Congenital Anomalies Of The Female Reproductive Tract Quiz

Here is a draft, high-yield 35-item MCQ quiz covering congenital anomalies of the female reproductive tract, including MRKH, CAH, imperforate hymen, transverse septum, and uterine anomalies. Each question includes the answer and short rationale. Please review first. I can adjust difficulty or format if needed. 📘 CONGENITAL ANOMALIES OF THE FEMALE REPRODUCTIVE TRACT 35-Item High-Yield MCQ Quiz 1. A 15-year-old girl has normal breast development, primary amenorrhea, and a short blind vaginal pouch. Most likely diagnosis? A. Imperforate hymen​ B. MRKH syndrome​ C. CAH​ D. AIS Answer: B Rationale: MRKH presents with absent uterus and short vagina with normal secondary sex characteristics. 2. The most common cause of ambiguous genitalia in 46,XX infants is: A. Turner syndrome​ B. Androgen insensitivity​ C. CAH​ D. MRKH Answer: C Rationale: CAH (21-hydroxylase deficiency) causes excess androgen production. 3. A bulging bluish membrane at the introitus in an adolescent suggests: A. Transverse septum​ B. Vaginal atresia​ C. Imperforate hymen​ D. MRKH Answer: C Rationale: Classic finding in imperforate hymen. 4. Which uterine anomaly results from complete failure of Müllerian fusion? A. Septate​ B. Bicornuate​ C. Didelphys​ D. Unicornuate Answer: C Rationale: Didelphys = two separate uteri and cervices. 5. A patient with recurrent miscarriage and normal external uterine contour most likely has: A. Bicornuate uterus​ B. Septate uterus​ C. Didelphys uterus​ D. Unicornuate uterus Answer: B Rationale: Septate uterus has normal outer shape but internal septum. 6. Which anomaly is most strongly associated with renal defects? A. Imperforate hymen​ B. MRKH​ C. CAH​ D. AIS Answer: B Rationale: MRKH is associated with urinary anomalies due to urogenital ridge origin. 7. Failure of septal resorption leads to: A. Didelphys​ B. Bicornuate​ C. Septate uterus​ D. Unicornuate Answer: C Rationale: Septum persists when resorption fails. 8. A newborn with dehydration, hyponatremia, hyperkalemia, and ambiguous genitalia likely has: A. MRKH​ B. Turner syndrome​ C. CAH​ D. AIS Answer: C Rationale: Salt-wasting CAH causes electrolyte abnormalities. 9. Upper two-thirds of the vagina originates from: A. Urogenital sinus​ B. Müllerian ducts​ C. Wolffian ducts​ D. Cloaca Answer: B Rationale: Upper vagina is Müllerian-derived. 10. A girl has amenorrhea, cyclic pain, no bulge at introitus. Most likely diagnosis? A. Imperforate hymen​ B. MRKH​ C. Transverse vaginal septum​ D. CAH Answer: C Rationale: Septum is internal, so no bulge is seen. 11. Which uterine anomaly is most surgically correctable? A. Didelphys​ B. Septate​ C. Unicornuate​ D. Bicornuate Answer: B Rationale: Septate uterus can be resected hysteroscopically. 12. A 46,XX infant with virilized genitalia and uterus present most likely has: A. AIS​ B. CAH​ C. MRKH​ D. Turner syndrome Answer: B Rationale: CAH causes virilization with intact internal organs. 13. A “heart-shaped” uterus describes: A. Septate​ B. Didelphys​ C. Bicornuate​ D. Unicornuate Answer: C Rationale: Bicornuate uterus has fundal indentation. 14. Which hormone deficiency causes salt-wasting in CAH? A. Cortisol​ B. Estrogen​ C. Aldosterone​ D. Testosterone Answer: C Rationale: Aldosterone deficiency leads to salt loss. 15. Most common presentation of imperforate hymen: A. Delayed puberty​ B. Primary amenorrhea + pain​ C. Hirsutism​ D. Hot flashes Answer: B Rationale: Obstructed menstrual flow causes pain. 16. One Müllerian duct fails to develop in: A. Septate uterus​ B. Bicornuate uterus​ C. Unicornuate uterus​ D. Didelphys uterus Answer: C Rationale: Unicornuate = single duct development. 17. A girl has normal breasts, no uterus, XY karyotype. Diagnosis? A. MRKH​ B. AIS​ C. CAH​ D. Turner Answer: B Rationale: AIS = XY female with androgen resistance. 18. Failure of canalization of vaginal plate causes: A. MRKH​ B. Imperforate hymen​ C. Transverse septum​ D. Didelphys Answer: C Rationale: Septum results from incomplete canalization. 19. Which anomaly causes “double cervix”? A. Bicornuate​ B. Septate​ C. Didelphys​ D. Unicornuate Answer: C Rationale: Didelphys has two cervices. 20. In MRKH, ovaries are normal because they arise from: A. Müllerian ducts​ B. Wolffian ducts​ C. Urogenital ridge​ D. Cloaca Answer: C Rationale: Ovaries originate from urogenital ridge. 21. Avascular uterine septum mainly causes: A. Ectopic pregnancy​ B. Infertility​ C. Miscarriage​ D. Dysmenorrhea Answer: C Rationale: Poor placental support causes pregnancy loss. 22. Best imaging to define uterine anomalies: A. X-ray​ B. CT scan​ C. MRI​ D. IVP Answer: C Rationale: MRI gives best soft tissue detail. 23. A neonate with ambiguous genitalia must undergo which first? A. Surgery​ B. Gender assignment​ C. Complete evaluation​ D. Hormone therapy Answer: C Rationale: Diagnosis must precede sex assignment. 24. A patient with hematocolpos and hematometra likely has: A. MRKH​ B. CAH​ C. Outflow obstruction​ D. Turner syndrome Answer: C Rationale: Blood accumulation indicates obstruction. 25. The most common Müllerian anomaly is: A. Didelphys​ B. Bicornuate​ C. Septate​ D. Unicornuate Answer: C Rationale: Septate uterus is most common. 26. A woman has recurrent breech presentations. Likely anomaly? A. Septate​ B. Bicornuate​ C. MRKH​ D. CAH Answer: B Rationale: Abnormal shape limits fetal movement. 27. MRKH patients usually present at: A. Birth​ B. Childhood​ C. Puberty​ D. Menopause Answer: C Rationale: Primary amenorrhea appears at puberty. 28. A patient with unilateral renal agenesis should be screened for: A. CAH​ B. Uterine anomalies​ C. AIS​ D. PCOS Answer: B Rationale: Renal and uterine defects are linked. 29. The lower one-third of vagina comes from: A. Müllerian ducts​ B. Wolffian ducts​ C. Urogenital sinus​ D. Allantois Answer: C Rationale: Lower vagina is endoderm-derived. 30. Management of complete transverse vaginal septum is: A. Observation​ B. Dilators only​ C. Surgical excision​ D. Hormones Answer: C Rationale: Complete obstruction requires surgery. 31. In CAH, ACTH is increased because of: A. High aldosterone​ B. Low cortisol​ C. High estrogen​ D. Low androgen Answer: B Rationale: Loss of negative feedback increases ACTH. 32. Which anomaly causes infertility due to sperm misdirection? A. MRKH​ B. Septate uterus​ C. CAH​ D. AIS Answer: B Rationale: Septum blocks sperm passage. 33. A girl with normal uterus but absent vagina likely has: A. MRKH​ B. Vaginal atresia​ C. AIS​ D. CAH Answer: B Rationale: Vaginal atresia blocks canal formation. 34. First-line management for MRKH to create vagina is: A. Surgery​ B. Estrogen​ C. Dilators​ D. Chemotherapy Answer: C Rationale: Progressive dilation is first-line. 35. A newborn with fused labia and clitoromegaly most likely has: A. MRKH​ B. Turner syndrome​ C. CAH​ D. AIS Answer: C Rationale: Androgen excess in CAH causes virilization. ✅ CORE EXAM TAKEAWAYS Condition Key Feature CAH 46XX + virilization MRKH No uterus + normal ovaries Imperforate hymen Blue bulge Septate uterus Miscarriage Didelphys Double uterus Bicornuate Heart shape Unicornuate One horn If you want, I can next: ✔️ Turn this into a timed mock exam​ ✔️ Make a hard consultant-level set​ ✔️ Create a primary amenorrhea diagnostic flowchart​ ✔️ Summarize into a 1-page final reviewer Just tell me.