Acute abdomen in gynecology

! Fallopian gestation more often is terminated in the stages of pregnancy (weeks)

* 3-4

* 5-6

* 7-8

* 9-10

* 11-12

! Fallopian gestation is characterized by following morphological changes of the endometrium

* Cystic glandular hyperplasia

* Decidual transformation

* Chorionic villae

* Proliferation

* Atrophy

! Diagnosis of an ectopic pregnancy is proved by following histological report of macroscopic specimen examination

* Atrophy

* Proliferation

* Chorionic villae

* Decidual transformation

* Cystic glandular hyperplasia

! The most informative method of diagnostics of progressive fallopian pregnancy is

* laparoscopy

* hysteroscopy

* finding the human chorionic gonadotrophin (HCG) in urine

* aspiration biopsy of the endometrium

* puncture of abdominal cavity over the posterior vaginal fornix

! The volume of surgical intervention in case of progressive fallopian pregnancy

* ovariotomy

* adnexectomy

* salpingotomy

* salpingectomy

* hysterectomy

! A woman of 29 years old has a lower abdominal pain in the rectum, spotting bloody discharge, delay of menstruation to 2 weeks. Per vaginum: uterus soft, increased, there is a «dough» consistency tumour on the right side, painfull, posterior fornix of vagina is swelling, painfull. Clinical finding matches to following diagnosis

* Torsion of ovarian cyst pedicle

* Ectopic pregnancy

* Rupture of ovarian cyst

* Ovarian apoplexy

* Acute adnexitis

! During salpingotomy following anatomical structures are crossed

* Infundibulo-pelvic ligament and round ligament of uterus

* Pars uterinatubaeuterinae, mesosalpinx

* Infundibulo-pelvic ligament, mesosalpinx

* Ovarian ligament, mesosalpinx

* Round ligament of uterus, ovarian ligament

! Additional methods of diagnostics of an ectopic pregnancy

* Hysteroscopy, colposcopy, cystoscopy

* Colposcopy, cytological analysis of smear

* Metrosalpingography, pelviography, uterus scintigraphy

* Puncture of abdominal cavity over the posterior vaginal fornix, ultrasonography

* Bacterioscopic and bacteriological test of the cervix’s secret

! A woman of 29 years old with delay of menstruation and positive pregnancy test has a bloody discharge. Per vaginum: external orifice of uterus is slightly open, uterus soft, increased to 8 weeks of pregnancy, appendages aren’t determined. Clinical finding matches to following pathology

* Aborted tubal pregnancy

* Exacerbation of inflammatory process of uterine appendages

* Uterine pregnancy, inevitable abortion

* Progressive fallopian pregnancy

* Ovarian apoplexy

! The following volume of surgical intervention is preferred for patient of reproductive age in case of gynecological peritonitis

* Sanation and draining of an abdominal cavity

* Supravaginal hysterectomy with the fallopian tubes

* Supravaginal hysterectomy with uterine appendages

* Total hysterectomy with the fallopian tubes, sanation and draining of an abdominal cavity

* Total hysterectomy with the uterine appendages, sanation and draining of an abdominal cavity

! Dark blood of 150 ml, cyanotic left tube, thickened in a isthmic section 2,0* 2,5* 1,5 cm, which integrity is preserved, dripping blood from the ampullar section in the diagnostic laparoscopy of an abdominal cavity of 25 years old female patient. Future tactics

* Left-sided salpingectomy

* Left-sided adnexectomy

* Draining of an abdominal cavity

* Left-sided salpingectomy, removing the ovum

* Extruding and removing the ovum from the ampullar section

! A woman of 23 years old presenting from the women's medical clinic to the department of emergency gynecology with possible ectopic pregnancy. Future tactics

* Uterine probing

* Elective laparotomy, salpingectomy

* Dynamic observation in ICU (intensive care unit) of a hospital

* Emergency diagnostic laparoscopy

* Curettage with a histological study of the scrape

! Typical volume of surgical intervention in case of cervical pregnancy

* adnexectomy

* amputation of the uterus

* defundation of the uterus

* hysterectomy

* curettage of the cervix

! Classification of the ovarian apoplexy depending on the clinical forms

* mild, moderate, severe

* acute, subacute, chronic

* anemic, painful, mixed

* primary, secondary, recurrent

* central, peripheral, recurrent

! Characteristic signs of the ovarian apoplexy

* delay of menstruation, nausea, vomiting, positive pregnancy test

* spasmodic pain, delay of menstruation, signs of internal hemorrhage

* sharp pain, abdominal swelling, nausea, vomiting, hyperthermia without delay of menstruation

* sharp pain, signs of internal hemorrhage in the middle of menstrual period

* sharp pain, abdominal swelling, intoxication in first phase of menstrual period

!The volume of surgical intervention in case of anemic form of the ovarian apoplexy

* drilling

* vaporization

*ovariotomy

* wedge resection

*sutureorcoagulation

!A woman of 25 years old on the 15th day of menstrual period after sexual intercourse has sharp lower abdominal pain in the rectum. Per vaginum: the uterus is not increased, right-sided appendages area is painful, posterior fornix of vagina flattened, painful. Clinical finding matches to following pathology

* Torsion of ovarian cyst pedicle

* Ectopic pregnancy

* Rupture of ovarian cyst

* Ovarian apoplexy

* Acute adnexitis

! The volume of surgical intervention in case of the ovarian apoplexy

* Salpingectomy

* Cystectomy

* Ovariotomy

* Adnexectomy

* Sutureorcoagulationof ovary

!. Found after the macroscopic examination papillary excrescence on the internal surface of capsule of ovary tumor indicates the probability of following pathology

* Ovarian cyst

* Ovarian fibroma

* Dermoid cyst

* Papillarycystoma

* Simpleserouscystoma

! A woman of 28 years old was operated by laparoscopy about intra-abdominal hemorrhage, identified rupture of right-sided ovarian cyst. The volume of surgical intervention

* Cystectomy

* Adnexectomy

* Ovariotomy

* Ovary drillling

* Removing capsule of ovarian cyst

! A woman of 35 years old has a bilateral pyosalpinx in the diagnostic laparoscopy. Future tactics

* Stomatoplastics at both sides, draining of an abdominal cavity

* Supravaginal hysterectomy with the fallopian tubes

* Total hysterectomy with the uterine appendages

* Salpingectomy at both sides

* Removing both appendages

! There is an grayishwhite, tuberous, inhomogeneous, 5,0Ч6,0Ч7,0 sm sized ovary tumour on the macroscopic examination. On the cut - the internal surface of capsule is smooth, it contains – hair, teeth, fat. Macroscopic picture matches to the following diagnosis

* Endometrioidcyst of ovary

* Papillary cystoma

* Dermoid cyst

* Ovarian fibroma

* Simple cystoma

! Set volume of inquiry of patients with ovary tumour before elective surgery includes

* Pelviography

* Pneumoperitoneum

* Cervix-, hysterography

* Uterosalpingography

* X-ray of the stomach

! During of diagnostic laparoscopy of female of 25 years old polycystic ovaries was found. Future surgicaltactics

* Ovary drilling

* Ovary removing

* Ovary puncture

* Adnexectomy

* Cystectomy

!Anatomical pedicle of ovary tumour included

* Ovarian ligament, infundibular-pelvic ligament

* Infundibular-pelvic ligament, mesovarium, uterine tube

* Ovarian ligament, mesovarium, uterine tube

* Ovarian ligament, infundibular-pelvic ligament, mesovarium

* Ovarian ligament and mesovarium, infundibular-pelvic ligament, uterine tube

! Surgical pedicle of ovary tumour included

* Ovarian ligament, infundibular-pelvic ligament

* Infundibular-pelvic ligament, mesovarium, uterine tube

* Ovarian ligament, mesovarium, uterine tube

* Ovarian ligament, infundibular-pelvic ligament, mesovarium

* Ovarian ligament and mesovarium, infundibular-pelvic ligament, uterine tube

! The patient is 37 years old. She has sudden pain on the 8th day of the menstrual cycle with bloating, hyperthermia 37,8˚C; tachycardia. Her tongue is dry. A symptom of Shchetkin- Blumberg is positive. The vaginal examination of the uterus is not enlarged, on the right side is tight-extensible mass, a painful and slow-moving, size 11,0x12,0x13,0. The clinical picture is a pathology

*Acute pancreatitis

*Ovarian apoplexy

* Ectopic pregnancy

*Torsion the pedicle's of ovarian cyst

* Perforation of tuboovarian abscess

! «Acute abdomen» in gynecology because of inflammatory process in pelvic commonly occurs when

* Ovarian apoplexy

* Acute appendicitis

* Ectopic pregnancy

* Torsion the pedicle's of ovarian cyst

* Perforation of tuboovarian abscess

! It is a characteristic symptom for the submucosal fibroids

* Amenorrhea

* Dyspareunia

* Abundant leucorrhoea

* Hyperpolymenorrhea

* Contact spotting

! The internal endometriosis applies is:

* Peritoneum, ampullar and isthmic sections of the fallopian tubes

* Uterine and interstitial sections of the fallopian tubes

* Cervix, retrocervical

* Cervix, uterine, ovary

* The intestine, the ureters

! The most frequent localization of external genital endometriosis

* uterine, fallopian tubes

*fallopian tubes

* the intestine, umbilicus

* cervix

* ovary

Menstrual disorders.

! Opsomenorrhea – is menstrual disorder characterized by the following changes in menstruation

*more frequent periodicity

* slowing periodicity

* Increased bleeding duration

* Compression bleeding duration

* reducing the amount of lost blood

! Epimenorrhea - is menstrual disorder characterized by the following changes in menstruation

*More frequent periodicity

* Slowing periodicity

*Duration of increased bleeding

* Compression bleeding duration

* reducing the amount of lost blood

! Polymenorrhea - is menstrual disorder characterized by the following changes in menstruation

*more frequent periodicity

* slowing periodicity

* Increased bleeding duration

* Compression bleeding duration

* reducing the amount of lost blood

!. Oligomenorrhea - is menstrual disorder characterized by the following changes in menstruation

*more frequent periodicity

* slowing periodicity

* Increased bleeding duration

* Compression bleeding duration

* reducing the amount of lost blood

! Hypomenorrhea - is menstrual disorder characterized by the following changes in menstruation

*more frequent periodicity

* slowing periodicity

* Increased bleeding duration

* Compression bleeding duration

* reducing the amount of lost blood

! Hypermenorrhea - is menstrual disorder characterized by the following changes in menstruation

*more frequent periodicity

* slowing periodicity

* Increased bleeding duration

* Compression bleeding duration

* reducing the amount of lost blood

! Oligoopsomenorrhea - is menstrual disorder characterized by the following changes in menstruation

*short and sparse allocation of blood

* short and scarce allocation of blood

* abundant and short allocation of blood

* rare and painful allocation of blood

* painful and plentiful

! Algodismenorrhea - is menstrual disorder when menstruations correspond to the next parameter

* few

* short

* delayed

* abundant

* painful

! Hyperpolymenorrhea - is menstrual disorder characterized by the following changes in menstruation

* Scarce and short

* Abundant and short

* Painful and plentiful

* Abundant and long

* Painful and scanty

! Hypomenstrual syndrome – is menstrual disorder characterized by the following changes in menstruation

* Short, rare and scarce

* Short, frequent and scanty

* Short, rare and abundant

* Short, frequent and abundant

* Long, frequent and scarce

!. Pathogenesis of dysfunctional metrorrhagia due to the disorder of the frequency allocation

* FSH and luteinizing hormone

* FSH and TSH

* Luteinizing hormone and ACTH

* Luteinizing hormone and prolactin

* FSH and prolactin

!. Lack of ovulation at dysfunctional metrorrhagia due to the disorder of the cyclic products of the gonadotrop(h)in, especially

* Luteinizing hormone

* FSH

* TSH

* ACTH

* Prolactin

! Dysfunctional uterine bleeding on pathogenesis are divided into

* Primary, secondary

* Cyclic, acyclic

* Ovulatory, anovulatory

* Acute, subacute, chronic

* Juvenile, reproductive, menopausal

! Classification of ovulatory dysfunctional uterine bleeding on pathogenesis

* Primary, secondary

* Cyclic, acyclic

* Gipoestrogeniya, hyperandrogenism

* Juvenile, reproductive, menopausal

* Gipolyuteinizm, giperlyuteinizm, shortened follicular phase

! Presented schedule in the picture of basal temperature corresponds to the following form of the menstrual cycle

Acute abdomen in gynecology - student2.ru

* gipolyuteinizm

* giperlyuteinizm

* Follicle atresia

* physiological

* Persistence follicle

! Presented schedule in the picture of basal temperature corresponds to the following form of the menstrual cycle

Acute abdomen in gynecology - student2.ru

* Persistence follicle

* Extension of the luteal phase

* Shortening of the luteal phase

* Lengthening of the follicular phase

* Shortening of the follicular phase

! Presented schedule in the picture of basal temperature corresponds to the following form of the menstrual cycle

Acute abdomen in gynecology - student2.ru

* hypolyuteinizm

* hyperlyuteinizmu

* Follicle atresia

* physiological

* Persistence follicle

! Presented schedule in the picture of basal temperature corresponds to the following form of the menstrual cycle

Acute abdomen in gynecology - student2.ru

* hypolyuteinizm

* hyperlyuteinizmu

* Follicle atresia

* Persistence follicle

* Shortening of the follicular phase

! At persistence follicle is noted

* hyperandrogenism

* hyperandrogenism

* hypoestrogeniya

* normoandrogenemiya

* hyperestrogenemia

! Presented schedule in the picture of basal temperature corresponds to the following form of the menstrual cycle

Acute abdomen in gynecology - student2.ru

* hypolyuteinizm

* hyperlyuteinizm

* Follicle atresia

* Persistence follicle

* Shortening of the follicular phase

!Presented schedule in the picture of basal temperature corresponds to the following form of the menstrual cycle

Acute abdomen in gynecology - student2.ru

* hypolyuteinizm

* hyperlyuteinizmu

* Follicle atresia

* physiological

* Persistence follicle

! In juvenile bleeding treatment begins with

* diagnostic hysteroscopy and endometrial ablation

* Hemostatic therapy and cyclic vitamin therapy

* Hormonal hemostasis and regulating hormone

* Uterotonic, hemostatic and antianemic therapy

* Separate diagnostic curettage of the cervical canal and the uterine cavity

!. If there is no effect of symptomatic treatment of juvenile bleeding, one of the following must be fulfilled

* Surgical hemostasis

* Hormonal hemostasis

* Cyclic vitamin therapy

* Diagnostic hysteroscopy

* Regulating hormone

! If there is no effect of symptomatic therapy and hormonal hemostasis of juvenile bleeding, one of the following must be fulfilled

* Surgical hemostasis

* Hormonal hemostasis

* Cyclic vitamin therapy

* Diagnostic hysteroscopy

* Regulating hormone

! The patient is 26 years old with dysfunctional uterine bleeding in reproductive age, for the purpose of hemostasis the following must be fulfilled

* Hormonal hemostasis

* Hemostatic Therapy

* Uterotonic therapy

* Cyclical vitamin

* Diagnostic curettage

! At bleeding in reproductive and menopausal doing histological study of the scraping from the uterine cavity is mandatory to exclude

* adenomyosis

* endometriosis

* Uterine fibroids

* Uterine sarcoma

* Endometrial cancer

! At menopausal bleeding treatment begins with

* Uterotonic and hemostatic therapy

* Diagnosticheskoygisteroskopii and endometrial ablation

* Hemostatic therapy and cyclic vitamin therapy

* Hormonal hemostasis and regulating hormone

* Separate diagnostic curettage of the cervical canal and the uterine cavity

!. The patient is 47 years, she has abundant bleeding from the genital tract after a delay of menstruation for 3 months. In mirrors cervix is clean, discharge is bloody. At vaginal study of uterus and appendages are normal. The clinic corresponds the following pathology

* Dysfunctional uterine bleeding menopause

* Dysfunctional uterine bleeding reproductive period

* Home spontaneous miscarriage

* Submucous uterine fibroids

* Adenomyosis

! Climacteric syndrome includes changes developing in the female body, on the background of the progressive

* Excess of estrogen

* Excess of androgens

* Deficit of prolactin

* Deficiency of androgens

* Estrogen deficiency

! By clinical pathological forms, the primary, the true amenorrhea of ovarian genesis is referred syndrome of

* Sheehan

* Simmonds

* Cushing

* Chiari-Frommelya

* Turner

! A typical form of gonadal dysgenesis, accompanied by the primary, true, ovarian amenorrhea due to chromosomal aberrations, is called syndrome of

* Sheehan

* Simmonds

* Stein-Leventhal

* Laurence-Moon-Biedl

* Turner

!. One of the clinical forms of pathological, secondary, true, pituitary amenorrhea is a syndrome of

* Sheehan

* Morris

* Stein-Leventhal

* Laurence-Moon-Biedl

* Turner

! Postpartum hypopituitarism manifesting by pathological, secondary, true, pituitary amenorrhea after a massive obstetric bleeding, is called syndrome of

* Sheehan

* Morris

* Stein-Leventhal

* Laurence-Moon-Biedl

* Turner

Non-specific inflammation

!. The normal vaginal flora consists mainly of

* Candido

* gardnerella

* Trichomonas

* Escherichia coli

* Chopsticks Dederleyna

!. For vulvovaginal is characterized

* Serous whites, pale vulva

* Fever, abdominal pain

* Abstsedirovanie, chills, pain in the perineum

* Edema and hyperemia of the vulva, purulent leucorrhea

* Edema and hyperemia of the middle third of the labia

! At the formed purulent inflammation formation of the uterus the following tactics is recommended

* formation puncture through the posterior vaginal vault

* Lymphogenous antibiotics

* surgery

* conservative treatment

* physiotherapy

Specific inflammations

!The diagnosis of "fresh" trichomoniasis is exhibited when disease duration less than

* 2 years

* 2 days

* 2 hours

* 2 weeks

* 2 months

!. The criterion of cured patients with trichomoniasis is a negative result of tuberculosis microscopy smear from the vagina which is obtained at intervals of 1 month for the next number of menstrual cycles

* 1

* 2

* 3

* 4

* 5

! The standard method of diagnosis of vaginal candidiasis is

* clinical

* Vaginoscopy

* Culture method

* bacterioscopy

* colpocytology

! Specific prevention of tuberculosis of female genital mutilation is

* vaccination

* The use of contraception

* Surgical removal of lesions in the lungs

* Clinical examination of patients with pulmonary tuberculosis

* Sanatorium rehabilitation of pulmonary tuberculosis

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