Dx of Menstrual Disorders

Question 1

A 30 year old woman complains of pain during intercourse and painful periods. There are red vesicles in the Pouch of Douglas as well as black lesions on the uterosacral ligaments at the time of laparoscopy.

Answer 1

Endometriosis

Question 2

A 17 year old university student complains of abdominal swelling, some non-specific discomfort and six months amenorrhoea.

Answer 2

Pregnancy

Question 3

A 50 year old teacher complains of erratic periods and night sweats

Answer 3

Peri-menopause

Question 4

A 35 year old shop assistant complains of painless bright red bleeding occurring after intercourse.

Answer 4

Carcinoma of the Cervix

Question 5

A primigravida 30 year old with an 8 weeks gestation presents with painless uterine bleeding. The human chorionic gonadotrophin levels are 4 times the upper limit of normal for her gestation with echoluscent spaces on ultrasound scan.

Answer 5

Hydatidiform Mole

Question 6

A 17 year old long distance athlete presents with amenorrhoea and a stress fracture of a bone in her right
foot. She has a low BMI (13.5) and has lanugo hair growing on her back.

Answer 6

Hypoestrogenism

Question 7

A 28 year old lady presents with amonorrhoea for the last 12 months. She has galactorrhoea, dyspepsia
and has had a non-specific headache for some time.

Answer 7

Prolactinoma

Question 8

A 17 year old girl presented with abdominal swelling, a feeling of nausea and 5 months amenorrhoea.

Answer 8

Pregnancy

Question 9

A 17 year old university student complains of never having had any periods and underdeveloped breasts.
Her BMI is 18.5. Otherwise her secondary sexual characteristics are normal.

Answer 9

Late Menarche

Question 10

An 18 year old girl with learning difficulties is brought to hospital with amenorrhoea by her mother. Examination shows a web neck, wide spaced nipples and limited secondary sexual characteristics.

Answer 10

Turner’s syndrome