Gynaecology

Question 1

What is the first test to perform when a woman presents with amenorrhea?

Answer 1

B-hCG - the most common cause of amenorrhea is pregnancy

Question 2

What is the term for heavy bleeding during and between menstrual periods?

Answer 2

Menometrorrhagia

Question 3

What is the cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C?

Answer 3

Asherman syndrome

Question 4

What is the therapy for PCOS?

Answer 4

Weight loss and OCPs, consider metformin

Question 5

What medication is used to induce ovulation?

Answer 5

Clomiphene citrate

Question 6

What diagnostic step is required in a postmenopausal woman who presents with vaginal bleeding?

Answer 6

Endometrial biopsy

Question 7

What are the indications for MEDICAL treatment of ectopic pregnancy?

Answer 7

Patient is stable

Enraptured ectopic pregnancy of <3.5cm at <6weeks gestation

Question 8

What are the medical options for endometriosis?

Answer 8

OCPs
Danazol
GnRH agonists

Question 9

What are the laparoscopic findings in endometriosis?

Answer 9

Powder burns

Chocolate cysts

Question 10

Where is the most common location for an ectopic pregnancy?

Answer 10

Ampulla of the oviduct

Question 11

How do you diagnose and follow a leiomyoma (fibroid)?

Answer 11

Ultrasound

Question 12

What is the natural history of a leiomyoma?

Answer 12

Regresses after menopause

Question 13

A patient presents with increased vaginal discharge and petechial patches in the upper vagina and cervix. What is the likely diagnosis?

Answer 13

Trichomonal vaginitis

Question 14

What is the treatment for bacterial vaginosis?

Answer 14

Oral metronidazole

Question 15

What is the most common cause of bloody nipple discharge?

Answer 15

Intraductal papilloma

Question 16

What contraceptive methods prevent against PID?

Answer 16

Barrier contraception (OCP, maybe)

Question 17

Unopposed estrogen is contraindicated in which cancers?

Answer 17

Endometrial cancer

Estrogen receptor + breast cancer

Question 18

A patient presents with recent PID and RUQ pain, what is on your differential?

Answer 18

Consider Fitz-Hugh-Curtis syndrome

Question 19

A patient presents with itching, burning, and erosion of the nipple.

Answer 19

Patent disease (malignant)

Question 20

What is the annual screening for women with a strong family history of ovarian cancer?

Answer 20

CA-125

Transvaginal ultrasonography

Question 21

A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?

Answer 21

Kegel exercises, estrogen, pessaries for stress incontinence

Question 22

A 30-year-old woman has unpredictable urine loss. Examination is normal. What are the medical options?

Answer 22

Anticholinergics (oxybutynin)
B-adrenergics (metaproterenol)
for urge incontinence

Question 23

What lab value is suggestive of menopause?

Answer 23

Elevated serum FSH

Question 24

What is the most common cause of infertility?

Answer 24

Endometriosis

Question 25

Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on pap smear?
What is the follow-up evaluation?

Answer 25

Colposcopy and endocervical curettage

Question 26

Breast cancer type the increases the future risk of invasive carcinoma in both breasts?

Answer 26

Lobular carcinoma in situ