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  • Question 1 - Which of the following is likely to result in hematocolpos in a 12-year...

    Correct

    • Which of the following is likely to result in hematocolpos in a 12-year old girl?

      Your Answer: Imperforate hymen

      Explanation:

      Hematocolpos means accumulation of blood in vagina and hematometra is accumulation of blood in the uterus. These are most likely seen with an imperforate hymen; which is seen I 1 in 2000 females. If spontaneous resolution does not occur, treatment involves making a hole in the hymen to allow discharge of menstrual blood.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      37.7
      Seconds

  • Question 2 - A young female in the 15th week of pregnancy presented to the emergency...

    Correct

    • A young female in the 15th week of pregnancy presented to the emergency department with the passage of grape-like masses per vagina. Dilatation and curettage was done and microscopy revealed large avascular villi with trophoblastic proliferation. Which one of the following investigations is best recommended for her follow-up?

      Your Answer: Serum β-hCG

      Explanation:

      Trophoblast is the layer of cells surrounding the blastocyst and that later develops into the chorion and amnion. Gestational trophoblastic disease is a tumour arising from this trophoblast. It can occur during or after either an intrauterine or ectopic pregnancy. If it occurs in a pregnant woman, it usually leads to spontaneous abortion, eclampsia or fetal death. It can be either malignant or benign.

      In suspected cases, investigations include measurement of serum beta subunit of human chorionic gonadotrophin (β-hCG) and pelvic ultrasound. Confirmatory test is a biopsy. Post-removal, the disease is classified clinically to assess further treatment. To assess the presence of metastases, further work-up includes computed tomography of the brain, chest, abdomen and pelvis. Chemotherapy is usually needed for persistent disease. If at least three consecutive, weekly serum β-hCG measurements are normal, treatment is considered successful. Follow-up is also done by measuring β-hCG.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      30.2
      Seconds

  • Question 3 - A 38-year old woman presents to the clinic with a 2 cm eczema-like...

    Incorrect

    • A 38-year old woman presents to the clinic with a 2 cm eczema-like lesion on the areolar region of her left breast, for 5 months. Biopsy of the lesion showed large cells at the dermal-epidermal junction with positive staining for mucin. What is the likely diagnosis?

      Your Answer: Dermatophyte infection

      Correct Answer: Paget’s disease of the breast

      Explanation:

      Paget’s disease of the breast or nipple resembles eczema in appearance with an underlying carcinoma typically. The disease is usually unilateral and presents with inflammation, oozing and crusting along with a non-healing ulcer. Treatment is often delayed due to the innocuous appearance but can be fatal. It results due to spread of neoplastic cells from the ducts of the mammary gland to the epithelium.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      27.9
      Seconds

  • Question 4 - Endometrial hyperplasia is most likely to be associated with which of the following...

    Incorrect

    • Endometrial hyperplasia is most likely to be associated with which of the following conditions?

      Your Answer: Sertoli–Leydig cell tumour

      Correct Answer: Fibrothecoma

      Explanation:

      A benign tumour arising from the ovarian stroma, fibrothecoma are bilateral in 10% cases. The thecoma component of the tumour can produce oestrogen leading to endometrial hyperplasia. The thecoma is rich in lipid content and is responsible for the yellowish appearance of the tumour. Meig’s syndrome is the presence of fibrothecoma with a right-sided hydrothorax.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      10.8
      Seconds

  • Question 5 - A 24-year old, lactating mother presents to the clinic with a tender, 1.5cm...

    Correct

    • A 24-year old, lactating mother presents to the clinic with a tender, 1.5cm mass just below the right nipple, which shows multiple fissures. What finding is likely associated with her condition?

      Your Answer: Staphylococcus aureus infection

      Explanation:

      Breast abscess occur commonly in lactating mothers in the postpartum period due to cracking of the nipple. It is commonly caused due to Staphylococcus aureus infection. Fat necrosis usually results from trauma wherein an ill-defined mass is formed. Ductal carcinomas are malignant masses which are not tender usually, and rare in the young age group. Plasma cell mastitis affect women in an older age group. Sclerosing adenosis is a type of fibrocystic disease which can lead to a tender, cystic mass but no fissuring or cracks are seen in the nipple. Fibroadenoma and lipomas are non-tender, well-defined masses.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      25.7
      Seconds

  • Question 6 - Which of the following features is indicative of poor prognosis in a case...

    Correct

    • Which of the following features is indicative of poor prognosis in a case of breast carcinoma?

      Your Answer: Axillary lymph node metastases

      Explanation:

      Lymphatic spread indicates poor prognosis. Presence of family history is not a prognostic factor despite being linked to higher incidence. Aneuploidy is a poor prognostic factor. A breast tumour positive for oestrogen receptors is a good prognostic factor as it increases the responsiveness of the tumour to certain therapies. In-situ tumours carry the best prognosis.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      15.5
      Seconds

  • Question 7 - A 28-year old lady comes to the surgical clinic with a recently detected...

    Correct

    • A 28-year old lady comes to the surgical clinic with a recently detected lump in her right breast. On examination, the lump is found to be 1cm, rubbery, mobile with no palpable axillary nodes. Mammography reveals no microcalcifications and the opposite breast appears normal. What is the likely diagnosis?

      Your Answer: Fibroadenoma

      Explanation:

      A benign breast tumour, fibroadenoma is common below the age of 30 years and occurs due to oestrogenic excess. It is characterised by proliferation of both glandular and stromal elements. Fibroadenomas are usually solitary and are mobile, not fixed to surrounding structures. The tumour is elastic, nodular and encapsulated with a grey-white cut surface. The two main histological types include intracanalicular and pericanalicular types, with both types often present in the same tumour. In the intracanalicular type, the stromal proliferation component predominates causing compression of ducts making them appear slit-like. In pericanalicular type, the fibrous stroma dominates around the ductal spaces so that they remain oval on cross section.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      40.8
      Seconds

  • Question 8 - What is the most likely cause of bilateral gynaecomastia in a 55-year old...

    Correct

    • What is the most likely cause of bilateral gynaecomastia in a 55-year old male?

      Your Answer: Hepatic failure

      Explanation:

      Hypertrophy of breast tissue in males is known as gynaecomastia. It is normally due to proliferation of stroma and not of mammary ducts. Physiological gynaecomastia can occur during puberty and is often transient, bilateral, symmetrical and possibly tender. Gynaecomastia can occur during old age too, but is usually unilateral. Other causes include hepatic or renal failure, endocrinological disorders, drugs (anabolic steroids, antineoplastic drugs, calcium channel blockers, cimetidine, digitalis, oestrogens, isoniazid, ketoconazole, methadone, metronidazole, reserpine, spironolactone, theophylline), and marijuana. It should not be confused with malignancy which is often hard, asymmetric and fixed to the dermis or fascia. Treatment if indicated, includes withdrawal of the causative factor or treatment of the underlying disorder.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      8.4
      Seconds

  • Question 9 - A 46-year old lady presents with chief complaints of a large mass in...

    Incorrect

    • A 46-year old lady presents with chief complaints of a large mass in the left breast. Histopathology of the mass revealed a stromal component with an epithelial component. What is the likely lesion?

      Your Answer: Hamartoma

      Correct Answer: Phyllodes tumour

      Explanation:

      Phyllodes tumours are large, quickly growing tumours which arise from the periductal stroma of the breast. These are fibroepithelial tumours and account for less than 1% of breast cancers. These tumours can be benign, borderline or malignant based on the histology. The tumour usually affects adult women, mostly between the age of 40 to 50 years. It can be confused with fibroadenoma, which however affects much younger patients.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      17.6
      Seconds

  • Question 10 - The likely cause of a tender and swollen breast in a lactating mother...

    Incorrect

    • The likely cause of a tender and swollen breast in a lactating mother is:

      Your Answer: Galactocele

      Correct Answer: Acute mastitis

      Explanation:

      Acute mastitis results due to bacterial infection of the breast and results in signs of inflammation. It commonly occurs 2-3 weeks postpartum and common causative microorganisms are Staphylococcus aureus, Streptococcus species, and Escherichia coli. Complications like an abscess can be avoided by prompt treatment, which includes antibiotics and rest along with continued lactation.

    • This question is part of the following fields:

      • Pathology
      • Women's Health
      13
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Pathology (6/10) 60%
Women's Health (6/10) 60%
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