Gynae questions

Question 1

What is this a classic presentation of: 60 year old obese, nulliparous woman with vaginal bleeding

Answer 1

Endometrial cancer

Question 2

What treatment may be started before surgery to reduce the size of fibroids?

Answer 2

GnRH agonist

Question 3

What is the treatment of thrush in pregnancy?

Answer 3

Clotrimazole pessary

Question 4

What is the treatment of BV and trichomonas vaginalis?

Answer 4

Metronidazole

Question 5

What is the typical presentation of ectopic pregnancy?

Answer 5

Woman with 6-8 week hx of amenorrhoea who presents with lower abdominal pain and later develops vaginal bleeding. May be cervical excitation and shoulder tip pain

Question 6

What is the presentation of miscarriage?

Answer 6

Vaginal bleeding and crampy lower abdominal pain following a period of amenorrhoea

Question 7

What is first line imaging for suspected adenomyosis?

Answer 7

Transvaginal ultrasound

Question 8

What is the treatment for infertility in PCOS?

Answer 8

Clomifene

Question 9

How are medical abortions undertaken?

Answer 9

Oral mifepristone and vaginal prostaglandins (such as misoprostol)

Question 10

What are risk factors for hyperemesis gravidarum?

Answer 10

Increased levels of beta hCG (multiple pregnancies, trophoblastic disease), nulliparity, obesity, FHx/personal hx

Question 11

How does smoking affect the risk of hyperemesis?

Answer 11

Reduces the risk

Question 12

What is the management of two inadequate cervical cancer samples?

Answer 12

Refer for colposcopy

Question 13

What is the first line imaging in ectopic pregnancy?

Answer 13

Transvaginal ultrasound

Question 14

What HRT increases the risk of endometrial cancer?

Answer 14

Oestrogen only HRT

Question 15

Is it possible to reinfibulate (redo FGM) after vaginal delivery?

Answer 15

No: this is illegal. Any sort of FGM is illegal in the UK and can’t be done under any circumstance

Question 16

What is it called when hair/bone/teeth arise from a teratoma?

Answer 16

Rokintasky protuberance

Question 17

How long after a first cervical cancer sample will a woman return for the second one, if it was inadequate?

Answer 17

3 months

Question 18

What is Meig’s syndrome?

Answer 18

Benign ovarian tumour, ascites, pleural effusion

Question 19

What is the marker for pancreatic cancer?

Answer 19

CA 19-9

Question 20

How often is normal recall for screening in cervical cancer?

Answer 20

Every 3 years until 59 years old

Question 21

How is premature ovarian insufficiency diagnosed?

Answer 21

Repeated FSH levels, which will be raised: second one should be taken 4-6 weeks later

Question 22

What is first line investigation of a woman who cannot get pregnant after a year of trying?

Answer 22

Day 21 progesterone (checks if actually ovulating)

Question 23

What area is most associated with increased risk of rupture in ectopic pregnancy?

Answer 23

Isthmus: least able to expand to accomodate the growing embyro, so most likely to rupture

Question 24

What area is most likely to have an ecoptic pregnancy?

Answer 24

Ampulla

Question 25

What is Fitz-Hugh-Curtis syndrome?

Answer 25

Pelvic inflammatory disease that has progressed to perihepatitis (shown by RUQ pain that radiates to the shoulder)

Question 26

How does ovarian cancer spread?

Answer 26

Local invasion