Multiple Choice Quiz: Benign Cervical Lesions

This article provides information about benign cervical lesions, including: cervical ectropion, Nabothian cysts, cervical polyps, cervical dysplasia, and some related knowledge about diagnosis and treatment.

Note: This article is for informational purposes only and should not be considered a substitute for the advice of a doctor.

Questions

1. 1979. The phenomenon of squamous metaplasia can occur through the following mechanism:

   • A. Glandular epithelium overgrows the squamous epithelium.
   • B. Reserve cells of the glandular epithelium transform into squamous epithelium.
   • C. Multilayered proliferation with many mature, senescent cells.
   • D. Squamous epithelium transforms into columnar epithelium due to the action of estrogen.
   • E. All of the above statements are incorrect.

   Answer: B

   Explanation: Squamous metaplasia is the process of replacing glandular epithelium with squamous epithelium. This can occur due to the transformation of reserve cells of the glandular epithelium into squamous epithelium.

2. 1980. Cervical ectropion is uncommon in which of the following groups of people:

   • A. Women of reproductive age.
   • B. Pregnant women.
   • C. Women using combined oral contraceptives.
   • D. Women using intrauterine devices.
   • E. Women after menopause.

   Answer: E

   Explanation: Cervical ectropion is common in women of reproductive age, pregnant women, or those using contraceptives. After menopause, estrogen levels decline, the cervix shrinks, and ectropion is less common.

3. 1981. The most common symptom of cervical ectropion is

   • A. Vaginal discharge
   • B. Pain
   • C. Itching
   • D. Bleeding

   Answer: A

   Explanation: Cervical ectropion often causes abnormal vaginal discharge, which may have a foul odor. Other symptoms like pain, itching, or bleeding are less common.

4. 1982. Histopathological findings in benign cervical lesions are:

   • A. Disruption of epithelial structure.
   • B. Disruption of cellular structure.
   • C. Altered cell morphology.
   • D. The structure of the epithelium and cells is not disrupted.

   Answer: D

   Explanation: Benign cervical lesions typically do not cause alterations in the structure of the epithelium and cells.

5. 1983. The factor that creates the vaginal pH environment is:

   • A. Due to E. coli bacteria in the vagina.
   • B. Due to progesterone.
   • C. Due to yeast in the vaginal environment.
   • D. Due to Doderlein’s bacillus in the vaginal environment.

   Answer: D

   Explanation: Doderlein’s bacillus is a beneficial bacterium in the vagina that helps maintain an acidic vaginal pH (around 3.8-4.5).

6. 1984. Cervical ectropion is caused by, EXCEPT:

   • A. Trauma during childbirth.
   • B. Trauma due to abortion.
   • C. Congenital.
   • D. After syphilis infection.

   Answer: D

   Explanation: Cervical ectropion can be caused by trauma during childbirth, abortion, or congenital factors. Syphilis is not a direct cause of ectropion.

7. 1985. The following statements about the regenerative images of ectropion are all true, EXCEPT:

   • A. Glandular orifice.
   • B. Glandular islands.
   • C. Nabothian cysts.
   • D. White patch.

   Answer: D

   Explanation: Glandular orifice, glandular islands, and Nabothian cysts are regenerative images of ectropion. White patches can be a sign of cervical dysplasia.

8. 1986. Suspicious cervical lesions observed during colposcopy, EXCEPT:

   • A. White patch.
   • B. Mosaicism.
   • C. Punctation.
   • D. Glandular orifice, glandular islands.
   • E. Abnormal blood vessels.

   Answer: D

   Explanation: Glandular orifice and glandular islands are regenerative images of ectropion and are not suspicious lesions. White patches, mosaicism, punctation, and abnormal blood vessels can be signs of suspicious lesions.

9. 1987. Methods of gland destruction in the treatment of cervical ectropion, EXCEPT:

   • A. Electrocautery.
   • B. Cryotherapy.
   • C. Laser ablation.
   • D. Long-term medication placement.

   Answer: D

   Explanation: Electrocautery, cryotherapy, and laser ablation are methods of gland destruction used in the treatment of ectropion. Long-term medication placement is not a method of gland destruction.

10. 1988. Do not perform Pap smear when, EXCEPT:

    • A. Close to the menstrual period.
    • B. Having vaginal medication placement.
    • C. Vaginal or cervical infections.
    • D. During pregnancy.

    Answer: C

    Explanation: A Pap smear can be performed during menstruation, vaginal medication placement, or pregnancy. However, if there is vaginal or cervical infection, it should be treated before performing a Pap smear.

11. 1989. The purpose of colposcopy and Pap smear is to:

    • A. Diagnose early endometrial cancer.
    • B. Diagnose and detect early cervical cancer.
    • C. Help detect early ovarian cancer.
    • D. Help detect cervical ectropion.

    Answer: B

    Explanation: Colposcopy and Pap smear are cervical cancer screening methods that help detect early cervical cancer.

12. 1990. Normal pH in the cervical canal:

    • A. 3.8 – 4.2
    • B. 5.5 – 6
    • C. 6.5 – 7
    • D. 7.0 – 7.5

    Answer: A

    Explanation: The normal pH in the cervical canal is 3.8-4.2.

13. 1991. Age group at high risk of cervical dysplasia

    • A. 16 – 30
    • B. 20 – 40
    • C. 40 – 50 years old
    • D. 50 – 60

    Answer: B

    Explanation: The age group of 20-40 is at high risk of cervical dysplasia.

14. 1992. Indications for colposcopy when:

    • A. Diagnosis of benign cervical lesions.
    • B. Regular monitoring of cervical lesions.
    • C. Abnormal Pap smear.
    • D. Find suspicious areas for biopsy.

    Answer: C

    Explanation: Colposcopy is indicated when a Pap smear is abnormal to find suspicious areas for biopsy.

15. 1993. The best treatment for cervical ectropion is:

    • A. Cervical ablation.
    • B. Vaginal washing with Betadine solution.
    • C. Vaginal and cervical application of estrogen cream.
    • D. Vaginal and cervical application of progesterone cream.

    Answer: A

    Explanation: Cervical ablation is the most effective treatment for cervical ectropion.

16. 1994. Choose the INCORRECT statement regarding the benefits of colposcopy in diagnosis:

    • A. Primarily used to detect cervical ectropion.
    • B. See abnormal lesions such as white patches, mosaicism, punctation.
    • C. Guide cervical biopsy.
    • D. Early and definitive diagnosis of cervical cancer.

    Answer: D

    Explanation: Colposcopy cannot provide an early and definitive diagnosis of cervical cancer. Biopsy is the most accurate diagnostic method.

17. 1995. The following purposes of cervical biopsy are all correct, EXCEPT:

    • A. Help diagnose microscopic cytological findings.
    • B. Early diagnosis of cervical cancer.
    • C. Can rest assured to ablate the cervix for treatment of cervical ectropion.
    • D. Help in the early diagnosis of uterine body cancer.

    Answer: D

    Explanation: Cervical biopsy helps diagnose microscopic cytological findings and early cervical cancer. It cannot diagnose early uterine body cancer.

18. 1996. Choose the INCORRECT statement among the following statements about benign cervical lesions.

    • A. They can be a precursor to the development of cervical cancer.
    • B. They can cause infertility.
    • C. Ectropion is a pathological condition that cannot heal on its own.
    • D. They can become chronic.

    Answer: C

    Explanation: Cervical ectropion can heal on its own or become chronic.

19. 1997. Treatment for cervical ectropion includes the following, EXCEPT:

    • A. Cervical conization.
    • B. Topical medication.
    • C. Systemic antibiotics.
    • D. Cervical ablation (electrocautery, chemical cautery, cryotherapy…).

    Answer: A

    Explanation: Cervical conization is not a method of treating ectropion.

20. 1998. Colposcopy is performed through the following stages, EXCEPT:

    • A. Unscheduled colposcopy.
    • B. Colposcopy after applying acetic acid.
    • C. Colposcopy after applying 3% Lugol’s iodine.
    • D. Colposcopy after applying Betadine.

    Answer: D

    Explanation: Colposcopy is usually performed through these stages: unscheduled colposcopy, colposcopy after applying acetic acid, colposcopy after applying 3% Lugol’s iodine.

21. 1999. Cervical ectropion is often uncommon in which age group:

    • A. After puberty
    • B. During childbearing age
    • C. After menopause
    • D. During pregnancy

    Answer: C

    Explanation: Cervical ectropion is less common in women after menopause.

22. 2000. The best treatment for chronic cervical inflammation is:

    • A. Cervical ablation.
    • B. Daily vaginal washing with vinegar.
    • C. Total hysterectomy.
    • D. Cervical conization.

    Answer: A

    Explanation: Cervical ablation is the most effective treatment for chronic cervical inflammation.

23. 2001. All of the following statements about Nabothian cysts are true, EXCEPT:

    • A. They can be a consequence of the healing process of cervical ectropion.
    • B. They are microscopic lesions that can only be seen during colposcopy.
    • C. They can be a consequence of the healing of previous cervical ulcers.
    • D. They are completely benign lesions.

    Answer: B

    Explanation: Nabothian cysts can be seen with the naked eye during colposcopy.

24. 2002. Cervical ablation is indicated for the treatment of which of the following lesions:

    • A. Extensive ectropion.
    • B. Syphilis.
    • C. Cervical polyp within the cervix.
    • D. Increased discharge, excessive white discharge.

    Answer: A

    Explanation: Cervical ablation is indicated for the treatment of extensive ectropion.

25. 2003. The following statements about cervical ectropion are all true, EXCEPT:

    • A. The ectropion area does not take up Lugol’s iodine.
    • B. One contributing factor is changes in vaginal pH.
    • C. It is when the glandular epithelium of the endocervix extends to the ectocervix.
    • D. All cases of ectropion must be treated.

    Answer: D

    Explanation: Not all cases of ectropion require treatment. Mild ectropion can heal on its own or may not require treatment.

26. 2004. Common symptoms of cervical lesions are:

    Answer: Vaginal discharge, Bleeding

    Explanation: Vaginal discharge and bleeding are the most common symptoms of cervical lesions, including both benign and malignant lesions.

27. 2005. Which type of benign cervical lesion still requires careful monitoring?

    • A. Glandular orifice/Glandular islands of the cervix
    • B. Extensive cervical ectropion
    • C. Nabothian cysts of the cervix
    • D. Cervical dysplasia

    Answer: D

    Explanation: Cervical dysplasia, although benign, requires careful monitoring because it has the potential to progress to cervical cancer.

28. 2006. For long-standing cervical ectropion, the best treatment is:

    • A. Daily vaginal washing with Betadine solution.
    • B. Ablation of cervical ectropion lesions and antibiotic placement for inflammation.
    • C. Vaginal washing and antibiotic placement for inflammation.
    • D. Vaginal – CTC washing and antibiotic placement for inflammation with estrogen.

    Answer: B

    Explanation: Ablation of cervical ectropion lesions and antibiotic placement for inflammation is the most effective treatment for long-standing cervical ectropion.

29. 2007. Cervical ectropion has the following symptoms, EXCEPT:

    • A. Inflammation and ulceration causing shedding of the squamous epithelium of the cervix.
    • B. Exposing the glandular region of the cervix.
    • C. Cervical glands protrude outward like grape clusters.
    • D. Colposcopy shows punctation, mosaicism, white patches.

    Answer: D

    Explanation: Punctation, mosaicism, and white patches are usually signs of cervical dysplasia.

30. 2008. This is not a sign of cervical dysplasia:

    • A. The cervix loses its luster and smoothness.
    • B. There are obvious papules protruding on the surface.
    • C. Colposcopy may show mosaicism, punctation, and white patches.
    • D. The Lugol’s iodine test shows dark brown staining.

    Answer: D

    Explanation: Dysplastic areas usually do not stain with Lugol’s iodine.

31. 2009. Factors that contribute to cervical dysplasia include:

    • A. Sexual intercourse.
    • B. Hormonal disorders.
    • C. Obstetric trauma.
    • D. HPV.

    Answer: D

    Explanation: HPV (Human papillomavirus) is the main risk factor for cervical dysplasia.

32. 2010. Regarding cervical polyps, which of the following is true:

    • A. When observed with the naked eye, they appear paler than the ectocervical mucosa.
    • B. They have a high rate of transformation into cancer.
    • C. They may be completely asymptomatic and are only detected incidentally.
    • D. They are composed of stratified squamous epithelium surrounded by stroma and connective tissue.

    Answer: C

    Explanation: Cervical polyps are usually asymptomatic and are only detected incidentally. The rate of transformation into cancer is low.

33. 2011. Regarding the anatomy and histology of the cervix, choose the most accurate statement:

    • A. Hormonal status in the body does not affect the appearance of a normal cervix.
    • B. Ectropion is when the histological junction is outside the anatomical cervical os.
    • C. In women using combination oral contraceptives, the appearance and structure of the cervix is similar to postmenopausal women.
    • D. Cervical ectropion is a regenerative image of the cervix after a squamous epithelial lesion on the ectocervix.

    Answer: B

    Explanation: Ectropion is when the histological junction (between glandular and squamous epithelium) is located outside the anatomical cervical os.

34. 2012. Among benign cervical lesions, which of the following lesions is most likely to be mistaken for cervical cancer:

    • A. Cervical polyp.
    • B. Cervical ectropion.
    • C. Cervical tuberculosis.
    • D. Endometriosis.

    Answer: C

    Explanation: Cervical tuberculosis can appear similar to cervical cancer.

35. 2013. Severe cervical ectropion does not cause this complication:

    • A. Menstrual irregularities.
    • B. Postcoital bleeding.
    • C. May cause infertility.
    • D. Increased secretion of thick, clear mucus.

    Answer: A

    Explanation: Severe cervical ectropion can cause postcoital bleeding, increased secretion of thick, clear mucus, and may cause infertility. It usually does not cause menstrual irregularities.