.

Primary vulvitis may be due to:

A. Syphilis.
B. Urinary incontinence.
C. Condylomata acuminata.
D. Herpes genitalis.
E. Glycosuria.

199. Primary vulvitis may be due to:

A. Lymphogranuloma inguinale.
B. Furunculosis.
C. Vaginal discharge.
D. Bilharziasis.
E. Tuberculosis.

200. Primary vulvitis may be due to:

A. Tinea cruris.
B. Allergy.
C. Parasitic infestation.
D. Lymphogranuloma inguinale.
E. Vaginal discharge.

201. Secondary vulvitis may be due to:

A. Urinary incontinence.
B. Glycosuria.
C. Candidiasis.
D. Complete perineal tear.
E. Vaginal discharge.

202. Secondary vulvitis may be due to:

A. Lymphogranuloma inguinale.
B. Furunculosis.
C. Rectovaginal fistula.
D. Oxyuris infestation.
E. Intertrigo.

203. Acute vulvitis may be due to:

A. Herpes genitalis.
B. Secondary vulvitis.
C. Bilharziasis.
D. Diabetic vulvitis.
E. Bartholinitis.

204. Clinical picture of acute vulvitis includes:

A. Local pain.
B. Local edema.
C. Itching.
D. Low backache.
E. High fever.

205. Management of acute vulvitis includes:

A. Local hygiene.
B. Local antiseptic.
C. Anti allergic.
D. Biopsy from the lesions.
E. Dilatation and curettage.

206. Bartholinitis:
A. May be due to pyogenic or chlamydial infection.
B. Causes a tender swelling in the inferior third of the labia majora.
C. May turn into Bartholin's cyst.
D. May turn into Bartholin's abscess.
E. Is treated by marsupialization.

207. Appropriate treatment for an acute Bartholin's abscess includes:

A. Analgesics.
B. Local heat.
C. Antibiotics.
D. Incision and drainage.
E. Marsupialization.

208. Pruritis vulvae:

A. In the majority of cases pruritis is not associated with vaginal discharge.
B. May be due to vulval dystrophies.
C. Neurodermatitis is not a cause.
D. May be secondary to anal pruritis.
E. The condition is more evident in diabetic patients.

209. The following conditions may cause pruritis vulvae:

A. Vaginal moniliasis.
B. Hypertrophic dystrophy.
C. Urinary incontinence.
D. Chancre.
E. Neurodermatitis.

210. Vulval dystrophies:

A. Are more common during the childbearing period.
B. Are classified as sexually transmitted diseases.
C. May cause hypertrophic lesions.
D. May cause atrophic lesions.
E. Some cases require a biopsy.

211. Vulval dystrophy:

A. Usually results from chronic irritation of the vulva.
B. All types are precancerous.
C. The vulval skin is always thickened.
D. Present with vulval pain.
E. Is best treated by vulvectomy.

212. Causes of vulval ulcers include:

A. Chancre.
B. Chancroid.
C. Gonorrhea.
D. Tuberculosis.
E. Rodent ulcer.

213. Swellings of the vulva may be:

A. Congenital hypertrophy of the labia.
B. Imperforate hymen.
C. Hematoma of the vulva.
D. Edema due to pelvic congestion.
E. Bartholin's abscess.

214. Swellings arising in the vulva may be:

A. Condylomata acuminata.
B. Brenner tumor.
C. Sebaceous cyst.
D. Dermoid cyst.
E. Fibroid polyp.

215. Swellings arising in the vulva may be:

A. Endometrioma.
B. Fibroma.
C. Primary carcinoma of the vulva.
D. Metastases from choriocarcinoma.
E. Desmoid tumor.

216. Bartholin's cysts:

A. Are painless swellings.
B. Should be excised.
C. Are situated in the inferior 1/3 of the labia majora.
D. Are usually bilateral.
E. May become infected by gonococci.
217. Carcinoma of the vulva:
A. A history of chronic vulval irritation is common.
B. Pelvic irradiation is a predisposing factor.
C. The main route of spread is lymphatic.
D. Stage Ia is VIN.
E. Radiotherapy is recommended for cases with involved pelvic lymph nodes.

218. Carcinoma of the vulva:

A. Is more common in old age.
B. Infection with human papilloma virus is a predisposing factor.
C. In stage II, the tumor extends to the lower urethra or the perineum.
D. Local excision is sufficient for microinvasive lesions.
E. Radical vulvectomy is required for the majority of cases with advanced disease.

219. Carcinoma of the vulva:

A. Is usually an adenocarcinoma.
B. Occurs commonly on top of hypertrophic dystrophy.
C. Does not ulcerate until it is advanced.
D. The most important route of spread is through lymphatics.
E. Surgery and radiotherapy give similar results.
3- An 82-year-old woman underwent a vulvar biopsy for a 3-cm ulcerated
lesion on the left labium majus, which had been present for several
years. The pathology revealed a basal cell cancer. Your treatment
should be:
A) wide local excision
B) wide local excision and postoperative radiation therapy
C) radical partial left vulvectomy with ipsilateral inguinofemoral lymphadenectomy
D) radical vulvectomy
E) radical vulvectomy with bilateral inguinofemoral lymphadenectomy
20- A 63-year-old woman presents with a 2-cm erythematous lesion on the
left labium majus. Biopsies of the lesion reveal Grade 3 vulvar
intraepithelial neoplasia ( VIN3). The optimal treatment for this patient
is:
A) simple vulvectomy
B) wide local excision
C) laser vaporization
D) topical 5-fluorouracil
E) radical excision followed by local radiotherapy
22- Vulval Dystrophy, all are true EXCEPT:
A) Associated with pruritis
B) Extends to perineum
C) Premalignant condition
D) Malignant condition
E) Histological diagnosis
28- Vulval Cancer, all are true EXCEPT:
A) is more common than endometrial cancer
 B) metastasises via the blood stream
C) is treated with radiotherapy
D) has a peak incidence at age 55
E) is associated with vulval warts
F) the tumour is resistant to chemotherapy
68- Vulval dystrophy (Lichen Sclerosus), all are false except:
A) is usually found in patients with diabetes
B) responds well to steroid ointments
C) usually clears spontaneously after a few years
D) is not associated with vulval ulceration
76- Lichen sclerosus—the following are true EXCEPT:
A) A hypoplastic dystrophy
B) There is inactive epithelium
C) estrogen creams is not benificial
D) Dyspareunia
77- Hyperplastic dystrophy—the following are true EXCEPT:
A) Leads to introital contraction
B) Acanthosis
C) Hydrocortisone will help itching
D) Characterized by deepening of rete pegs
78- Malignant neoplasms of the vulva ,the following are true EXCEPT:
A) Most are squamous in type
B) There are suspicious groin nodes palpable in stage II disease
C) The verrucous type. has a poor prognosis
D) Groin node dissection can be dispensed in all lesions where the depth of
invasion is less than 5 mm
79- Recognised complications of radical vulvectomy and bilateral groin
dissection include all EXCEPT:
A) Osteitis pubis
B) Inguinal hernia
C) Paraesthesia over the anterior surface of the thigh
D) Thromboembolic disease
E) Varicose veins
110- In patients with carcinoma of the vulva, lymphatic drainage
characteristically:
A) is to the periaortic nodes
B) is to the superficial inguinal lymph nodes and from the clitoral region to the
deep femoral lymph nodes
C) bypasses the deep femoral lymph nodes
D) None of the above
133- Melanoma of the vulva, all are false EXCEPT:
A) constitutes 2 to 9 percent of most series of vulvar cancer
B) occurs mostly in the fifth decade
C) occurs mostly in premenopausal women
D) has an overall survival rate of 70 percent
E) is non aggressive
138- A woman is found to have a unilateral, invasive vulvar carcinoma that
is 2 cm in diameter but that is not associated with evidence of lymph
node spread. Initial management of this woman most likely would
consist of:
A) chemotherapy
B) radiation therapy
C) simple vulvectomy
D) radical vulvectomy
E) radical vulvectomy and bilateral inguinal lymphadenectomy
155- Which of the following statements can characterize epidermoid
carcinoma of the vulva?
A) It is associated with an increased incidence of epidermoid carcinoma of the
endocervix
B) It is seen less frequently than adenocarcinoma
C) It tends to develop in women who are younger than those affected by
adenocarcinoma
D) It tends to be more advanced when diagnosed than adenocarcinoma
163- Lichen sclerosis is characterized by all EXCEPT:
A) blunting or loss of the rete ridges
B) development of a homogeneous subepithelial layer in the dennis
C) a band of chronic inflammatory infiltrate below the dermis
D) an increase in the number of cellular layers in the epidermis