Female reproductive histology — MCQs

A 26-year-old woman presents with vaginal discharge and dyspareunia. Wet mount microscopy shows clue cells. Which of the following additional findings would confirm the diagnosis?

A 47-year-old woman comes to the physician because of fatigue, difficulty falling asleep, and night sweats for the past 6 months. Over the past year, her menstrual cycle has become irregular and her last menstrual period was 2 months ago. She quit smoking 2 years ago. Pelvic exam shows vulvovaginal atrophy. A pregnancy test is negative. Which of the following changes is most likely to occur in this patient's condition?

A researcher is studying the effects of hormones on different cells within the ovarian follicle. She adds follicle stimulating hormone (FSH) to a culture of ovarian follicle cells. She then measures the activity levels of different enzymes within the cells. Which enzyme and ovarian cell type would be expected to be stimulated by the addition of FSH?

A 27-year-old woman visits her family physician complaining of the recent onset of an unpleasant fish-like vaginal odor that has started to affect her sexual life. She was recently treated for traveler’s diarrhea after a trip to Thailand. External genitalia appear normal on pelvic examination, speculoscopy shows a gray, thin, homogenous, and malodorous vaginal discharge. Cervical mobilization is painless and no adnexal masses are identified. A sample of the vaginal discharge is taken for saline wet mount examination. Which of the following characteristics is most likely to be present in the microscopic evaluation of the sample?

A 24-year-old woman comes to the emergency department because of lower abdominal pain for 4 hours. She has had vaginal spotting for 2 days. Menses occur at irregular 20- to 45-day intervals and last for 3 to 7 days. Her last menstrual period was 8 weeks ago. She was treated for pelvic inflammatory disease at the age of 20 years with ceftriaxone and azithromycin. She is sexually active with one male partner and uses condoms inconsistently. Her pulse is 118/min, respirations are 20/min, and blood pressure is 118/66 mm Hg. Examination shows lower abdominal tenderness. Pelvic examination shows a closed cervix and a uterus of normal size with right adnexal tenderness. Her serum β-human chorionic gonadotropin concentration is 16,000 mIU/mL (N < 5). Transvaginal ultrasonography shows a 5-cm hypoechoic lesion at the junction of the fallopian tube and uterine cavity with a 3-mm layer of myometrium surrounding it. Which of the following is the most likely diagnosis?

A 43-year-old woman, gravida 2, para 2, comes to the physician because of a 6-month history of heavy, irregular menstrual bleeding. Pelvic examination shows blood and clots in the posterior fornix and normal-appearing internal and external genitalia. An endometrial biopsy specimen shows straight uniform tubular glands lined with tall pseudostratified columnar epithelial cells with high mitotic activity embedded in an edematous stroma. Increased activity of which of the following is directly responsible for the histologic appearance of the biopsy specimen?

A 22-year-old female presents to her physician for evaluation of a vaginal discharge, itching, and irritation. She recently started a new relationship with her boyfriend, who is her only sexual partner. He does not report any genitourinary symptoms. She takes oral contraceptives and does not use barrier contraception. The medical history is unremarkable. The vital signs are within normal limits. A gynecologic examination reveals a thin, yellow, frothy vaginal discharge with a musty, unpleasant odor and numerous punctate red maculae on the ectocervix. The remainder of the exam is normal. Which of the following organisms will most likely be revealed on wet mount microscopy?

A 4-week-old boy is brought to the emergency department with a 2-day history of projectile vomiting after feeding. His parents state that he is their firstborn child and that he was born healthy. He developed normally for several weeks but started to eat less 1 week ago. Physical exam reveals a small, round mass in the right upper quadrant of the abdomen close to the midline. The infant throws up in the emergency department, and the vomitus is observed to be watery with no traces of bile. Which of the following is associated with the most likely cause of this patient's symptoms?

A 32-year-old woman presents with amenorrhea and galactorrhea. MRI shows a pituitary adenoma. Histological examination of the surgical specimen shows cells arranged in cords and nests with sinusoidal capillaries. Special staining reveals three distinct cell types: chromophobes (50%), acidophils (40%), and basophils (10%). Immunohistochemistry shows the tumor cells staining strongly for prolactin. Evaluate the relationship between normal pituitary architecture and tumor development to determine which cell type most likely gave rise to this neoplasm.

A 65-year-old man with progressive shortness of breath undergoes transbronchial biopsy. Microscopy shows thickened alveolar septa with increased collagen deposition. Type I pneumocytes are decreased, and there is proliferation of type II pneumocytes. Alveolar macrophages are present. The patient has a history of environmental asbestos exposure 30 years ago. Evaluate the histological progression and synthesize the most likely diagnosis considering the temporal relationship and cellular changes.