Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Медведєв Михайло Володимирович // 07 Апреля 2020

Вопросов в тесте: 20

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Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

A 23-year-old G0 woman presents complaining of increasing pelvic pain with her menses over the last year since she stopped her OCPs. In particular, she has noticed more pain on her left side in the last couple of months. She denies any changes in her bladder or bowel habits but reports that she has begun to have pain with deep penetration during intercourse. She started OCPs when she was 17 for painful irregular cycles but stopped them a year ago when her insurance changed. She has had only one lifetime sexual partner and no history of sexually transmitted infections. She would like to preserve fertility. On examination, she has no abnormal discharge but her uterus is tender as well as her left adnexa. You appreciate a fullness that you suspect may be a mass. On pelvic ultrasound she has a 5 cm cystic ovarian mass thought to be an endometrioma. It persists in repeat ultrasound 8 weeks later and the patient is still symptomatic. What would be the most appropriate next step in her care?

вопрос 1 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

The patient is 49 years old complains in the protracted and abundant menstruations during last 2 years. At vaginal examination: the uterine cervix is cylindric, cervical canal skips one finger, higher than level of internal os there’s hard tumor in diameter up to 4 cm. Uterus is enlarged to 10 weeks of pregnancy, firm, unpainful. Adnexa are not palpated. What’s most credible diagnosis?

вопрос 2 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

A 26-year-old G0 patient comes in with a problem visit for a complaint of an intermittent painless mass on her vulva near the introitus. It seems to be aggravated by intercourse, but usually goes away on its own. She’s had two lifetime sexual partners and has been with her last partner for 5 years. She has always had normal periods and Pap smears and has never had an STI. You examine her and find a 3 cm nontender mass in the area described. What type of abnormality is this most likely to be?

вопрос 3 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

The patient 48 years complains on abundant menstruations. Menstruations to this time were without deviations from norm. Birthss – 2, abortions – 2. The last 2 years she did not visit gynecologist. Objectively: external genital organs without pathology, the uterine cervix is cylindric, clean. The uterus is enlarged to 14-15 weeks of pregnancy, unequal surface, mobile, not painful. Adnexa are not determined, unpainful. Parametria are free. Excretions are mucous. What is most probable diagnosis?

вопрос 4 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Female patient, 55 years old, menopausal period – 5 years, ovarian cyst has been found. Prescribe appropriate treatment.

вопрос 5 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Female patient, 35 years old. Complains on considerable bloody discharge during each menstruation. Menstruation lasts 5-7 days. Gynecologiacal status: cervix is clean, uterus is enlarged up to the 8 weeks of pregnancy. Adnexa are not palpable. US – 1 submucouse and 3 interstitial nodes from 1 to 3 cm in size. Prescribe appropriate treatment.

вопрос 6 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Female patient, 30 years old. Complains on considerable bloody discharge during each menstruation. Menstruation lasts 7–10 days. Gynecologiacal status: cervix is clean, uterus is enlarged up to the 14 weeks of pregnancy. Adnexa are not palpable. US – submucous, subserosal and interstitial nodes from 2 to 5 cm in size. Prescribe the most appropriate treatment.

вопрос 7 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Patient 48 years complains on very abundant menstruation for the last 8-9 months. During 2 years she’s been observed by a gynecologist concerning uterine myoma. Objectively: the uterine cervix is clean, external os is closed. The uterus is in normal position, enlarged to 9-10 weeks of pregnancy, unequal surface, firm, mobile, not painful. Adnexa on both sides are not determined. Parametria are free. Excretions are mucous. What is the most reliable diagnosis?

вопрос 8 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

To gynecologyst appealed patient 32 years old with complaints on dismenorrea, dispareunia, rectal pain, prementsrual spotting, pain in the back during menstruation. At vaginal examination: sacro-uterine ligaments are sensible, nodulated. The uterus’s of normal size, fixed, firm. Adnexa are not palpated. At laparoscopy there are small violet pathes on the peritoneum and posteriorr surface of uterus. What diagnosis is most credible?

вопрос 9 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

In 32 years old female patient during assessment near the uterus we found not painful elastic tumour like formation with smooth surface, mobile. There are no complains. US – unicameral cyst, homogeneous echogenicity, diameter – 16 cm. Diagnosis?

вопрос 10 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Female patient, 50 year old. Menopause – 1 year. No complains. During assessment: cervix is clean, uterine body is increased up to the 7 weeks of pregnancy. Uterine adnexa are not palpable. US – intramural node, 2 cm. What is appropriate treatment?

вопрос 11 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Female patient, 51 years old. Complains on considerable bloody discharge during each menstruation. Menstruation lasts 10–12 days. Gynecological status: cervix has dysplasia, uterus is enlarged up to the 12 weeks of pregnancy. Adnexa are enlarged. US intramural node 3,5 cm and 4 subserosal nodes from 1 to 2,5 cm. Both ovaries have cysts. Prescribe appropriate treatment.

вопрос 12 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Patient 22 years. Complains on pain in a right labia majora, rise of body temperature to 38.0 °C. At the exam of genital organs the considerable enlargement of right labia majora defined, especially in the lower third. Erythema, edema, at palpation it’s acutely painful, fluctuation is determined. It is impossible to conduct vaginal examination due to acute pain. Blood test: Leucocytes — 10,0 x 109 per liter, left shift of formula. Whhat to do?

вопрос 13 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

A 53-year-old G0 woman comes to your office to report that her menses have returned. She underwent menopause 4 years ago, and had not experienced any bleeding until the past 3 months. She reports several episodes of bleeding. She has a normal Pap smear history and had a normal pap and negative high-risk HPV screen performed 2 years ago. She has been taking over-the-counter medications and supplements for hot flashes, but cannot recall the names of them. She is in a monogamous relationship with her husband of 20 years. Further history reveals that she has type 2 diabetes and has a lifelong history of oligomenorrhea with heavy or prolonged bleeds when she does have a cycle. She had a prior laparoscopic cholecystectomy 8 years ago as her only surgical history. Physical examination reveals the following: BP: 150/85 mm Hg; BMI: 48; general characteristics: obese female with moderate acanthosis over posterior neck, inner thighs and inguinal area, moderate hirsutism over chin/neck area; Abdomen: well-healed laparoscopic scars; GU: uterus mobile, 9 weeks’ sized (mildly enlarged), limited palpation of adnexa due to habitus, overall nontender, without discrete masses. In addition to a thorough physical examination, which of the following is the next best step in evaluation of this patient?

вопрос 14 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

The patient is 36 years old complains on pain in lower abdomen on left side, which arose up suddenly. Objectively: external genital organs are without pathology, the uterine cervix is cylindric, clean. The body of uterus is enlarged to 12–13 weeks of pregnancy, the mobility is limited. One of fibroids on the left near fundus is acutely painful. Adnexa are not determined, their region is unpainful. Parametria are free. Excretions are serous. Blood test: Haemoglobin – 120 g/l, leucocytes — 12x10*9/l. What is the most reliable diagnosis?

вопрос 15 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Patient, 32 years referred to gynecologist with complaints of abundant, protracted menstruations during 3 years, aching pain in lumbal area. She did not visit a gynecologist for 2 years. The last menstruation was 2 weeks ago, in time. In anamnesis: menarhe at 13 years, menstruations last 7 days, every 28 days; births-0, abortions-3. At vaginal examination: the uterine cervix is clean, the uterus is enlarged to 9 weeks of pregnancy, firm, mobile, not painful, in anteflexio. Adnexa on either side are not enlarged. Excretions are mucous. What is to be carried out first of all?

вопрос 16 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

The patient 46 years is delivered to the gynecological department with complaints of severe uterine bleeding during the last 2 days, weakness. At vaginal examination: the uterus is firm, unpainful, enlarged to 9 weeks of pregnancy. What is the doctor desicion?

вопрос 17 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

A 32 years old woman appealed to the doctor with complaints on abundant and protracted menstruations, which proceed already during 6 months, general weakness. Skin is pale. At vaginal examination: uterus is enlarged up to 9-10 weeks of pregnancy, irregular shape, unpainful, mobile, adnexa are not palpated. The diagnosis of uterine myoma was set. What should be done first?

вопрос 18 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Patient 38 years old, 5 years with diagnosis uterine myoma (size of tumor up to 10 weeks of pregnancy), complains of abundant protracted menstruations with posthemorrhagic anemia (hemoglobin 80 g\l). At the admission: the time of menstruation, 8th day, discharge is abundant, patient is pale. What is the first step of treatment?

вопрос 19 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

Patient 34 years old. The uterine myoma was diagnosed 2 years ago. Growth is not present. There is pain in lower parts of abdomen. Leucocytosis 17х10 9 /l. The symptoms of irritation of peritoneum are positive. At vaginal examination: the uterus is enlarged up to 10 weeks of pregnancy, one of fibroids is mobile, painful. Discharge is mucous. Diagnosis?

вопрос 20 из 20 //

Варианты ответа:

Benign and premalignant diseases of female reproductive organs. Malignant neoplasms. Trophoblastic disease.

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Female patient, 55 years old, menopausal period – 5 years, ovarian cyst has been found. Prescribe appropriate treatment.

In 32 years old female patient during assessment near the uterus we found not painful elastic tumour like formation with smooth surface, mobile. There are no complains. US – unicameral cyst, homogeneous echogenicity, diameter – 16 cm. Diagnosis?

Female patient, 50 year old. Menopause – 1 year. No complains. During assessment: cervix is clean, uterine body is increased up to the 7 weeks of pregnancy. Uterine adnexa are not palpable. US – intramural node, 2 cm. What is appropriate treatment?

The patient 46 years is delivered to the gynecological department with complaints of severe uterine bleeding during the last 2 days, weakness. At vaginal examination: the uterus is firm, unpainful, enlarged to 9 weeks of pregnancy. What is the doctor desicion?