Chapter 22: Female genital

Chapter 22: Female genital

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A 55-year-old woman who has diabetes mellitus complains of genital itching. Examination shows whitish plaques on the mucosa of the vulva and vagina. Which of the following infectious agents most likely caused these changes?
2. Human papillomavirus
3. Herpes simplex virus type 2
4. Trichomonas vaginalis
5. Gardnerella vaginalis
6. Candida albicans

ANS: E, Candida vaginalis infections of the vulva and vagina are the most common genital complications of diabetes mellitus.

2. Which of the following genital lesions is associated with a greater than expected risk of carcinoma of the vulva?
3. Condyloma acuminatum
4. Condyloma latum
5. Lichen simplex chronicus
6. Lichen sclerosus
7. Papillary hydradenoma

ANS: D, Lichen sclerosus is not recognized as a precancerous condition, but it has been associated with genetic alteration and a greater than expected risk of subsequent carcinoma in 1%–4% of all patients. Condyloma acuminatum is caused by human papillomavirus types 6 and 11 and tends to involute spontaneously. Condyloma latum is a manifestation of secondary syphilis and is not associated with cancer. Lichen simplex chronicus is caused by rubbing and scratching and is not related to cancer. Papillary hydradenoma is a benign tumor of the vulvar modified apocrine sweat glands and does not predispose to cancer.

3. A physical examination of a 5-year-old girl shows a grape-like polypoid mass protruding from the vagina. Histologic examination reveals that the mass has a myxoid stroma that contains small oval-shaped cells. Some of these cells have pink cytoplasm and resemble tennis rackets. These cells reacted positively upon immunohistochemical staining with the antibodies to desmin. Which of the following is the most likely diagnosis?

1. Squamous cell carcinoma
2. Clear cell adenocarcinoma of the cervix
3. Leiomyosarcoma
4. Rhabdomyosarcoma
5. Malignant melanoma

ANS: D, This grape-like tumor is an embryonal rhabdomyosarcoma, also known as sarcoma botryoides (Greek word for “grape-like”).

4. Assuming that a vaccination will be discovered for the human papillomavirus in women, it is expected that the vaccination will reduce the incidence of carcinoma at which of the following sites?
5. Clitoris
6. Vagina
7. Cervix
8. Endometrium
9. Ovary

ANS: C, Cancers associated with the human papillomavirus (HPV) occur most often on the cervix. Vaccination against HPV is expected to reduce the incidence of all human genital cancers caused by HPV, but most prominently carcinoma of the cervix.