GYNE LONG EXAM 5

PREMALIGNANT AND MALIGNANT LESIONS

VULVA AND VAGINA
1. Lichen sclerosus is a change in vulvar skin that often
appears whitish. It also is described as the following
EXCEPT:
a. The epithelium is become markedly thick
including the ________.
b. Inflammation is usually present
c. Studies show small premalignant
d. Tumors develop usually in clitoral in location
2. Pruritic erythematous lesions of the vulva with large
cell microscopic finding are characteristic of
a. Pagets disease
b. Carcinoma in situ
c. Verrucous carcinoma
d. Lichen sclerosis

11. Endodermal sinus tumor of the vagina can be

monitored by what tumor marker
Answer: AFP
12. What is the most common histologic type of primary
vaginal cancer
Answer: Squamous cell carcinoma
13. Most cervical neoplasia will start at
Answer: Transformation zone
14. Human papilloma type cause of genital warts
Answer: HPV 6,11

CERVIX

3. Major symptom in most vulvar atypia

a. Mass
b. Itchiness ??
c. Numbness
d. Discharge

15. Most effective screening tool in the detection of

cervical cancer
Answer: Pap smear

4. The best diagnostic procedure in evaluating vulvar

lesions:
a. Biopsy
5. Vulvar cancer that extends to the anus is what stage?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
6. Tumors of the upper 3rd of the vagina will drain into
which node?
a. Pelvic nodes
7. What is the most frequently used modality of
treatment of sqamous cell carcinoma of vagina?
a. Vaginectomy
b. Radiation
c. Chemotherapy
8. Most cases of VAIN occur in?
Answer: Upper 3rd
9. What vaginal malignancy occurs primarily after 14
years of age and is associated to prenatal exposure
(to DES)
Answer: Clear cell adenocarcinoma
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10. The vaginal cancer involving subvaginal tissue with

pelvic wall but no pelvic node extension
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4

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16. A 30 year old G3P2 asymptomatic woman had routine

annual pap smear. The result of her pap smear
showed squamous metaplasia. What do you do next?
a. Refer for colposcopy.
b. Do a cervical punch biopsy.
c. Do a Schillers test
d. Advise a repeat pap smear.
17. A 40 year-old G1P1 patient with CIN 3 had a
Schillers done. On Schillers test you would expect
the cervical lesion stain-Answer: Yellow
18. Ablative therapy for CIN will include which of the
following
a. Cryotherapy
b. Loop electrosurgical procedure
c. Loop
d. Hysterectomy
19. The Atypical squamous cell of undetermined
significance should be managed with:
a. Repeat pap smear after 6 months
b. HPV testing
c. Colposcopy
d. Any of the above

20. The prevalence of squamous cell carcinoma of cervix

is highest in which condition
a. Frequent sexual intercourse
b. Sex at a young age
c. Late menopause
d. Alcoholic
21. Most common histology type of cervical cancer
Answer: Squamous large cell non keratinizing
22. Cervical cancer which shows unilateral
hydronephrosis in IVP
Answer: Stage 3b

34. Stage 2 endometrial carcinoma will include the

endometrium and
Answer: Cervix
35. The broad ligament lymphatics drain at which group
of nodes
a. Pelvic node
36. The primary treatment for all patients with endometrial
carcinoma
a. Complete surgical staging
37. Finding>5-10 / hpf mitosis with cytologic atypia will
lead to diagnosis of
a. Leiomyosarcoma

23. Radical hysterectomy with pelvic node adenectomy is

indicated for:
Answer: Stage Ib1
24. Most effective screening for cervical cancer
Answer: Pap smear

38. Treatment of endometrial sarcoma will be:

Answer: Surgical removal

ADNEXA

27. Approximately 5 percent of cases of endometrial

carcinoma, diagnosed at what age group?
Answer: < 40

39. Structures of adnexa except:

a. Ovaries
b. Fallopian tube
c. Broad ligament
d. Round ligament
40. Pathology of reproductive organ that is often mistaken
for adnexal mass
a. Peritoneal cyst
b. Intraligamentary myoma
c. Omental cyst
d. All of the above
41. Most common cell type of ovarian cancer
a. Epithelial

28. Which type of hyperplasia which mostly lead to

endometrial carcinoma
Answer: Complex atypical hyperplasia

42. Most common neoplastic ovarian tumor following

menarche
a. Mature cystic teratoma

29. Endometrium with dilated glands, with abundant

stroma and some outpouchings
Answer: Simple hyperplasia

43. Ovarian cyst highly associated with Hydatidiform mole

a. Theca lutein cyst
44. Incidence of ovarian neoplasm being malignant in
menopause
a. 45%
45. Ovarian mass associated with dyspareunia highly
suggestive of
a. Mittelschmerz
b. Endometriosis
c. FT ca
d. Meigs syndrome
46. Meigg;s syndrome triad except:
a. Pleural effusion
b. Ascites
c. Ovarian fibroma
d. Bipedal edema

25. Most common type of vaginal bleeding in cervical

cancer
a. Post coital bleeding

UTERUS
26. Most common age group affected by endometrial
adenocarcinoma
a. Perimenopausal and postmenopausal

30. Glands are crowded, with complex outpouchings, with

very little stroma
Answer: Complex
31. Most frequent symptom of women with endometrial
hyperplasia
a. Abnormal vaginal bleeding
32. On TVS, which of the following shows a lack of
endometrial pathology?
a. <4 mm of endometrial thickness
(postmenopausal )
33. The diagnosis of endometrial carcinoma is
established best by:
a. Endometrial biopsy
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47. Abdominal pain , with vaginal bleeding, with

disappearance of pain
a. Ovarian cancer
b. Fallopian tube cancer
c. Uterine cancer
48. Abdominal mass, amenorrhea, hirsutism, clitoral
hypertrophy and decreased breast mass
a. Sertoli-Leydig cell carcinoma

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49. Sonographic criteria that is graded and scored

possibility of ovarian mass include the following
except
a. Echogenicity
b. Septal wall thickness
c. Shadowing
d. Presence of ascites
50. Psamomma bodies is seen in
a. Papillary serous cystadenocarcinoma