1.	Adenocarcinoma in situ (ACIS) of the cervix:

A.	Is more common than squamous carcinoma in situ of the cervix.
B.	May develop into invasive adenocarcinoma.
C.	Has a positive association with use of oral contraceptive pill.
D.	Is more readily detected by cervical cytology than its squamous counterpart.
E.	Is increasing in detected incidence.

2.	Endometrial hyperplasia:

A.	Is associated with obesity.
B.	Of the simple type, is associated with an increased risk of endometrial adenocarcinoma.
C.	Is associated with unopposed estrogenic stimulation.
D.	May be diagnosed clinically.
E.	Is more common in post- than in pre-menopausal women.

3.	Ovarian carcinoma:

A.	Has an increased incidence in women who give birth before the age of 25 years.
B.	Is the commonest fatal gynaecological malignancy.
C.	Has a survival rate of over 50% at 5 years.
D.	Which is aneuploid, has a better prognosis than diploid tumors.
E.	Commonly spreads to the contralateral ovary.

4.	Cervical carcinoma:

A.	Is usually an adenocarcinoma.
B.	Is associated with infection by some types of human papillomavirus.
C.	May cause death due to uraemia.
D.	May arise from areas of cervical intraepithelial neoplasia.
E.	Rarely spreads to lymph nodes.
1.	Adenocarcinoma in situ (ACIS) of the cervix:

A.	False.
B.	True.
C.	True.
D.	False. The glandular cells are further up the endocervical canal and may not be sampled by a cervical spatula.
E.	True. This may be a real increase in the incidence of the disease or may be due to increased recognition of glandular neoplasia.

2.	Endometrial hyperplasia:

A.	True.
B.	False.
C.	True.
D.	False. 
E.	False. It occurs most commonly in pre- and peri-menopausal women.

3.	Ovarian carcinoma:

A.	False. It is associated with a diminished risk of ovarian cancer.
B.	True.
C.	False. The crude overall 5-year survival rate is about 35%.
D.	False. Aneuploid tumors pursue a more aggressive course than do their diploid counterparts.
E.	True. The peritoneal cavity and para-aortic lymph nodes are the other common sites of spread.

4.	Cervical carcinoma:

A.	False.
B.	True.
C.	True.
D.	True.
E.	False.
5.	Endometrial carcinoma:

A.	Has an overall 5-year survival rate of 36%.
B.	Has an increased incidence in women with estrogenic ovarian tumors.
C.	Has a peak incidence in the sixth decade.
D.	Rarely invades the myometrium.
E.	Has a higher incidence in multiparous women.

6.	Granulomatous inflammation of the ovary may occur with:

A.	Crohn’s disease of the ileum.
B.	Rupture of an ovarian cystic teratoma.
C.	Pregnancy.
D.	Introduction of an intra-uterine contraceptive device.
E.	Miliary tuberculosis.

7.	The following statements about ovarian endometriosis are true:

A.	It is associated with multiparity.
B.	Ascites is the commonest presenting feature.
C.	It tends to regress after the menopause.
D.	It is characterized histologically by endometrial glands, endometrial stroma and haemorrhagic foci.
E.	It may be the site of origin of endometrial-type carcinoma.

8.	Complete hydatidiform mole:

A.	Has a greater incidence in Europe when compared to Southeast Asia.
B.	Is usually triploid on chromosomal analysis.
C.	May progress to choriocarcinoma.
D.	Always produces chorionic gonadotrophin.
E.	May cause hyperthyroidism.
5.	Endometrial carcinoma:

A.	True.
B.	True.
C.	True. Occurs most commonly between the ages of 50 and 60 years.
D.	False. Invades the myometrium at an early stage.
E.	False. Higher incidence in nulliparous women.

6.	Granulomatous inflammation of the ovary may occur with:

A.	True. 
B.	True. A granulomatous response to keratin may occur.
C.	False.
D.	True. Infection with actinomycetes may occur after introduction of an intra-uterine contraceptive device.
E.	True.

7.	The following statements about ovarian endometriosis are true:

A.	False. Ovarian endometriosis is associated with sterility and hence low parity.
B.	False. Pain is the commonest presenting feature. Ascites is an infrequent complication.
C.	True.
D.	True. In long-standing lesions, only haemosiderin-laden macrophages may remain.
E.	True. Carcinoma does rarely arise in deposits of endometriosis and the endometrioid type is the most frequent.

8.	Complete hydatidiform mole:

A.	False.
B.	False. It is diploid. Partial hydatidiform mole is triploid.
C.	True. 2% will go on to develop choriocarcinoma.
D.	True. Beta-HCG is measured.
E.	True. Due to a thyroid stimulator secreted by the mole.

9.	Uterine leiomyoma:

A.	Are the commonest tumors of the female genital tract.
B.	Are associated with high parity.
C.	May cause subfertility.
D.	May cause abnormal uterine bleeding.
E.	May measure up to 200mm in diameter.

10.	The following tumors of the ovary are thought to be derived from germ cells:

A.	Granulosa cell tumor.
B.	Krukenberg tumor.
C.	Brenner tumor.
D.	Yolk sac tumor.
E.	Endometrioid carcinoma.

11.	The following tumors are malignant:

A.	Fibromas.
B.	Mature cystic teratomas.
C.	Brenner tumors.
D.	Krukenberg tumors.
E.	Mucinous cystadenocarcinomas.

12.	Mucinous neoplasms of the ovary:

A.	May be lined by intestinal-type epithelium.
B.	Are usually unilocular.
C.	Occur more frequently than serous neoplasms of the ovary.
D.	May give rise to pseudomyxoma peritonei.
E.	Are bilateral in 50% of cases.

9.	Uterine leiomyoma:

A.	True.
B.	False. They are associated with low parity.
C.	True. Submucosal leiomyomas may distort the uterine cavity and interfere with embryo implantation.
D.	True. This is also due to distortion of the uterine cavity.  
E.	True.

10.	The following tumors of the ovary are thought to be derived from germ cells:

A.	False. They are of the sex cord-stromal type.
B.	False. They are metastatic deposits of an adenocarcinoma with a surrounding desmoplastic reaction.
C.	False. They are thought to be derived from the surface epithelium of the ovary.
D.	True.
E.	False. They are derived from the surface epithelium of the ovary. 

11.	The following tumors are malignant:

A.	False.
B.	False.
C.	False.
D.	True.
E.	True.

12.	Mucinous neoplasms of the ovary:

A.	True. Intestinal-type epithelium with goblet, Paneth and endocrine cells may be present.
B.	False. They are most commonly multilocular.
C.	False.
D.	True. Peritoneal seedlings from a mucinous cystadenocarcinomas may fill the peritoneal cavity with mucinous material leading to intestinal obstruction.
E.	False. They are bilateral in 10 – 20% of cases. 

13.	Ectopic pregnancy:

A.	Occurs most commonly in the ovary.
B.	May lead to a haemoperitoneum.
C.	May produce Arias-Stella changes in the endometrium.
D.	Is associated with chronic salpingitis.
E.	Can proceed to term.

14.	Gestational choriocarcinoma:

A.	Is usually treated with radiotherapy.
B.	Contains hydropic chorionic villi.
C.	Often metastasizes to the lung.
D.	Occurs after a complete hydatidiform mole in 50% of cases.
E.	Usually spreads by lymphatic pathways. 

15.	Lymphoma of the testis:

A.	Usually occurs below the age of 40.
B.	May produce bilateral testicular tumors.
C.	Accounts for over 50% of malignant testicular tumors.
D.	Histologically shows malignant cells predominantly within seminiferous tubules.
E.	Has a characteristic mottled macroscopic appearance.

16.	Carcinoma of the penis:

A.	Is usually of the squamous type.
B.	Is more common amongst Jewish than Moslem populations.
C.	May arise in areas of erythroplasia of Queyrat.
D.	Metastasies to inguinal lymph nodes.
E.	Has a peak incidence in the fourth decade of life. 

13.	Ectopic pregnancy:

A.	False. The fallopian tube is the commonest site of ectopic pregnancy.
B.	True. Rupture of an ectopic pregnancy can lead to hemorrhage into the peritoneal cavity.
C.	True. 
D.	True. Chronic salpingitis can lead to scarring of the fallopian tubes with disordered motility.
E.	True. It is more usual for rupture to occur during the first trimester. 

14.	Gestational choriocarcinoma:

A.	False. Chemotherapy is the most common treatment modality and can achieve a high remission rate.
B.	False. It is only composed of cytotrophoblasts and syncytiotrophoblasts; no chorionic villi are present.
C.	True. About 50% of gestational choriocarcinomas will have metastasized to the lung at the time of presentation.
D.	True. Some 25% arise after an abortion and the rest after previous ordinary pregnancies.
E.	False. Hematogenous spread is the commonest route.

15.	Lymphoma of the testis:

A.	False. Usually occur over the age of 40 years and are the most common malignant testicular tumors in elderly male.
B.	True.
C.	False. Account for about 5%.
D.	False. The malignant infiltrate is mainly interstitial.
E.	False. Homogenous macroscopic appearance.

16.	Carcinoma of the penis:

A.	True.
B.	False.
C.	True. Another precursor is Bowen’s disease.
D.	True.
E.	False. Usually affects men over age of 40 years. 
17.	Prostatic carcinoma:

A.	Is usually a squamous cell carcinoma.
B.	Often metastasizes to the lumbar and sacral spine.
C.	Usually produces osteolytic bony metastases.
D.	Often shows regression with estrogen therapy.
E.	Secretes alkaline phosphatase.

18.	Seminomas of the testes:

A.	Are common before puberty.
B.	Have an increased incidence in undescended testes.
C.	May contain teratomatous elements.
D.	Are usually very responsive to radiotherapy.
E.	Often metastasizes to the inguinal lymph nodes.

19.	Benign nodular hyperplasia of the prostate:

A.	Affects about three-quarters of men aged 70 – 80 years.
B.	Is characterized by glandular hypoplasia.
C.	Predisposes to the development of prostatic carcinoma.
D.	May cause renal failure.
E.	May contain areas of squamous metaplasia.

20.	Idiopathic gangrene of the scrotum (Fournier’s syndrome):

A.	Has a positive association with diabetes mellitus.
B.	Has a positive association with anal fissure and ischiorectal abscesses.
C.	Usually affects young men.
D.	Is caused by group B streptococci.
E.	May involve the abdominal wall.

17.	Prostatic carcinoma:

A.	False. Majority are adenocarcinomas.
B.	True. By the retrograde venous route.
C.	False. They are usually osteosclerotic.
D.	True. 
E.	False. It secretes acid phosphatase. 

18.	Seminomas of the testes:

A.	False. Peak incidence between 30 and 50 years of age.
B.	True. About 5% arise in undescended testes.
C.	True.
D.	True.
E.	False. The para-aortic lymph nodes are the usual site of lymphatic spread.

19.	Benign nodular hyperplasia of the prostate:

A.	True.
B.	False.
C.	False.
D.	True.
E.	True.

20.	Idiopathic gangrene of the scrotum (Fournier’s syndrome):

A.	True.
B.	True.
C.	False. It usually affects middle-aged and elderly men.
D.	False. Faecal organisms are the causative agents, usually in a mixed infection with coliforms and Bacteroides.
E.	True. The disease may spread to the abdominal wall, perineum and penis. When extensive, it is often fatal.

21.	Lymphogranuloma venereum:

A.	Is commoner in Europe than in the tropics.
B.	Is caused by Treponema pallidum.
C.	Often causes an inguinal lymphadenitis.
D.	Is often diagnosed by dark-background microscopy of aspirated material.
E.	Causes condylomata acuminata.

22.	Yolk sac tumor of the testes:

A.	Usually occurs in the second decade of life.
B.	Contains Schiller-Duval bodies.
C.	Contains alpha-fetoprotein.
D.	Is also known as orchioblastoma.
E.	May be a component of mixed germ-cell tumors.