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Pretest PA Blok 3.3 Reproductive system

Total questions: 15

Worksheet time: 15mins

Name
Class
Date
1.

A 23-year-old woman undergoes pelvic ultrasound, which reveals a 1.8 cm thin-walled cyst containing clear fluid. The cyst wall shows a smooth glistening membrane and preserved granulosa cells. No solid components are identified. Which type of ovarian lesion is most consistent with these findings?

a)

Serous cystadenoma

b)

Follicular cyst

c)

Partial hydatidiform mole

d)

Mature teratoma

e)

Endometrioma

2.

A 19-year-old woman presents with irregular menses, acne, and hirsutism. Ultrasound shows enlarged ovaries with multiple small cystic follicles beneath a thickened cortex. Which mechanism best explains her increased risk of endometrial hyperplasia?

a)

Elevated progesterone levels

b)

Increased estrone due to peripheral aromatization

c)

Excess FSH leading to gland proliferation

d)

Androgen deficiency in ovarian stroma

e)

Thickened cortex inhibiting ovulation

3.

A 28-year-old woman presents with acute pelvic pain. Imaging shows a cyst containing areas of old hemorrhage and yellow tissue at the periphery. Which characteristic feature supports a diagnosis of luteal cyst?

a)

Scalloped villi

b)

Luteinized granulosa cells lining the cyst

c)

Complex glandular crowding

d)

Thick fibrous stroma with vessels

e)

Hydropic chorionic villi

4.

A 32-year-old woman with severe dysmenorrhea is diagnosed with endometriosis. Lesions are found along the pelvic peritoneum. Which theory best explains typical pelvic distribution of lesions?

a)

Coelomic metaplasia

b)

Retrograde menstruation

c)

Benign metastasis via lymphatics

d)

Stem cell differentiation from bone marrow

e)

Hematogenous spread

5.

A pathologist reviews a biopsy from an ovarian cyst containing thick brown fluid. Microscopy reveals hemosiderin-laden macrophages. Which additional finding is required for definitive diagnosis?

a)

Trophoblastic proliferation

b)

Endometrial glands and stroma

c)

Luteinized theca cells

d)

Back-to-back glands

e)

Hydropic villi

6.

A 29-year-old woman presents with dyspareunia and chronic pelvic pain. Laparoscopy reveals multiple blue-brown nodules on the uterosacral ligament. Which associated clinical condition is most likely?

a)

Increased risk of granulosa cell tumor

b)

Infertility

c)

Vaginal prolapse

d)

Ureteral stricture

e)

Preeclampsia

7.

A 40-year-old woman has a uniformly enlarged uterus with thickened myometrium. Histology shows endometrial glands located 3 mm below the endometrial–myometrial junction. Which mechanism best explains this finding?

a)

Transformation of myometrial cells into endometrial tissue

b)

Invagination of basalis endometrium into myometrium

c)

Metastatic spread via lymphatics

d)

Failure of ovulation

e)

Increased progesterone exposure

8.

Which symptom most strongly suggests adenomyosis?

a)

Cyclic mastalgia

b)

Intermenstrual spotting

c)

Severe dysmenorrhea and menometrorrhagia

d)

Galactorrhea

e)

Early pregnancy loss

9.

A 55-year-old woman on tamoxifen develops abnormal uterine bleeding. Ultrasound reveals a pedunculated mass projecting into the uterine cavity. Which feature supports its neoplastic stromal origin?

a)

Aromatase overexpression

b)

Thick-walled blood vessels within a fibrous stroma

c)

Luteinization of theca cells

d)

Hydropic villi

e)

Trophoblast invasion

10.

Which complication may arise from an endometrial polyp?

a)

High risk of choriocarcinoma

b)

Infertility

c)

Severe virilization

d)

Rapid hemodynamic collapse

e)

Ovarian torsion

11.

A 48-year-old obese woman presents with abnormal uterine bleeding. Biopsy shows increased gland-to-stroma ratio and cystically dilated glands. Which risk factor most directly contributes to her condition?

a)

Elevated progesterone

b)

PTEN overexpression

c)

Unopposed estrogen

d)

Chronic endometritis

e)

High-protein diet

12.

A biopsy shows crowded, back-to-back glands with cytologic atypia and loss of polarity. What is the most important clinical implication?

a)

The lesion is benign and requires no treatment

b)

High likelihood of concurrent carcinoma

c)

Immediate chemotherapy is required

d)

Risk of ovarian torsion

e)

Condition will resolve spontaneously

13.

A woman's evacuated uterine contents show diffuse hydropic villi with circumferential trophoblastic proliferation and no fetal tissue. Which karyotype is most consistent with this diagnosis?

a)

69,XXY

b)

46,XY of biparental origin

c)

46,XX from duplication of paternal genome

d)

45,X

e)

47,XXX

14.

A biopsy reveals a mixture of normal and hydropic villi, focal trophoblastic hyperplasia, and the presence of fetal parts. Which diagnosis is most likely?

a)

Complete mole

b)

Partial mole

c)

Invasive mole

d)

Choriocarcinoma

e)

Normal gestation

15.

A patient treated for complete mole continues to have elevated hCG levels and persistent uterine enlargement. Curettage shows trophoblastic proliferation invading the myometrium. Which statement is correct?

a)

It rarely responds to chemotherapy

b)

It represents metastatic disease to distant organs

c)

Hydropic villi may embolize but do not metastasize

d)

It always requires hysterectomy

e)

Fetal tissue is typically present