Genital Tuberculosis MCQs

Answer- B. Serous CA Serous - 49.5% - 83.3%

The cloaca (endodermal) is divided by formation of the urorectal septum by the seventh week (7 th ) and is separated to create the rectum and the urogenital sinus. Urogenital sinus has 3 parts The cephalad or vesicle portion → urinary bladder The middle or pelvic portion → female urethra The caudal or phallic part → distal 1/3 of vagina (sinovaginal bulb) and the greater vestibular (Bartholin), urethral, and paraurethral (Skene) glands Reference : William's Obstetrics 25th Edition, chapter 7, page no. 121

As discussed in chapter on fetal malformation, anencephaly can be diagnosed as early as 8-10 weeks/first trimester in experienced hands. Microcephaly: - USG in Obs and Gynae Callen 4/e, p 298, 299 It has decreased head size. In these patients both brain mass and total cell number are reduced. There is a disproportion in size between the skull and face. It is difficult to recognize this anomaly by ultrasound - A head circumference below 2 SD from the mean is used as a diagnostic criteria in midtrimester scan. Holoprosencephaly is the presence of a single centrally placed cerebral ventricle and may be associated with midline abnormalities of the face. With the use of a vaginal probe it can be recognised in the beginning of midtrimester. Reference: Williams Obs. 21/e, p 1120; USG in Obs. and Gynae by Callen 4/e, p 284, Fernando Arias 3/e, p 64, 66, 69

Warfarin is an anticoagulant drug. Action : Interferes with the synthesis of the vitamin K dependent factors like II, VII, IX and X. Side effects: Hemorrhage It leads to: – Contradi’s syndrome : skeletal and facial anomalies in the fetus Chondrodysplasia punctata in the fetus. Miscarriage, IUGR and stillbirths accentuates neonatal hypothrombinemia. Reference : Dutta Obs. 7/e, pg 511

Menstrual problems occurring in TB patients: M/C menstrual complain oligomenorrhea/Amenorrhea 1st menstrual complain – Menorrhagia (due to Endometritis in acute phase) Pelvic examination – M/C finding = Normal pelvic examination 2nd M/C finding – tenderness present Reference: J B Sharma, Textbook of Gynecology 1 st edition p380

The M/c causes of genital ulcers in young, sexually active women are: Herpes simplex virus (HSV) Treponema pallidum (syphilis) Haemophilus ducreyi (chancroid). In this case, a painless ulcer with an everted margin leaves no doubt that the cause of the ulcer is syphilis (treponema pallidum). reference: J B Sharma, Textbook of Gynecology 1 st edition p359

Ectocervix is covered by squamous epithelium and squamous epithelium is resistant to Gonococcal infection Primary genital sites of involvement of gonorrhea : Endocervix Urethra Skene’s gland Bartholin’s gland Reference: Dutta Gynae 6th/ed p 147.

Genital tuberculosis is usually secondary to primary infection (lungs, bones, lymph nodes). It spreads by haematogenous route (not lymphatic route) leading to endosalpingitis. Caseous granulomatous lesions with giant cells on pathological examination are suggestive of TB but are not diagnostic as it can be seen in fungal infection and sarcoidosis. PCR is more sensitive (85–95%) than microscopy and bacteriological culture. This method can detect fewer than 10 organisms in clinical specimens compared to 10,000 necessary for smear positivity. Reproductive outcome even after treatment is poor. Pregnancy rate is about 20%, live birth rate is only 7%. The risk of miscarriage and ectopic pregnancy are high. Reference: Dutta Gynae 6th/ed p 140