Cases Flashcards
25 y/o woman presents for her routine antenatal visit. She is @ 32wks gestation and reports no symptom. On examination, her BP is 145/95 mmHg and urinalysis revels proteinuria (+2). She is referred to the antenatal day unit where her protein is measured at 1.5g/24hr. Further tests show elevated liver enzymes.
PET
32y/o woman has just been confirmed by US as pregnant with twins at a gestational age of 10wks. She had been trying for a pregnancy for 5 years, but no sub-fertility treatment has been used. On her way home she notices bright red vaginal bleeding. She is not in any pain and has no postural dizziness.
Miscarriage
23y/o who is primigravida presents with a 2-day Hx of sharp intermittent RLQ abdominal pain, which is exacerbated with movement and is progressively worsening. She has no GI symptoms. Her LMP was 7wks ago. Her PMH includes a chlamydia infection as a teenager.
Ectopic pregnancy
24y/o woman presents 8wks after her LMP, complaining of one episode of vaginal spotting during the last week. Urine pregnancy test is positive, and serum bHCG is elevated. US of the pelvis reveals an apparent missed abortion, with no identifiable foetal pole.
Molar pregnancy
42y/o smoker presented to labour & delivery @ 28wks gestation with worsening abdominal pain. She has also had some vaginal bleeding within the past hour. She was found to have low-amplitude, high-frequency uterine contraction, and the CTG showed recurrent late decelerations and reduced variability. Her uterus was tender and firm to palpation.
Placental abruption
38y/o, G5P4, smoker is found to have her uterus in the lower 1/3 of the uterus on a routine US at 13wks. She returns with painless, bright red vaginal bleeding @ 28wks; she is not in labour.
Placenta praevia
35y/o G2P1 has had an induction of labour due to PET; her last pregnancy involved undergoing a c-section. She is now experiencing severe abdominal pain, with PV bleeding. CTG shows foetal distress.
Uterine rupture
55y/o woman present with painless vaginal bleeding, no other symptoms are present. She has no risk factors for cervical cancer and undertakes regular screening.
Endometrial polyps
38y/o woman presents to her gynaecologist for her annual examination. She has no specific complaints. Her menstrual cycle is regular, occurring every 28-30 days and lasting around 5 days. However, she has noticed that recently her periods have been heavier than usual. On pelvic examination, she has an enlarged uterus. FBC is normal and pregnancy test is negative.
Uterine fibroids
65y/o obese woman with hypertension presents with PMB, 12yrs post-menopause. She has never been pregnancy. Bleeding is scanty but has persisted for more than 1mth. She has not recently used HRT and had a normal smear result 6mths previously.
Endometrial cancer
46y/o woman presents for a routine gynaecological examination. She has a history of unprotected intercourse with multiple partners and is a smoker. She has never been for a smear test.
Cervical cancer
32y/o nulliparous woman presents with a history of worsening menstrual pain that is now causing severe distress. She has missed 2-3 days of work each month since it first began. She finds no relief with ibuprofen. Her relationship with her long-term partner has become affected because of dyspareunia.
Endometriosis
42y/o woman (G3P2) presents with bilateral breast pain of mild-moderate intensity. Pain is worse just before and improves a few days after the start of menarche. Physical examination of the breast demonstrates diffuse nodularity throughout.
Fibrocystic change
28y/o woman 2wks postpartum presents with recent-onset breast pain and a tender wedge-shaped are in one breast that feels firm, warm and looks erythematous. She has decreased milk output, flu-like symptoms and is feeling fatigued.
Mastitis
58y/o woman has clustered microcalcifications in the right breast on routine mammography, which were not seen on her previous mammogram. She is post-menopausal, has used HRT for 6 years and has a BMI of 26. She has one sister who was diagnosed with breast cancer 5 years ago.
DCIS
