ovarian cancer: CA-125
- Other tumor markers: Beta-hCG, AFP, CEA
Infertility
- Definition of infertility: Inability to conceive after 12 months of regular, unprotected intercourse
- Hormone for ovarian reserve: Anti-Müllerian hormone (AMH)
- Fallopian tube blockage test: Hysterosalpingography (HSG)
- Infertility causes: Polycystic ovary syndrome (PCOS), endometriosis, low body weight
- Scarring/adhesion cause: Endometriosis
- Lifestyle factor affecting male fertility: Smoking
- Ovulation-stimulating medication: Clomiphene citrate
Gynecological Examination & Procedures
- First step: Taking the patient's medical history
- Vaginal canal/cervix exam tool: Speculum
- Pap smear purpose: Detect cervical cell abnormalities
- Imaging for uterus/ovaries/fallopian tubes: Ultrasound
- Pelvic organ assessment: Bimanual examination
Specific Clinical Cases (Page 5)
- Severe pelvic pain during menstruation, painful intercourse, and ultrasound showing ovarian cysts: Likely diagnosis is endometriosis.
- Chronic pelvic pain, heavy periods, and infertility issues: Likely diagnosis is endometriosis.
- Endometriosis with increasing pain despite hormonal therapy: Laparoscopic surgery is a potential next treatment option.
- Painful urination and rectal pain during menstruation accompanied by lower abdominal pain: Possible impacted endometrial tissue in the bladder and bowel.
- Endometriosis, desire to maintain fertility: Conservative laparoscopic surgery might be indicated.
- Endometriosis and persistent symptoms: GnRH agonists are a potential medication for symptom management.
IUD Insertion
- Optimal IUD insertion time: 4-6 days or 14-16 days of the menstrual cycle
Acute Abdomen in Gynecology
- Common causes: Ectopic pregnancy, endometriosis, uterine fibroids, and ovarian cysts
- Symptom of ruptured ectopic pregnancy: Severe pelvic pain and vaginal bleeding
- Imaging for gynecological acute abdomen: Ultrasound
- First-line treatment for a ruptured ovarian cyst: Surgical intervention (if bleeding is severe)
- Condition requiring emergency treatment: Ovarian torsion
- Symptom of PID (Pelvic Inflammatory Disease): Pelvic pain, fever, and vaginal discharge
- Risk factor for ectopic pregnancy: Previous history of PID
- Blood test for ectopic pregnancy: Serum hCG
Assisted Reproductive Technologies (ART)
- ART purposes: Overcome infertility, restore fallopian tube patency, and stimulate ovulation/spermatogenesis
- Artificial Insemination (AI): Introduction of sperm into the uterus
- Main causes of anovulation: Hypothalamic-pituitary insufficiency, hypothalamic-pituitary dysfunction, polycystic ovaries
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Description
Explore the essentials of the menstrual cycle, common ovarian tumors, and the definitions and causes of infertility. This quiz covers hormone roles, tumor markers, and diagnostic procedures, providing a comprehensive overview of reproductive health topics. Test your understanding of these vital medical concepts.