A. Congestion and edema of cervical mucosa

B. infiltration of lymphocytes and monocytes.

C. Epithelial metaplasia with glandular epithelium

D. Glands gradually expand and cysts appear.

E. it will form a cervical cyst.

2. The following do not belong to the classification of cervical invasive cancer:

A. erosive type

B. flower shape of lettuce

C. Endogenous osmotic type

D. nipple type

E. Type of ulcer

3. The most common and important metastatic route of cervical cancer is:

A. Direct communication

B. Lymphatic metastasis

C. hematogenous metastasis

D. local infiltration

E. Planting transfer

4. Endometriosis refers to the appearance of endometrial glands and stroma outside the endometrium. The most common parts are:

A. Ovary

B. Broad ligament of uterus

C. Pelvic peritoneum

D. rectovaginal fossa

E. vagina

5. Microscopically, the most important features of hydatidiform mole are:

A. Interstitial high porosity and edema

B. disappearance of blood vessels in villous stroma

C. trophoblast cells proliferate in different degrees.

D. High edema of placental villi

E. non-invasive muscle layer

6. Choriocarcinoma has a strong ability to invade and destroy blood vessels. In addition to local destruction and diffusion, it is easy to transfer through blood channels. The most common metastatic sites are:

A. brain

B. Gastrointestinal tract

C. liver

D. vagina

E. lung

Reference answer and analysis

1. Reference answer C. Analysis: Chronic cervicitis is the most common gynecological disease among women of childbearing age. It is often caused by streptococcus, enterococcus and staphylococcus, chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus and herpes simplex virus. In addition, childbirth and mechanical injury are also inducing factors of chronic cervicitis. Clinically, the main manifestation is the increase of leucorrhea. Microscopically, the cervical mucosa is hyperemia and edema (A pair), and chronic inflammatory cells such as lymphocytes, plasma cells and monocytes are infiltrated in the stroma (B pair). Cervical glandular epithelium may be accompanied by hyperplasia and squamous metaplasia (C wrong, the correct answer to this question). If the hyperplastic squamous epithelium covers and blocks the opening of the cervical canal gland, resulting in mucus retention, the gland gradually expands into a cyst, forming a cervical cyst (DE pair), which is called Naboth cyst.

2. Reference answer D. Analysis: Classification of cervical invasive cancer: (1) erosive type: the mucosa at the lesion is flushed, granular, fragile and easy to bleed when touched. Histologically, most of them belong to carcinoma in situ and early invasive carcinoma. (2) Flower shape of lettuce: The cancer tissue mainly grows to the surface of the cervix, forming a papillary or cauliflower-like process, and necrosis and superficial ulcers often form on the surface. (3) Endogenous infiltration type: The cancer tissue mainly infiltrates into the deep part of the cervix, which makes the anterior and posterior lips of the cervix thicken and harden, and the surface is often smooth, so it is easy to miss the diagnosis in clinical examination. (4) Ulcer type: In addition to the deep infiltration of cancer tissue, there are large pieces of necrosis and shedding on the surface at the same time, forming an ulcer, which looks like a crater.

3. Reference answer B. Analysis: Lymphatic metastasis is the most common and important metastasis route of cervical cancer. The cancer tissue first metastasized to parauterine lymph nodes, then to obturator, internal iliac, external iliac, common iliac, inguinal and presacral lymph nodes in turn, and finally to supraclavicular lymph nodes.

4. Reference answer A. Analysis: Endometriosis refers to the fact that endometrial glands and stroma appear outside the endometrium, 80% occur in the ovary, and the rest occur in the following tissues or organs in turn: broad ligament of uterus, rectovaginal recess, pelvic peritoneum, abdominal surgical scar, umbilical region, vagina, vulva and appendix. If the endometrial glands and stroma are located in the myometrium (more than 2mm away from the basal layer of endometrium), it is called adenomyosis.

5. Reference answer C. Analysis: hydatidiform mole: (1) Macroscopically, the lesion was confined to the uterine cavity and did not invade the myometrium. Placental villi are highly edematous, forming transparent or translucent thin-walled blisters, containing clear liquid, connected by pedicles, and shaped like grapes. (2) Microscopically, hydatidiform mole has the following three characteristics: ① villi are enlarged due to high interstitial porosity, edema and mucinous degeneration; ② The villous interstitial blood vessels disappeared, or a few nonfunctional capillaries were seen, among which there were no red blood cells; ③ Trophoblast cells proliferated in different degrees, including syncytial trophoblast cells and cytotrophoblast cells, with different proportions and mild atypia. The proliferation of trophoblast cells is the most important feature of hydatidiform mole (C pair).

6. reference answer e. analysis: choriocarcinoma has a strong ability to invade and destroy blood vessels. In addition to local destruction and diffusion, it is easy to transfer through blood, with lung (more than 90%) being the most common, followed by brain, gastrointestinal tract, liver and vaginal wall. In a few cases, after resection of the primary focus, the metastatic focus can subside on its own.

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