Topic 1. Semiotics nd dignosis of gynecologicl diseses Ptient 34 yers

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Topic 1. Semiotics and diagnosis of gynecological diseases

1.  Patient 34 years. In history 4 pregnancy. Gynecologic diseases denies. At 17th day of menstrual cycle uterine bleeding occurred. What test should be conducted in the first place?

 

1.  Biopsy of endometrium 
2.  Thyreoid profile 
3.  HSG 
4.  Colpocytology 
5.  Measurement of basal temperature

1.  44-year-old woman with uterine myoma during 10 years, the last year seen the rapid growth of the tumor, menstrual cycle is 35-40 days with 8-10-days significant bleeding. Which of methods of examination from the following required to determine the future therapeutic approach to the patient?

1.  Biopsy of endometrium 
2.  pelvic ultrasound 
3.  Intravenous pielographia  
4.  HSG
5.  Colpotcytology

1.  Patient 28 y.o. arrived to the GYN department complaining of acute pain in the lower abdomen which appeared suddenly after the delay of menstruation for 4 weeks. Skin is pale. Pulse 110 bpm, BP 90/50 mmHg. Belly is sharply painful to palpation in the lower segments, positive symptom of irritation of the peritoneum. Vaginal examination: uterus is enlarged, declined to the right, to the left palpated elongated tumor, painful to palpation, rear vault is sharply painful, hangs. What is the most informative method of investigation?

1.  Diagnostic laparoscopy 
2.   Puncture of the Douglas puoch 
3.  Test chorionic gonadotropin 
4.  Ultrasound 
5.  Dynamics of total blood count

1.  Patient 18 years old, complained of significant purulent discharge from the vagina. In history unprotected sexual contact a day before the appearance of complaints. During additional examination of vaginal smear: leukocytes - all of the field, discovered tryhomonas vaginalis. What grade of vaginal smear diagnosed?

1.  I 
2.  II 
3.  III 
4.  IV 
5.  O

1.  Patient 32 y.o. turned to the women's consultation with complaints of infertility for 7 years. Biphasic menstrual cycle. According to HSG uterine tubes impassable in ampular departments due to adhesions in small pelvis. What treatment is most appropriate in this case?

1.  Adnexectomy 
2.  laparotomy 
3.  Laparoscopy 
4.  Hydrotubation 

1.  8 years old girl complained of white purulent character, which irritate the skin, genitals and thighs, itching in this area. In exam: the external genitals, vagina and vestibulum swollen, congested. Discharge is significant, mucopurulent. Previous diagnosis vulvovaginitis. Submit test

 

1.  Bacterioscopic, bacteriological research. 
2.  Cytological studies. 
3.  Colposcopy. 
4.  Vaginoscopy. 
5.  Hormonal colpocytology 

1.  Patient 28 years old. Complained of infertility. Menstrual function is not impaired. 5 years of sexual life without contraception. 1 artificial abortion was 4 years ago. In the history Chlamydia infection. Which method of study will help establish the diagnosis?

1.  Hormonal colpocytology 
2.  HSG 
3.  Ultrasound of the pelvis 
4.  Culdocentesis
5.  Colposcopy

1.  Patient complains of lack of pregnancy for 7 years. Regular menses. Male is healthy. In HSG uterine tubes filled with contrast on both sides to isthmic departments. Which interpretation is correct?

1.  tubal left impassable 
2.  uterine tubes impassable on both sides 
3.  uterine tube passable
4.  Right tube impenetrable 
5.  All wrong

1.  To gynecologist referred 36 years old woman with complaints of infertility. With a history: in the first 5 years of marriage. P-1, artificial abortion -11. Last abortion 6 years ago complicated by uterine bleeding, removal of remnants of the product of conception and endometritis. Menstruation is not broken. Vaginal exam: normal. Spermogram is normal. What test should be carried out?

 

1.  Tests of functional diagnosis of hormonal status 
2.  Laparoscopy 
3.  Culdoskopy 
4.  Colposcopy 
5.  Hysteroscopy.

1.  Patient 55 y.o. referred to gynecologist complaining of constant pain in the lover abdomen, difficulty urinating. In the history 1 childbirth with big baby that complicated by rupture of perineum II degree. Somatic anamnesis not overburdened. 4 years postmenopause. Gynecological status: there is weakness of levator ani muscles, cystocele, rectocele, metrocele. Which structures form suspending apparatus of uterus?

1.  Sacro-uterine and round ligaments. 
2.  Round ligaments of the uterus, ovarian and broad ligaments 
3.  Muscles of pelvic bottom
4.  Levator ani muscle 
5.  Sacro-uterine, cardinal, and pubo-cervical ligaments

                   

1.  Patient 54 years old was performed biopsy of the cervix. In hystological study picture of squamous cancer. Most informative screening testing for early detection of cervical cancer?

1.  History taking 
2.  General examination
3.  Examination of the external genitalia, vagina and cervix in speculum 
4.  Rectovaginal examination
5.  Pap smear

                      

1.  In the gynecological department entered thirty years old patient with complaints of sharp pain in the lower abdomen, fever to 38.8 C. Discharge is mucopurulent. P0, 2 artificial abortions. At gynecological examination: Uterus is not changed. Adnexa - enlarged, painful on both sides. Discharge from vagina excessive,  mucopurulent. What do you need to confirm the diagnosis?

1.  Bacterioscopic research 
2.  Hysteroscopy 
3.  D&C
4.  Puncture of the abdominal cavity through the Doughlas
5.  D&C

1.  Marriage couple arrived to the center of family planning with complaints of infertility for three years. Which method of investigation should be started first?

1.  HSG 
2.  Ultrasound
3.  Hydrotubation 
4.  Laparoscopy 
5.  Spermogram

1.  What is the indication for the sounding of uterine cavity? 

1.  Acute inflammatory diseases of the vagina. 
2.  suspicion of cervical pregnancy_
3.  Acute diseases of the uterus and adnexa 
4.  Before D&C, abortion 
5.  Presence of cancer sores that break

1.  Female 28 y.o. came to the doctor complaining of contact bleeding. Menstrual function is not broken, P0. What types of colposcopy are used for inspection of the cervix?

1.  Simple 
2.  Advanced Colposcopy 
3.  Colpomicroscopy. 
4.  Cervicoscopy
5.  All mentioned

1.  29 y.o. patient complains of lack of periods for 1 year, passage of milk from nipples when pressed. Which test should be assigned first?

1.  Determining the level of progesterone in the blood 
2.  determination of blood prolactine 
3.  Definition of excreted 17-ketosteroids in urine 
4.  Identification of tumor marker Ca125 
5.  Determining the level of estradiol in the blood

1.  To gynecological department referred 16 y.o. girl with complaints of absence of periods. The girl with low growth, secondary sexual characteristics are underdeveloped. In gynecological examination marked hypoplasia of the internal genital organs. What to do to determine the cause of delayed sexual development?

1.  Culdoscopy
2.  Hysteroscopy __
3.  Colposcopy 
4.  Determine the level of hormones in the blood. 
5.  HSG

1.  Patient in 3 days after unprotected intercourse began to disturb pain in lower abdomen and when urinating, significant purulent discharge from the vagina, raising the temperature to 37,8 °C. Diagnosis: acute bilateral sdnexitis. In smears: leukocytes in the entire field of view, diplococci, located internally and extracellular. What grade of vaginal smear?

1.  I 
2.  II 
3.  III 
4.  O 
5.  IV

1.  Patient 28 y.o. referred to the gynecologist with complaints of infertility during 3 years. Irregular menstrual function. Physician appointed for the functional diagnostics tests. Which of the following tests is not TFD?

1.  basal temperature 
2.  symptom of "pupil"
3.  symptom of cervical mucus tension 
4.  Symptom of "Fern"
5.  Determining of levels of sex hormones

1.  Female 28 y.o. referred to the gynecologist. Vaginal examination: uterus of normal size, mobile, adnexa are not palpating. When conducting colpocytology on 21st  day of menstrual cycle: the surface cells 20%, 80% intermediate, karyopicnotic index 15%. How do you assess this situation?

1.  single-phase menstrual cycle 
2.  normal menstrual cycle 
3.  Lack of second phase of the cycle 
4.  There are signs of luteinisation  
5.  There are signs of endometrial proliferation

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