Gyne

1. The most common pathophysiologic mechanism in perimenopausal bleeding is: (Compre

Gyne, 1082)
A. cervical ancer
B. endometrial cancer
C. anovulation
D. abnormal pregnancy states

2. A 34 yo G3P3 (3-0-0-3) presents with episodes of missed period for 2 cycles then irregular and
profuse bleeding for the past two weeks. Her pregnancy test is negative with unremarkable
pelvic exam findings except for the moderate bleeding. What is the most likely diagnosis:
(Compre Gyne, p. 1082-1083)
A. threatened abortion
B. hydatidiform mole
C. dysfunctional uterine bleeding
D. endometrial cancer

3. A 60 yo G5P5 (5-0-0-5) has been menopausal for the past 12 years presents with minimal
vaginal bleeding. What diagnostic exam will you recommend? (Compre Gyne, p. 1082-1083)
A. colposcopy
B. laparoscopy
C. diagnostic Dilatation and Curettage
D. Transvaginal Ultrasound

4. An adnexal cystic mass was seen appreciated on TVS, 6 cm in diameter, in a 24 yo patient

who presents with abnormal vaginal bleeding. What is the most likely diagnosis? (Compre
Gyne, p. 506-507)
A. follicular cyst
B. dermoid cyst
C. serous cyst
D. corpus luteum cyst

5. A 5 year old child was initially treated with antibiotics for purulent vaginal discharge for a
week. On follow up, the discharge was noted to be foul smelling and bloody. The most
probable cause is: (Comprehensive Gynecology, 4 th ed, page 274-277)
A. monilial infection
B. child molestation
C. foreign body in the vagina
D. precocious puberty

6. A mother is concerned with the appearance of whitish, non puritic vaginal discharge on her 11
year old child noted since 8 month preceding menarche. It is best to; (Comprehensive
Gynecology, 4th ed, page 276)
A. do gram stain on the discharge
B. advise vaginal douche
C. prescribe oral antibiotics
D. reassure the mother and the child that the discharge is normal

7. The most frequent symptoms of endometrial hyperplasia is: (Compre Gyne, p. 870)
A. foul smelling vaginal discharge
 B. abnormal vaginal bleeding
C. pelvic pain
D. alternating constipation and diarrhea

8. A 46 yo G4P4 (4-0-0-4) with a nodular uterus, enlarged to 20 weeks AOG presents with
menorrhagia. What is the most likely diagnosis? (Comprehensive Gynecology Chapter 18
Page 502)
A. Subserous myoma
B. Submucous myoma
C. Adenomyosis
D. Abnormal pregnancy

9. A 65 year old nulligravida consulted at the emergency room due to postmenopausal bleeding
for 3 yrs. Shes obese and known to be hypertensive for 10 years. Her menstrual history
revealed irregularly irregular cycles. She was treated for breast cancer 6 years ago and has
been taking tamoxifen for the past 5 years. The most probable cause of her bleeding is a
pathology in the: (Compre Gyne, p. 860-867)
A. Cervix
B. Endometrium
C. Ovary
D. Vagina

10. A 35 year old, G6P6 (6006) wife of a seaman, consulted due to postcoital bleeding. Speculum
exam revealed a flat warty lesion along the posterior cervical lip. Histopathology of cervical
punch biopsy done revealed dysplastic cells involving nearly the whole thickness of the
epithelium. The most probable diagnosis is CIN? (Compre Gyne, 802-803)
A. I
B. II
C. III
D. IV
11. A 65 year old nulligravida consulted at the emergency room due to postmenopause bleeding x
3 yrs. Shes obese and known to be hypertensive for 10 years. Her menstrual history
revealed irregularly irregular cycles. She was treated for breast cancer 6 years ago and has
been taking tamoxifen for the past 5 years. The most appropriate diagnostic test is: (Compre
Gyne, 870-871)
A. Pap smear
B. Cervical punch biopsy
C. Fractional curettage
D. Transvaginal ultrasound

12. A 25 year old, G6P0 (0060) consulted at the emergency room due to postcoital bleeding x 3
months duration. Shes a victim of child prostitution. On pelvic exam, there was a 2 cm
cauliflower like lesion on the anterior lip of the cervix. The vagina and parametria are
smooth. What is the most appropriate diagnostic test? (Compre Gyne, p. 844)
A. pap smear
B. colposcopy with biopsy
C. direct punch biopsy
D. cone biopsy
13. A 20 year old commercial sex worker presented at the clinic due to painful shallow ulcers in the
vulva associated with burning sensation during urination. She also has multiple oral ulcers at
the time of consultation. The most likely diagnosis is: (Compre Gyne, , Chapter 22, page 656)
A. Herpes simplex infection
B. granuloma inguinale
C. Lymphogranuloma venereum
D. Syphilis

14. A 38 year old diabeteic patient presented at the clinic due to vaginal pruritus and whitish
vaginal discharge. On examination, the vulva is beefy red in appearance with whitish curdled
discharge. The most likely diagnosis is: (Compre Gyne, Chapter 22, page 669)
A. Trichomoniasis
B. Candidiasis
C. Bacterial vaginosis
D. Mucopuruloent Cervicitis

15. The presence of heavy concentration of coccobacilli surrounding vaginal epithelial cells with
loss of distinct cell margins is the appearance of; (Compre Gyne, Chapter 22, page 671)
A. Donovan bodies
B. Clue cells
C. chancre
D. inclusion cells

16. A patient with chronic ulcers in the vulva had smears done taken from the ulcers. Findings
shows presence of dark staining bacteria with a bipolar appearance found in the cytoplasm of
large mononuclear cells .These are diagnostic of ; (Compre Gyne, Chapter 22, page 660
A. Granuloma inguinale
B. Lymphogranuloma venereum
C. Chancroid
D. Syphilis

17. A patient with painless vulvar ulcers came with a positive screening test for syphilis.
Confirmatory test that should be done can either be any of the following except: (Compre
Gyne, Chapter 22, page 664)
A. RPR
B. TPI
C. FTA-ABS
D. MHA-TP

18. According to CDC, treatment of patients diagnosed with HIV includes the following except:
(Compre Gyne Chapter 22, page 686)
A. behavioral
B. psychosocial
C. emotional
D. medical

19. A patient diagnosed with gonorrhea should: (Compre Gyne, Chapter 22, page 692)
A. be treated with Chloramphenicol
B. also be treated for Chlamydia infection
C. have follow-up cultures done for asymptomatic women
D. not have serologic test for syphilis if cultures for gonorrhea are positive
20. Linda, 65 year old, G7P7 came to your clinic complaining of vaginal itching with burning
discomfort. This condition may be due to a decrease in what hormone? (Compre Gyne,
p.1223)
A. LH
B. progesterone
C. estrogen
D. FSH

21. Linda, 18 year old, delivered an 8 lbs baby. There was note of laceration on the lateral wall off
the vaginal vault with profuse vaginal bleeding. There was a sudden drop of BP. Post partum
there was note of amenorrhea. Lab examination shows destruction of the pituitary gland.
Linda has what syndrome? (Compre Gyne p. 1116)
A. Simmonds syndrome
B. Sheehans syndrome
C. Edwards syndrome
D. Ashermans syndrome

22. The patient with abnormal uterine bleeding is a:

A. 18 y.o. whose interval of menses is 24 to 30 days
B. 41 y.o. whose menses last 8 to 10 days
C. 29 y.o. on DMPA with occasional vaginal spotting
D. 22 y.o. leukemic patient with menstrual blood loss of 80 ml

Compre Gyne 4th ed, p. 1079-80

23. A 55 y.o. G5P5 (5005) consulted for fish-wash like vaginal discharge and on-and-off vaginal
bleeding. Pelvic exam showed the cervix to be converted to a 6 x 5 cm nodular, fungating
mass extending to the R lateral fornix, the right parametria nodular and fixed while the left
was free. Based on the information given, this patient can be clinically staged as
A. IIB
B. IIIA
C. IIIB
D. IVA

Compre Gyne 4th ed, p. 897

24. A 53 y.o. G1P1 (1001) underwent exploratory laparotomy for an ovarian new growth.
Intraoperative findings showed the right ovary to be converted to a 10 cm predominantly cystic
mass with excrescences on its outer capsule. The left ovary was grossly normal. All other
abdominopelvic organs were grossly normal. Based on the information given, the
Intraoperative stage of this patient is
A. IA
B. IB
C. IC
D. IIA

Compre Gyne 4th ed, p. 966

25. Speculum exam of a 27 y.o. complaining of leucorrhea showed copious frothy greenish vaginal
discharge with strawberry-like mucosa. This is most likely due to:
A. candidiasis
 B. trichomoniasis
C. gonococcal infection
D. bacterial vaginosis

Compre Gyne 4th ed, p. 672-73

26. A woman using the oral contraceptive pills for the first time should be advised to start taking it :
A. on day 1 of menses
B. on day 5 of menses
C. on day 7 of menses
D. anytime as long as she is not pregnant

27. Management of choice for procidentia uteri in a 60 year old multiparous patient with marked
cystorectocoele:
A. observation and close follow up
B. vaginal hysterectomy
C. vaginal hysterectomy with anterior-posterior repair
D. total abdominal hysterectomy with anterior-posterior repair

28. The following are characteristics of Rokitansky syndrome EXCEPT:

A. phenotypically female
B. normal ovaries
C. normal uterus
D. absent vagina

29. The following are congenital anomalies of the mullerian duct EXCEPT:
A. imperforate hymen
B. transverse vaginal septum
C. unicornuate uterus
D. uterus didelphys

30. The so called psammoma bodies are found in:

A. serous cystadenoma
B. mucinous cysadenoma
C. clear cell carcinoma
D. mucinous cystadenoma

31. Abnormal uterine bleeding during the pubertal and perimenarcheal period is due to:
A. polycystic ovaries
B. failing ovarian function
C. delayed,aynchronous hypothalamic maturation
D. exogenous estrogen stimulation

32. Most common cause of vaginal bleeding among postmenopausal women:

A. endometrial carcinoma
B. endometrial hyperplasia
C. endometrial polyp
D. atrophic endometrium

33. A woman with postmenopausal bleeding warrants:

A. an endometrial biopsy
 B. observation and Paps smear yearly
C. total hysterectomy
D. total hysterectomy with bilateral salpingooophorectomy

34. In Meigs syndrome, the ovarian newgrowth is a:

A. Fibroma
B. mature teratoma
C. immature teratoma
D. cystadenoma

35. Drug of choice for pregnant patients with Chlamydia infection:

A. Doxycycline
B. azythromicin
C. erythromycin
D. ampicilin

36. The so called tobacco pouch appearance of the fallopian tube is seen in:
A. gonorrhea infection with tubo ovarian abscess
B. Chlamydia infenction with tubo ovarian abscess
C. Pelvic tuberculos
D. Old tubal ectopic gestation

37. Type of endometrial hyperplasis which is mot likely to progress to endometrial carcinoma:
A. simple hyperplasis with atypia
B. cystic hyperplasia with atypia
C. complex hyperplasia without atypia
D. complex hyperplasia with atypia

38. A post coital test is best done:

A. pre menstrual
B. right after menses
C. periovulatory period
D. anytime during the cycle

39. Hysterosalpingography is best done:

A. periovulatory period
B. before menses
C. after menses
D. anytime during the cycle

40. Which of the following Paps smear will definitely require colposcopic examination of the cervix:
A. AGUS
B. ASCUS
C. LSIL
D. HSIL

41. Which of the following is considered a precursor of cervical carcinoma:

A. Metaplasia
B. dysplasia
C. eversion
D. severe eroisions
42. Endometrial carcinoma is LEAST likely if endometrial thickness is:
A. 5 mm
B. <5mm
C. 10mm
D. <10mm

43. Cystocele and rectocele occur because of weakness of the (ANS: C page 44)
A. uterosacral ligaments
B. anal sphincter
C. endopelvic fascia
D. cardinal ligament

44. The sequence of events leading to menstruation (ANS: C page 106)

A. coiling of the arteries, vasoconstriction, decrease in endometrial thickness,
vasodilatation, menses
B. coiling of the arteries, vasodilatation, vasoconstriction, decrease in
endometrial thickness, , menses
C. decrease in endometrial thickness, coiling of the arteries,
vasoconstriction, vasodilatation, menses
D. vasoconstriction, decrease in endometrial thickness, coiling of the arteries
vasodilatation, menses

45. Thromboxane differs from prostacyclin in that it (ANS: A page 89-90)

A. causes vasoconstriction
B. causes platelet aggregation
C. is not formed from arachidonic acid
D. is not an eicosanoid

46. A main action prostaglandin 2 (PGF2) is ( ANS: C page 89-90)

A. vasodilatation
B. platelet aggregation
C. bronchoconstriction
D. smooth muscle relaxation

47. A Pap smear is likely to identify all the following except (ANS: B page 150-151)
A. cervical squamous cell carcinoma
B. gonorrhea
C. human papilloma virus
D. inflammatory changes

48. Examination of a 3-year-old reveals labial adhesion. The child is able to void without difficulty.
One should initially recommend (ANS: A page 278)
A. topical estrogen
B. surgical separation
C. a work-up for sexual abuse
D. manual separation in the clinic

49. The major mechanism of DMPA, which accounts for its contraceptive effect, is the (ANS: A
page 327)
A. inhibition of the midcycle gonadotropin surge
 B. production of unfavorable endometrial environment
C. alteration of tubal motility
D. alteration of cervical mucus

50. The most commonly encountered cancer of the breast (ANS: D page 383)
A. lobular carcinoma in situ
B. lobular infiltrating carcinoma
C. ductal carcinoma in situ
D. ductal infiltrating carcinoma

51. Fibrocystic breast change is characterized by (ANS: B page 364)

A. cyclic enlargement of the lymph nodes
B. diffuse bilateral findings
C. blunted response to cyclic ovarian hormones
D. uniform histologic changes

52. A 52-year-old woman has persistent, unilateral, spontaneous bloody nipple discharge and a
cluster of microcalcifications identified by xeroradiography to be 3 cm deep under the nipple of
the left breast. The next step in her management should be (ANS: B page 429-430)
A. needle aspiration under ultrasound guidance
B. repeat mammography in 3 months
C. submission of the bloody discharge for cytologic examination
D. open biopsy of the left breast on an out patient basis

53. The greatest lifetime risk of breast cancer is associated with a(an) (ANS: C page 430)
A. early menarche
B. late menopause
C. history of oral contraceptive use longer than 10 years
D. history of postmenopausal estrogen use longer than 10 years

54. Anitiphospholipid antibodies have been found in the circulation of women with (ANS: A page
425-426)
A. recurrent abortions
B. systemic lupus erythematosus only
C. a history of thrombocytopenia
D. a false negative result for syphilis

55. The most consistent symptom of ectopic pregnancy is (ANS: D page 456)
A. amoenorrhea
B. vaginal bleeding
C. subjective symptoms of pregnancy
D. abdominal pain

56. A morbidly obese woman undergoes preoperative evaluation for adenocarcinoma of the
endometrium. Because of the high risk associated with an abdominal procedure, vaginal
surgery is being considered. What tumor marker may be of help in her condition? (ANS D page
934-935)
A. human chorionic gonadotropin (hCG)
B. carcinoembryonic antigen (CEA)
C. alpha-fetoprotein
D. CA-125
57. The cell origin of the most common type of ovarian neoplasm is (ANS B page 958)
A. germ cells
B. epithelial cells
C. stromal cells
D. lipoid cells

58. The most common cause of direct maternal deaths in the Philippines: (ANS: A p.4)
A. Hemorrhage
B. Hypertension
C. Infection
D. Heart disease
59. A 16 y/o girl is complaining of irregular menstruation.What would be the ideal treatment to
restore her menstrual cycle?
A. Oral contraceptive pills
B. NSAIDs
C. Cyclic estrogen
D. Cyclic progesterone

Answer: d
Reference: Comprehensive Gynecology 3rd edition, page 1032

60. When is it recommended to start doing Pap smear for screening of cervical cancer?
A. At age 25 years old
B. At age 21 years old
C. At age 20 years old
D. At age 18 or earlier when sexually active
Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 817

61. Which of the following increases the risk of developing endometrial cancer?
A. Multiparity
B. Use of contraception pills
C. Polycystic ovarian symdrome
D. Menopause at age 40
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, pages 866-867

62. What is the most appropriate treatment for a 20 year nulligravid diagnosed with simple
hyperplasia without atypia by curettage?
A. Endometrial oblation
B. Continous or cyclic progestin
C. Total hysterectomy
D. External radiotherapy
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 871

63. Which of the following is classified as homologous type of sarcoma?

A. High grade endometrial stromal sarcoma
B. Liposarcoma
C. Chondrosarcoma
D. Perabdo myosarcoma
 Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 888

64. What type of ovarian tumor is Brenner tumor classified?

A. Epithelial tumor
B. Stromal tumor
C. Germ cell tumor
D. Sex cord tumor
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 904

65. A patient underwent THBSO omentectomy and lymph node dissection for an ovarian cancer.
Histopathological report showed the tumor in the right ovary measured 10x8x8 cm ruptured
with extension to the fallopian tube and omentum. One para aortic node showed malignant
cells. What is the stage?
A. Stage II-C
B. Stage III-A
C. Stage III-B
D. Stage III-C
Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 912

66. What is the primary treatment of malignant epithelial ovarian tumor?

A. Chemotherapy
B. Surgical removal of the tumor
C. Radiotherapy
D. Chemo and radiotherapy

Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 918

67. Definitive diagnosis of vulvar carcinoma is established by .

A. Toluidine blue test
B. Colposcopy of the vulva
C. Pap smear of the vulva
D. Biopsy

Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 949

68. The major symptom of most vulvar atypias is .

A. Bleeding
B. Pain
C. Pruritus
D. Burning sensation
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 948
69. A 3 y/o girl was brought to the Emergency Room because of vaginal bleeding.
On inspection of the external genitalia, there was a mass protruding through the vaginal introitus.
It measured 4x3 cm and resembled a cluster of grapes forming multiple polypoid masses.
The most likely diagnosis is .
A. Vaginal adenosis
B. Sarcoma botryoides
C. Epidermoid cancer
D. Condyloma acuminata
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 981

70. The most common symptom of vaginal cancer is .

A. Pain
B. abnormal bleeding
C. urinary frequency
D. tenesmus
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 975

71. Which of the following patients with PID must be hospitalized?

A. A 22 y/o G2P2 with adnexal tenderness
B. A 21 y/o G1P0 at 10 weeks AOG
C. A 35 y/o G4P4 with fever
D. A 38 y/o G1P1 who is an OCW
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 677

72. What is the most common route of spread of the organisms in PID?
A. Lymphatic spread
B. Hematogenous route
C. Direct extension
D. Ascending route
Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 663

73. What is the route of spread of abdomino-pelvic Kochs?

A. Direct extension
B. Lymphatic spread
C. Hematogenous spread
D. ascending route
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 684

74. On histologic sections, what are the findings highly suggestive of AP Kocks?
A. Islands of endometrial glands
B. Necrotic foci in the endometrium
C. Langhans glant cell
D. Absence of stroma
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 684
75. Which of the following is an indicator of ovulation?
A. Progesterone level of 10 mg/ml during luteal phase
B. 100F to 110F temperature
C. estradiol level 50mg/ml
D. Leteinizing hormone level 15mg/ml
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1118

76. Which of the following is required in semen analysis?

A. 2-3 days abstinence before collection
B. collection done by masturbation at home
C. use of plastic cup for urine samples
D. submission of aspirated semen from vagina after coitus
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1119

77. WHO standard for normal semen analysis include .

A. 40 M sperm count
B. 60% M motility
C. 60% M morphology
D. 10 M white cell count
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1119

78. Which of the following is required for hysterosalpingogram?

A. Done post menstrual, pre-ovulatory
B. Routine antibiotics given after procedure
C. Test for tubal function
D. Oil based contrast medium is better than water based medium
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1121

79. Which of the following organisms are hostile to sperm in the vagina?
A. Ureaplsma urealyticum
B. Amoeba
C. Mycobacterium tuberculosis
D. Clostridia
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1124

80. A 12 y/o girl was noted to have breast budding. What is the average age you would expect her
to experience menarche?
A. 10 year old
B. 12 year old
C. 14 year old
D. 16 year old
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 1046
81. A 45 y/o patient consulted at your clinic because of amenorrhea of 10 months duration. She
would want to know if indeed she is menopausal already. What laboratory test will you
request?
A. Estrogen assay
B. FSH assay
C. Progesterone assay
D. Prolactin assay

Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 1161

82. What will be the first index of declining ovarian function?

A. Increase in FSH
B. Declining inhibin levels
C. Increase in LH
D. Increase in prolactin

Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 1161

83. Which of the following events is associated with menstrual flow?

A. withdrawal of progesterone
B. prolonged maintenance of estrogen
C. withdrawal of LH
D. prolonged maintenance of progesterone
MPL 0.25 p: 106

84. A 47 year old woman has poorly differentiated endometrial carcinoma and a uterine cavity that
measures 10 cm in depth. The endocervix has stromal invasion of endometrial carcinoma but
no other structure is involved. What is the stage of her disease?
A. I A
B. I B
C. II A
D. II B
MPL 0.5 p: 929

85. What endoscopic procedure is utilized to evaluate tubal disease?

A. colposcopy
B. laparoscopy
C. hysteroscopy
D. hysterosalpingography
MPL 0.5 p: 719

86. Tuberculosis of the genital tract invariably involves the

A. fallopian tubes
B. ovaries
C. cervix
D. vagina
MPL 1.0 p: 731
87. A 26 year old G1P1 had cervical intraepithelial neoplasia involving the entire thickness of the
cervical epithelium. What is the best management?
A. cryosurgery
B. electrocautery
C. conization
D. hysterectomy
MPL 0.5 p: 878

88. A 25 year old woman and her husband use natural family planning as their method of
contraception. Her menstrual cycle length range from 26 to 32 days. She does not measure
her basal body temperature. The time of her maximum or peak fertility with the first day of her
menses defined as day 1 would be between
A. day 1 14
B. day 8 14
C. day 8 21
D. day 14 21
MPL 0.5 p: 301

89. What is the drug of choice for bacterial vaginosis?

A. tetracycline
B. fluconazole
C. cefoxitin
D. metronidazole
MPL 1.0 p: 671

90. What type of myoma insinuates itself between the leaves of the broad ligament?
A. parasitic
B. serosal
C. interstitial
D. intraligamentary
MPL 0.5 p: 498

91. What tumor will be positive for the tumor marker HCG?
A. embryonal carcinoma
B. choriocarcinoma
C. endodermal sinus tumor
D. adenocarcinoma
MPL 0.5 p: 1053

92. What type of abnormal uterine bleeding is excessive in amount and duration of flow occurring
at regular interval?
A. Menorrhagia
B. metrorrhagia
C. polymenorrhea
D. menometrorrhagia
MPL 0.5 p: 1079

93. A 67 year old had episodes of vaginal bleeding 15 years after menopause. Biopsy revealed
endometrial hyperplasia. Transvaginal sonogram reveals a solid adnexal mass of 4 cm
diameter. She is not on hormonal replacement therapy. What is the most likely cause of the
bleeding?
 A. sertoli-leydig tumor
B. granulose cell tumor
C. serous cystadenocarcinoma
D. endodermal sinus tumor
MPL 0.5 p: 173

94. A 40 year old housewife complains of foul smelling vaginal discharge. On examination,
discharge was greenish-gray in color, fishy odor, and frothy. What is the primary
consideration?
A. Yeast
B. Trichomoniasis
C. Chlamydia
D. Bacterial vaginosis
MPL 0.5 p: 673

95. A 36 year old G2P2 has amenorrhea of 11 months with hot flushes. Examination reveals a
small uterus. If this is a case of premature ovarian failure, which finding is applicable?
A. biphasic basal body temperature
B. endometrial hyperplasia
C. elevated FSH > 40 IU/ml
D. tonically raised LH
MPL 0.5 p: 1100

96. What is a contraindication to hormonal replacement therapy?

A. history of pulmonary thromboembolism
B. hot flushes, insomnia in a 50 year old with irregular menses
C. history of fibrocystic disease of the breast
D. elevated serum lipids
MPL 0.33 p: 1249

97. Which of these is the most likely site for implantation of endometriosis?
A. omentum
B. appendix
C. bladder mucosa
D. peritoneum of culdesac
MPL 0.5 p: 536

98. Which disease of the vulva is best treated with wide excision?
A. hidradenitis suppuritiva
B. invasive vulvar cancer
C. angioma
D. contact dermatitis
MPL 0.5 p: 489

99. What ovarian tumor will most commonly cause precocious puberty ?
A. teratoma
B. luteoma
C. granulosa cell tumor
D. sertoli leydig tumor
MPL 0.5 p: 173
100. A woman with this type of pelvis is more prone to urethrocoele because of more force of the
fetal head on this area during descent in labor
A. platypelloid
B. anthropoid
C. gynecoid
D. android
MPL 1.0 p: 571

101. Stage III vaginal cancer means extension of lesion up to

A. vaginal wall
B. subvaginal tissue
C. pelvic wall
D. rectal mucosa
MPL 0.33 p:1028

102. On endometrial biopsy, glycogen-rich subnuclear vacuoles were seen in the base of the cells
lining the glands. What does this mean?
A. the woman is in her late luteal phase
B. ovulation has occurred
C. she is progesterone deficient
D. menstruation is about to set in
MPL 0.33 p: 104

103. Which theory of endometriosis best explains remote sites of the disease such as in the spinal
cord, nasal septum or lungs?
A. iatrogenic dissemination
B. coelomic metaplasia
C. immunologic changes
D. lymphovascular metastasis
MPL 0.33 p: 533

104. Which is an abnormal semen parameter?

A. white cell count of 105 per ml
B. sperm morphology 30 %
C. sperm count 40 x 106 per ml
D. progressive motility in 65 %
MPL 0.33 p: 1175

105. A 32 year old has been having her regular pap smear for the last ten years. Her latest result
however revealed low grade SIL. What is the next step to do?
A. colposcopic examination
B. repeat smear in 4 months
C. conization
D. laser ablation
MPL 0.33 p: 873

106. A 19 year old was brought to the ER because of acute pain. There was also vaginal spotting.
Examination revealed a small tender adnexal mass. Based on the LMP, she is on day 25 of
her cycle. Pregnancy test was negative. What is the most likely diagnosis?
A. ectopic pregnancy
B. acute salpingitis
 C. ruptured corpus luteum
D. ruptured endometrial cyst
MPL 0.33 p: 509

107. A 28 year old nulligravida with primary infertility and cyclic pelvic pain was diagnosed to have
endometriosis. She was placed on hormonal treatment. However, while on this drug, she
developed acne, hirsutism, and deepening of the voice. What is a better alternative?
A. laparoscopic fulguration
B. GnRH agonist
C. Progesterone injectables
D. Oral contraceptives
MPL 0.33 p. 546

108. A 35 year old consulted because of vesicular lesions in the vulva. She related that several
days prior to the appearance of the vesicles, she felt numbing sensation over her vulvar skin.
Which is the best treatment?
A. metronidazole
B. acyclovir
C. doxycycline
D. penicillin
MPL 0.33 p. 659

109. A 17 year old consulted because of lower abdominal pain of 3 days duration described as
constant and dull. On speculum exam, purulent vaginal discharge was noted. Patient was
febrile at 38.5 C. Pertinent finding on internal exam: tenderness with motion of the uterus and
cervix. What is the most likely etiologic agents?
A. Neisseria gonorrheae and Chlamydia trachomatis
B. Trichomonas vaginalis and gardnerela
C. Anaerobic gram negative bacteria
D. Pseudomonas
MPL 0.5 p. 724
110. A 5 year old was referred to you at the ER due to complaints of perineal pain. What is the best
way to examine the vagina of this child?
A. dorsal lithotomy
B. knee-chest position
C. lying on her mothers lap
D. standing with one leg raised
MPL 0.25 p: 274

111. Keanna, 32 y/o sexy dancer and ramp model complained of burning sensation over her vulva
after a lingerie fashion show where she wore thongs and stringed nylon bikinis. There was
pruritus so she used a newly-launched vaginal wash. Immediately, the burning sensation
became worse but she thought it was normal. The next morning, she found her vulva to be
erythematous and inflamed. The redness now reached the peri-anal area. What is the
diagnosis?
A. Vulva vestibulitis
B. Mechanical intertrigo
C. Allergic dermatitis
D. Fungal vulvo-vaginitis
MPL 0.33 p: 487
112. On cut-section of an ovarian mass in a 26 year old nulligravida, there were ufts of hair, sebum
and bony cartilage. What type of ovarian mass is most likely in this case?
A. Follicular cyst
B. Dysontogenetic cyst
C. Cystic teratoma (dermoid)
D. Theca lutein cyst
MPL 0.33 p: 979

113. What ulcerative lesion of the genital tract is characterized by the presence of groove sign?
A. Granuloma inguinale
B. Lymphogranuloma venereum
C. Chancroid
D. Syphilis
MPL 0.33 p: 661

114. What surgical procedure will prevent a woman from experiencing vaginal coitus?
A. Manchester Fothergill
B. Colpocleisis
C. Vaginal hysterectomy
D. Perineorrhaphy
MPL 0.25 p: 580

115. Which is the most common predisposing factor to ectopic pregnancy?

A. previous genital infection
B. smoking
C. contraceptive pills
D. douching
MPL 0.33 p: 254