OBGYN

Question 1

Investigations of endometrial cancer

Answer 1

• TVUS -> estimate endometrial thickness

Endometrial biopsy is gold standard for Dx

• endometrial biopsy in post-meno when endometrial thickness is > 4mm
• endometrial biopsy in pre or perimeno when present with CF e.g. AUB

Biopsy cannot be performed in cervical stenosis -> hysteroscopy and biopsy

Question 2

How is endometrial cancer managed?

Answer 2

• almost always surgery

Question 3

You are treating a 31-year-old woman with danazol for endometriosis. You warned the patient of potential side effects of prolonged treatment with the medication. When used in the treatment of endometriosis, which of the following changes should the patient be expecting?

Answer 3

Lighter or absent menstruation, since danazol causes endometrial atrophy

Question 4

A 34-year old woman presented with the 3-month history of pelvic pain. On examination, she was found to have a mass in her right iliac fossa. An ultrasound shows an ovarian cyst measuring 8 cm x 12cm.
What is the next step in management?

Answer 4

Refer to a gynecologist

Gynae 5 Q6

Question 5

A young woman presented for your advice on her choice of oral contraceptive pills. She does not want to use any other method. Past medical history includes hypertension and diet managed type II diabetes mellitus.
What will you prescribe her?

Answer 5

Progestogen only pills

G5 and Q9

Question 6

What is premature ovarian failure

Answer 6

• menopause like symptoms before the age of 40
• low estrogen from various reasons e.g. follicle depletion, surgery, infection etc

Question 7

Clinical diagnosis of premature ovarian failure ?

Answer 7

• oligo/amenorrhea
• raised FSH taken on 2 samples each 4-6 weeks apart

Question 8

First line therapy for ovulatory DUB?

Answer 8

Tranxemic acid

Question 9

Tx of mild-moderate PID

Answer 9

ceftriaxone IM
plus
doxycycline
plus
metronidazole