Gyne

Question 1

Risk factors of ectopic pregnancy

Answer 1

Prior ectopic pregnancy
Prior tubal surgery
Smoking > 20 cigarettes per day
PID confirmed by laparoscopy or positive test for Chlamydia trachomatis
≥ 3 prior spontaneous miscarriages Age ≥ 40 years
Prior medical or surgical abortion Infertility > 1 year
Lifelong sexual partners >5
Prior IUD use

Question 2

Without intervention, an ectopic tubal pregnancy can lead to

Answer 2

Tubal abortion : is the expulsion of products through the fimbrial end. This tissue can then either regress or reimplant in the abdominal cavity. With reimplantation, bleeding or pain necessitating surgical intervention is a common complication.

Tubal rupture:

is associated with significant intraabdominal hemorrhage.

spontaneous resolution, small ectopic pregnancies die and are resorbed without adverse patient effects. As with the ending of any early pregnancy, Rh status is assessed.

Question 3

Indications of methotrexate in ectopic pregnancy

Answer 3

Minimal symptoms
Adnexal mass mass <40mm
BHCG less than 3000 IU/L

Question 4

C.I of methotrexate

Answer 4

Active infection
Immunedeficiency
Breastfeeding
Chronic liver dis
Renal or haematological disorders

Question 5

Risk factors of detrusor overactivityء٦ت

Answer 5

Smoking..
Childhood bed wetting
Previous hysterectomy
Obesity

Question 6

Indication of endometrial biopsy

Answer 6

women over 45 with menstrual symptoms, including HMB and PCB, after ensuring that the woman is not pregnant (see Chapter 4, Disorders of menstrual bleeding)
Endometrial hyperplasia more than 4 cm

Question 7

diagnostic cone biopsy indicated :

Answer 7

Pap smear shows high grade lesion& colposcopic examination is unsatisfactory

. Endo cervical curettage shows a high grade lesion .

Pap smear shows adenocarcinoma in situ Pap smear shows a high grade lesion that is not confirmed by punch biopsy.

Micro invasion is present on the punch biopsy

Question 8

Menopause ?

Answer 8

is the permanent cessation of menstruation resulting from loss of ovarian follicular activity.

■ It can only be determined after 12 months’ spontaneous amenorrhoea.

Question 9

Early sign of menopause

Answer 9

Hot flushes

Question 10

Late sign of menopause

Answer 10

Osteoporosis

Question 11

شكد تفقد من الbone mass after menopause

Answer 11

5% per year

Question 12

Osteoporosis due to menopause Rx

Answer 12

Estrogen selective receptors
Tamoxifen
Raloxifene

Calcitonin
Calcium
Vit D
Biphosphonate

Question 13

Progesterone شكد ييقى

Answer 13

16-21

Question 14

Day 14 what is increased

Answer 14

LH surge for 36h