Gyne.

LE 4
1. Puberty described as all of the following except
a. biological change after which sexual reproduction becomes possibleTRUE
b. Type of accelerated linear growth and secondary sexual characteristicsTRUE
c. Menarche occurs before axillary or pubic hair- FALSE
d. Normal puberty occurs in a wide range of ages- TRUE
2. Precocious puberty describes all of the following except
a. A relatively common d/o
b. Appearance of any kind of sexual maturation at an early age
c. Diminished ultimate height due to premature closure of epiphyseal
closing centre
d. Majority develop GNRH dependent
3. Most common cause of GnRH dependent precocious puberty
a. unknown
4. Most common cause of GNRH independent precocious puberty
a. Functioning ovarian tumor
b. MCCune Albright syndrome
c. Exposure to external hormones
d. Tumour in adrenal or pituitary
5. Primary emphasis in a child w/ precocious puberty would be
a. To rule out life threatening neoplasm of ovary, adrenal or CNS
6. Secondary emphasis would be
a. To delineate the spread of tumor
7. Role of chemotherapy in precocious puberty is to
a. Reduce gonadotrophin secretion
b. Counteract the peripheral action of steroids
c. Decrease the growth.....
d. All of the above
8. Most important in the medical management of GNRH dependent
precocious puberty is to
a. Change the growth pattern
9. Classic definition of Polycystic ovarian syndrome is
a. Women w/
b. Women who have irregular period
c. Hyperandrogenism
d. All of the above
10.Ultrasound finding of PCOS include all except
a. Abnormal follicles measuring 17mm
b.
11.Central Pathophysiology of PCOS
a. Insulin resistance
12.35y/o... BMI 32, ovarian follicles... diagnostic tests except
a. OGTT
b. Serum testosterone
c. LDL, HDL, Cholesterol
d. Urinalysis
13.First step in mgmt of this pt
a. Loose weight
14.Long term consequence of PCOS
a. Risk of Ovarian cancer
15.Idiopathic hirsuitism...best treatment

Spironolactone
16.Major androgen provided by ovary
Testosterone
17.Source of androgen production in foll organs except
Pituitary
18.Symptoms of PCOS except
a. Hirsuitism
b. Alopecia
c. Dysmenorrhea
d. Glucose intolerance
19.Ovarian new growth secreting excessiveamt of testosterone
a. Brenners Tumor
b. Theca leutin cyst- prog
c. Fibroma
d. CL cyst prog
20.Treatment for hyperandrogenism except
a. Ocp
b. Surgery
c. Diet and exercise
d. Testosterone
21.Natural menopause
a. Cessation of menstrual flow due to change in secondary to
change in reproductive physiology.
22.Mean age for menopause
a. 35- 55
23.Factors that speed up menopause
a. Underweight
b. Deseases that damage ovary
c. Overweight
d. smoking
24.Premature ov falure causes premature menopause because
a. It depletes the ovarian follicles before age of 40
25.Perimenopause characterized by except
a. Decreased estradiol
26.Pathgnomonic symptom of menopause
a. Hot flushes
27.Initial endocrinologic change in menopause
Decresed inhibin production and inc pit. Fsh
28.Treatment for menopause except
a. Hysterectomy
b. OCP
c. Hormonal therapy
d. Fractional D and C
29.If menopause is due to organ failure which organ is involved
a. Ovary
30.Which organ is deficient in menopausal women
17 Beta progesterone
31.Anatomical changes in menopausal women except
Cervix does not atrophy
32.Female in menopause are prone to dysparunia coz of
a. Decreased estrogen production
33.All are true about HRT for menopausal women except
a. For urogenital atrophy
b. Primary and secondary prevention of CV disease

c. Decrease the risk of osteoporosis and colorectal cancer

d. Does not increase risk of Endometrial cancer
34.Recommendation for care of menopausal women except
a. CT scan every year
35.Most effective treatment for urogenital and vasomotor symptom
a. Highest dose
b. All women
c. ....... is the most effective treatment
36.Major cause of infertility are
a. Male factor.....
b. ALLL
37.Assessment of ovulation includes all of the foll except
a.
b. Semen analysis
c. ultrasound
38.Conditions for semen collection
All of the above
39.Initial screening in evaluation of tubal pathology would be
Hysterosalpingogram
40.Qualities of a post coital test except
a. Poor predictor of infertility
b. In vivo evaluation of sperm mucous interaction
c. Tests the male factor of infertility
d. 5-10 progressive motility
41.Components of a basic infertility work up
a. Post coital test
b. Hysterosalpingogram
c. Laparoscopy
42.A value greater than 30nm/L is a predictor of ovulation
a. LH testing
b. Serum progesterone
c. Semen analysis
43.Accurate way to do document ovulation
a. Ultrasound
44.Normal semen parameters except
Concentration of Less than 20M (40-60M)
45.Parameters for semen analysis- liquifactive time, leukocyte count, ....
All
CASES
46.25y/o women G2P2...hx of ruptures appendicitis- surgery; regular periods;
Husband normal- TUBAL FACTOR
47.29y/o women G5P4...bimanual examination- enlarged uterus- UTERINE
FACTOR(MYOMA)
48.
31y/o women. Secondary infertility... regular menses. Decreased
follicle count- OOCYTE QUANTITY
49.Could not get preg after reversal of husbands vasectomy- MALE FACTOR
50.Irregular periods, ROS- hair growth on her abdomen- OVULATION
FACTOR.