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Obstetrics & Gynecology actual exam-2024 with question and answers What is the most common ovarian malignancy in women <30 years - CORRECT ANSWEROvarian Germ Cell Tumor Clinical manifestation: Pelvic pain due to rapid expansion --> Hemorrhage or

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Obstetrics & Gynecology actual
exam-2024 with question and
answers

What is the most common ovarian malignancy in women <30 years - CORRECT
ANSWEROvarian Germ Cell Tumor

Clinical manifestation:
Pelvic pain due to rapid expansion --> Hemorrhage or necrosis
85% - Pelvic pain + Pelvic mass

Treatment:
Benign teratoma - Cystectomy or oophorectomy
Malignant - Unilateral SO or TAHBSO (Depends on fertility desire)

Types of malignant Germ Cell Tumor - CORRECT ANSWER1. Dysgerminoma (LDH)
-Germ cells infiltrated with lymphocytes
-10% bilateral; analogous to seminoma

2. EST/YST (AFP)
-Schiller Duval Bodies w/ hyaline droplets

3. Choriocarcinoma (HCG)
-Hemorrhagic
-Highly malignant cytotrophoblast and syncitiotrophoblast

4. Immature Teratoma (AFP)
-Immature embryonic structures with mature elements

Types of Sex Cord Tumors - CORRECT ANSWER1. Granulosa Theca Cell Tumor
-Grooved coffee bean nuclei around central cavity (CALL-EXNER Bodies)
-Estrogenic secretions
-Cause precocious puberty, menstrual irregularities, or bleeding in postmenopausal

2. Sertoli Leydig Tumor
-Resemble fetal testes
-Testosterogenic secretions
-Masculinization/Hirsutism

,Management:
Young women - Unilateral SO
Postmenopausal - TAHBSO

Match the tumors to the ff descriptions

Sertoli-Leydig Tumor
Granulosa-Theca Tumor
Choriocarcinoma
YST
Dysgerminoma
Dermoid
Struma Ovarii
Tubercle of Rokitansky

1. Most common benign tumor <30y/o
2. Schiller-Duval bodies
3. Call-exner bodies
4. Precocious puberty in children
5. Nipple projections in dermoids
6. Presents as virilization
7. Numerous hyaline droplets
8. Presence of thyroid tissue in ovary
9. Tumor marker is HCG
10. Tumor marker is AFP
11. Tumor marker is LDH
12. Analogous to seminoma in males
13. Composed of malignant syncitiotrophoblast and cytotrophoblast
14. Presents as vaginal bleeding in adults
15. Most common malignant tumor <30
16. Eosinophilic bodies surrounded by granulosa cells - CORRECT ANSWER1. Most
common benign tumor <30y/o - DERMOID
2. Schiller-Duval bodies - YOLK SAC TUMOR
3. Call-exner bodies - GRANULOSA-THECA
4. Precocious puberty in children - GRANULOSA-THECA
5. Nipple projections in dermoids - TUBERCLE OF ROKITANSKY
6. Presents as virilization - SERTOLI-LEYDIG
7. Numerous hyaline droplets - YOLK SAC TUMOR
8. Presence of thyroid tissue in ovary - STRUMA OVARII
9. Tumor marker is HCG - CHORIOCARCINOMA
10. Tumor marker is AFP - YOLK SAC TUMOR
11. Tumor marker is LDH - DYSGERMINOMA
12. Analogous to seminoma in males - DYSGERMINOMA
13. Composed of malignant syncitiotrophoblast and cytotrophoblast -
CHORIOCARCINOMA

,14. Presents as vaginal bleeding in adults - GRANULOSA-THECA TUMOR
15. Most common malignant tumor <30 - DYSGERMINOMA
16. Eosinophilic bodies surrounded by granulosa cells - GRANULOSA-THECA

School of fish appearance in Microscopy - CORRECT ANSWERChancroid

Presents as painful ulcer + Tender suppurative inguinal adenopathy

Diagnosis: "school of fish" on microscopy

Treatment:
1. Azithromycin 1g
2. Ceftriaxone
3. Ciprofloxacin
4. Erythromycin

What are the 3 phases of Lymphogranuloma Venereum - CORRECT
ANSWERLYMPHOGRANULOMA VENEREUM
Chlamydia trachomatis

Three phases
1. Primary Infection - Shallow painless ulcer
2. Secondary infection - Bubo (painful adenopathy) + Groove Sign (enlarge matted
tender LN)
3. Tertiary - multiple draining sinuses + fistula with extensive destruction of genital and
anorectal region

Treatment
1. Doxycycline 100mg BID for 21 days
What causes the enlargement of the uterus? - CORRECT ANSWER1. Hormonal -
Estrogen + Progesterone (Hypertrophy)
2. Pressure exerted by fetal contents (Stretching)

Which layer of the uterine musculature forms the majority of the uterine wall?

What is the configuration of uterine myocytes and what is its function? - CORRECT
ANSWERMiddle layer - Dense network of muscle fibers and vessels

Internal layer - Sphincter like fibers
Outer hood-like Layer - Arches over fundus and extends into various ligaments

*Configuration of myocytes: Figure of 8 to allow contraction after delivery and constrict
penetrating vessels to halt bleeding

, What is responsible for dextrorotation of the uterus? - CORRECT
ANSWERRectosigmoid - By the end of 12 weeks, uterine ascent allows for dextrotation
of the uterus due to the rectosigmoid on the left

What arteries supply the placenta and lose contractility during vasodilation? -
CORRECT ANSWERSpiral Arteries

What hormones act to dilate the spiral arteries? - CORRECT ANSWER1. Estrogen
2. Progesterone
3. Activin
4. Placenta Growth Factor
5. Vascular Endothelial Growth Factor (VEGF)

Signs of Pregnancy:

1. Cervical mucus shows poor crystallization as a result of Progesterone

2. Seen on glass slide as an arborization of ice-crystals. What is the cause and the
sign?

3. Endocervical gland hyperplasia and hypersecretory appearance that is difficult to
differentiate from atypical glandular cells

4. Purplish coloring of the cervix, vulva, and vagina - CORRECT ANSWER1. Beading --
> Poor crystallization due to progesterone

2. Ferning --> Due to amniotic leakage

3. Arias-Stell Reaction

4. Chadwick Sign --> Due to greater vascularity and hyperemia of skin and muscles in
perineum

Changes in the ovaries

1. Slightly elevated clear or red patches that easily bleed seen just beneath the ovarian
surface

2. Hormone secreted by corpus luteum, decidua, placenta, brain, heart, and kidney to
assist in remodeling of reproductive tract connective tissue to accommodate labor

3. Bilateral moderately enlarged cystic ovaries due to elevates serum hCG - CORRECT
ANSWER1. Decidual Reaction - Slightly elevated patches seen just beneath the ovarian
surface; Stimulated by progesterone

2. RELAXIN - Remodeling of reproductive tract connective tissue to accommodate labor

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Obstetrics & Gynecology actual exam-2024 with question and answers What is the most common ovarian malignancy in women <30 years - CORRECT ANSWEROvarian Germ Cell Tumor Clinical manifestation: Pelvic pain due to rapid expansion --> Hemorrhage or

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