Question 1

Your 24-year-old female patient complains of tenderness at the entrance of the vagina on the right side. She cannot sit comfortably because of the soreness in the perineal area. On pelvic examination, there is a tender, inflamed, fluctuant cyst at the introitus on the right side. These signs and symptoms are indicative of:

Accepted Answer

Bartholin cysts occur when a Bartholin's gland is blocked, leading to a fluid-filled cyst. They can become infected, causing pain and inflammation at the vaginal entrance, matching the patient's symptoms. Nabothian cysts are found on the cervix, candidiasis typically presents with itching and discharge, and there's no indication of malignancy from the described symptoms.

Question 2

Which of the following findings on the bimanual examination of a female patient in early pregnancy requires further investigation?

Accepted Answer

Unilateral adnexal tenderness during early pregnancy may indicate an ectopic pregnancy or an ovarian cyst, both of which require further investigation. Bluish colored cervix (Chadwick's sign) and varicose veins of the vaginal walls are normal findings in pregnancy due to increased blood flow and do not typically require further investigation.

Question 3

Your patient who has a uterine fibroid complains of bleeding through up to 10 tampons per day. Excessive bleeding at the time of the menstrual cycle is termed:

Accepted Answer

Menorrhagia refers to heavy or prolonged menstrual bleeding, such as soaking through one or more tampons or sanitary pads every hour for several consecutive hours. In this scenario, the patient experiencing bleeding through up to 10 tampons per day is indicative of menorrhagia.

Question 4

If amenorrhea is reported by the young female patient, the clinician should attribute this to _____________ until proven otherwise.

Accepted Answer

Pregnancy is the most common cause of amenorrhea in women of reproductive age, and it should always be considered and ruled out first before considering other causes.

Question 5

Your 24-year-old patient complains of vaginal discharge. When deciding what diagnostics to perform, what is most important to ascertain?

Accepted Answer

Sexual activity and safe sex practices are crucial to understand the risk factors for sexually transmitted infections (STIs), which are a common cause of vaginal discharge. This information guides the selection of appropriate diagnostic tests.

Question 6

Which of the following infections can cause an eye infection in the newborn during vaginal delivery?

Accepted Answer

Chlamydia trachomatis can cause neonatal conjunctivitis (ophthalmia neonatorum) when the baby is exposed to the bacteria during vaginal delivery.

Question 7

A 23-year-old female complains of a white-yellow vaginal discharge with a fishy odor for the last 2 days. A wet prep shows characteristic clue cells (epithelial cells embedded with bacteria). These findings are indicative of:

Accepted Answer

The presence of clue cells (epithelial cells covered with bacteria) on a wet prep, along with a white-yellow discharge with a fishy odor, is indicative of Bacterial vaginosis.

Question 8

In the health history, you ask a young adult female patient about safe sex and the use of contraception. The patient does not understand what you mean by safe sex. This is an indication for:

Accepted Answer

Patient teaching and counseling are indicated when a patient does not understand the concept of safe sex. This provides an opportunity to educate the patient on safe sex practices and the importance of contraception to prevent sexually transmitted infections (STIs) and unplanned pregnancies.

Question 9

It is important for the clinician to ask the female patient about multiple sexual partners. It is known that multiple sexual partners increases patient risk for:

Accepted Answer

Having multiple sexual partners is a known risk factor for Human papilloma virus (HPV) infection, which can lead to cervical cancer and other health issues. The other options listed are not directly associated with the number of sexual partners.

Question 10

A 38-year-old female complains of having trouble with conception. It is important to ask the patient to:

Accepted Answer

Charting menstrual cycles and taking basal body temperature for three cycles can help in assessing ovulation patterns and fertility, which are crucial for addressing conception issues.

Question 11

A 65-year-old female complains of frequency and urgency of urination, and episodes of urinary incontinence. On pelvic examination, there is a smooth, soft bulge of the anterior vaginal wall that is more pronounced with straining. These findings are indicative of:

Accepted Answer

The symptoms and the physical examination findings described are indicative of a cystocele, which is a prolapse of the bladder into the vagina, leading to a bulge in the anterior vaginal wall. This condition can cause urinary frequency, urgency, and incontinence.

Question 12

Which of the following findings on the bimanual examination of a female patient requires further investigation?

Accepted Answer

Cervical motion tenderness is a sign that may indicate pelvic inflammatory disease or other significant pathology and requires further investigation. Retroverted and anteflexed uteri are common variations of normal, and varicose veins in the vaginal wall, while possibly uncomfortable, are not typically indicative of a serious condition requiring immediate further investigation.

Question 13

During a pelvic examination, a clinician asks the patient to bear down to inspect the vaginal outlet for:

Accepted Answer

Bearing down during a pelvic exam can reveal a cystocele, rectocele, or prolapsed uterus as it increases intra-abdominal pressure, making these conditions more apparent.

Question 14

Your 35-year-old female patient complains of severe cramping with monthly menstrual flow. Painful menstrual periods are termed:

Accepted Answer

Dysmenorrhea is the medical term for painful menstrual periods, which is what the patient is experiencing.

Question 15

When obtaining the health history of a 60-year-old female, it is important to ask:

Accepted Answer

All of the options are important aspects of a comprehensive health history for a 60-year-old female. The age of menopause, any postmenopausal bleeding, and the use of hormone replacement therapy can provide crucial information about her hormonal status, risk for certain diseases, and overall health.

Question 16

In order to perform interventions or prescribe medication for the female patient, it is most important to obtain a complete health history. Which of the following is the most important question to ask female patients?

Accepted Answer

The last menstrual period (LMP) is crucial for determining a patient's current reproductive status, potential pregnancy, and can help in diagnosing various health conditions.

Question 17

Your 16-year-old patient reports that she gets her period sometimes every month and sometimes she skips a month. If menstrual periods are irregular, the term for this condition is:

Accepted Answer

Metrorrhagia refers to irregular, acyclic bleeding from the uterus between periods. The patient's description of sometimes getting her period every month and sometimes skipping a month fits the definition of metrorrhagia.

Question 18

A 33-year-old female patient complains of white, thick vaginal discharge and severe pruritus of the outer genitalia. On pelvic examination, the vaginal introitus is red and swollen with a thin layer of white exudate. The bimanual examination is normal. A KOH prep is positive for hyphae. These findings are indicative of:

Accepted Answer

The presence of white, thick vaginal discharge, severe pruritus, red and swollen vaginal introitus, and a KOH prep positive for hyphae are indicative of vaginal candidiasis.

Question 19

A 32-year-old female reports normal monthly menstrual periods but complains of having trouble with conception. It is important to ask about history of:

Accepted Answer

A history of sexually transmitted diseases (STDs) can lead to complications such as pelvic inflammatory disease (PID), which can cause infertility. Therefore, it is important to inquire about any history of STDs when assessing fertility issues.

Question 20

A 20-year-old female complains of thin vaginal discharge and pruritus. On pelvic examination, there are "strawberry spots" on the vaginal walls. With this infection, it is important to:

Accepted Answer

The description of "strawberry spots" on the vaginal walls is characteristic of Trichomonas vaginalis infection, a sexually transmitted infection (STI). It is important to treat the patient's partner to prevent reinfection and to perform STD and HIV testing due to the association between STIs and increased risk of acquiring or transmitting HIV.

Quiz 13: Female Reproductive System