PHAS 6320 Maternal & Child Medicine Quiz

Questions and Answers

Which structure is NOT a component of the vulva?

Bartholin’s glands

Mons pubis

Endometrium (correct)

Labia majora

What is the average size of Bartholin’s glands?

0.5 cm (correct)

3 cm

2 cm

1 cm

Which part of the female anatomy extends from the uterus to the vestibule?

Fallopian tubes

Vagina (correct)

Ovaries

Vulva

Which of the following structures provides blood supply to the vagina?

Vaginal branch of the uterine artery Signup and view all the answers

What is the primary function of Bartholin’s glands?

Production of vaginal lubrication Signup and view all the answers

Which condition is characterized by the presence of ovarian cysts?

Polycystic ovarian syndrome Signup and view all the answers

What component of the vulva extends anteriorly to form the prepuce?

Labia minora Signup and view all the answers

Which of the following is NOT associated with malignant ovarian neoplasms?

Ruptured ovarian cyst Signup and view all the answers

What is the primary cause of squamous cell vaginal cancer?

Human Papillomavirus (HPV) Signup and view all the answers

Which symptom is typically associated with late-stage vaginal cancer?

Weight loss Signup and view all the answers

What is the primary method for diagnosing vaginal cancer?

Biopsy confirmed via colposcopy Signup and view all the answers

Which statement regarding the prognosis for squamous cell vaginal cancer is correct?

Stage I has a 77% five-year survival rate. Signup and view all the answers

Which surgical procedure is primarily considered for Stage I vaginal cancer?

Local excision Signup and view all the answers

What age range has the peak incidence of vaginal cancer?

60-65 years Signup and view all the answers

Which risk factor is associated with a clear cell variant of vaginal cancer?

In utero DES exposure Signup and view all the answers

What is the most common location for vaginal carcinoma?

Upper one-third of the posterior vaginal wall Signup and view all the answers

What treatment is typically used for larger vaginal cancer lesions?

External beam radiotherapy Signup and view all the answers

What is the significance of the carcinoma being limited to the vaginal wall in staging?

Defined as Stage I Signup and view all the answers

What is the primary characteristic that distinguishes endometriosis from adenomyosis?

Presence of endometrial glands and stroma outside the uterine cavity Signup and view all the answers

Which of the following treatments is NOT indicated for endometriosis?

Non-steroidal anti-inflammatory drugs (NSAIDs) Signup and view all the answers

Which factor is NOT considered a risk factor for developing endometriosis?

High body mass index (BMI) Signup and view all the answers

What distinguishes conservative surgical treatment for endometriosis from non-conservative treatment?

Conservative surgery aims to remove endometrial growths without affecting fertility Signup and view all the answers

What is a common symptom both endometriosis and adenomyosis share?

Pelvic pain Signup and view all the answers

Which hormone imbalances are predominantly involved in the pathophysiology of Polycystic Ovarian Syndrome (PCOS)?

Elevated serum androgen concentrations Signup and view all the answers

What is a common clinical manifestation of Polycystic Ovarian Syndrome?

Oligomenorrhea Signup and view all the answers

Which diagnostic tool is most effective for identifying polycystic ovaries?

Transvaginal ultrasound (TVUS) Signup and view all the answers

What is the primary goal when managing clinical manifestations of Polycystic Ovarian Syndrome?

Regulation of menstruation and management of metabolic issues Signup and view all the answers

Which treatment options are commonly used for managing hirsutism in women with PCOS?

Oral contraceptives and antiandrogens Signup and view all the answers

What is the characteristic appearance of polycystic ovaries observed through ultrasonography?

String of pearls appearance Signup and view all the answers

What lifestyle modifications are recommended for patients with Polycystic Ovarian Syndrome?

Diet and exercise Signup and view all the answers

Which medication is often used for treating infertility in women with PCOS?

Metformin Signup and view all the answers

What condition is associated with an increased risk due to Polycystic Ovarian Syndrome?

Cardiovascular disease Signup and view all the answers

Which of the following is an uncommon manifestation of hyperandrogenism in women with PCOS?

Increased breast size Signup and view all the answers

Which type of uterine cancer is most commonly associated with postmenopausal women?

Carcinosarcoma Signup and view all the answers

What is a common symptom of endometrial sarcoma?

Menorrhagia Signup and view all the answers

Which factor is commonly associated with adenosarcomas of the uterus?

Tamoxifen or radiation therapy Signup and view all the answers

What is the most characteristic type of lesion found in the lungs of patients with uterine sarcoma?

Coin lesions Signup and view all the answers

Which method is commonly used to diagnose endometrial sarcoma?

D&C (Dilation and Curettage) Signup and view all the answers

Which condition is characterized by the aberrant growth of endometrium outside the uterus?

Endometriosis Signup and view all the answers

What common treatment is recommended for primary dysmenorrhea?

NSAIDs and heat therapy Signup and view all the answers

Which of the following is NOT a symptom of endometriosis?

Chronic constipation Signup and view all the answers

When does endometrial stromal sarcoma most commonly occur?

In postmenopausal women Signup and view all the answers

What is the primary cause attributed to the symptoms of endometriosis?

Retrograde menstruation Signup and view all the answers

Study Notes

Neoplasms Overview

Includes vaginal, vulvar, uterine, and ovarian neoplasms (both benign and malignant).
Ovarian conditions: cysts, polycystic ovarian syndrome (PCOS), cancer, and torsion.
Uterine conditions: endometrial cancer, endometriosis, adenomyosis, and leiomyoma.

Anatomy and Physiology

Vagina and Vulva: Vaginal canal is 7-9 cm long, opening to external genitalia, with a blood supply from the vaginal branch of the uterine artery.
Vulva Structure: Comprised of mons pubis, labia majora, labia minora, and clitoris; clitoris measures about 2 cm.

Bartholin’s Glands

Produces mucoid secretion for lubrication, located in the vulvar vestibule, non-palpable, measures ~0.5 cm. Each gland connects to the vagina via a 2 cm duct.

Vaginal Cancer

Represents about 1% of gynecological malignancies, primarily secondary to cancers from adjacent structures.
Peak incidence occurs between ages 60-65; most are squamous cell carcinomas, often linked to HPV.
Commonly asymptomatic; may present with early painless bleeding and later symptoms including pain and weight loss.
Key risk factors: smoking, HPV, multiple sex partners.
Confirmation of diagnosis through biopsy after routine examination.

Vaginal Cancer Treatment and Prognosis

Surgery: Local excision for Stage 1; consider radical hysterectomy and pelvic lymphadenectomy.
Radiotherapy options: brachytherapy for superficial lesions; external beam for larger tumors.
Prognosis dependent on tumor size and stage: survival rates decline from stage 1 (77%) to stage 4 (18%).

Polycystic Ovarian Syndrome (PCOS)

Characterized by enlarged ovaries with multiple follicular cysts.
Symptoms include menstrual dysfunction (oligomenorrhea, amenorrhea), hyperandrogenism (hirsutism, acne), and increased risk of metabolic issues.
Diagnosis via transvaginal ultrasound showing “string of pearls” appearance.
Management focuses on symptom treatment, including oral contraceptives, insulin sensitizers, and lifestyle changes.

Uterine and Endometrial Cancer

Types include endometrial sarcomas and adenosarcomas, with prevalent symptoms being abnormal bleeding and abdominal pain.
Common sites for metastasis include the abdomen, liver, and lung.
Diagnosis often requires D&C or pathology analysis from surgery.

Chronic Pelvic Pain

Distinction between acute/chronic, cyclic/non-cyclic pain.
Primary Dysmenorrhea: Common menstrual pain treatable via NSAIDs, heat therapy, and hormonal contraceptives.
Endometriosis: Growth of endometrial tissue outside the uterus leading to chronic pain, infertility, and menstrual abnormalities; often diagnosed via laparoscopy.

Endometriosis Characteristics

Prevalence is 7-10% among women of reproductive age, with risk factors including nulliparity and prolonged estrogen exposure.
Symptoms: pelvic pain, infertility, dysmenorrhea, abnormal bleeding; may require hormonal treatments or surgery for management.

Adenomyosis

Defined by endometrial tissue within the myometrium; common findings include pelvic pain and menorrhagia.
Diagnosis typically via imaging (TVUS, MRI) to observe uterine enlargement and increased junctional zone width.
Treatment options include hormonal therapy or hysterectomy depending on symptoms.

Leiomyoma (Fibroids)

Most common benign neoplasm; may cause heavy bleeding, dysmenorrhea, and pelvic pressure.
Diagnosed via ultrasound; treatment options range from NSAIDs and hormonal management to surgical interventions like myomectomy or hysterectomy.

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Description

Test your knowledge on vulvar, vaginal, uterine, and ovarian neoplasms, including both benign and malignant forms. This quiz covers anatomy, ovarian conditions, and endometrial neoplasms, providing a comprehensive review of critical topics in maternal and child medicine.