REPRODUCTIVE/ENDOCRINE MCQ

Question 1

1. Which of the following features are most useful to differentiate between endometriosis and fibroids? a. Passing clots b. Age c. Pain with defecation during menstruation d. Associated fatigue, shortness of breath on exertion, palpitations e. Unable to fall pregnant after 1 year of trying

Answer 1

Pain with defecation during menstruationPain with defecation during menstruation

Question 2

A 25 year old woman was told her pap smear was slightly abnormal and she would need to repeat it in a year’s time (instead of second yearly). She’s worried that she’ll get cancer in the meantime. What can you say to reassure her?

1. If you don’t have genital warts, you can’t get cervical cancer
2. The pap smear is designed to pick up early changes in cells on the cervix, the changes on your pap smear were probably minimal and in most cases are cleared by the next pap smear. Cervical cancer typically takes 10 years to form.
3. If you have any abnormal bleeding, for example bleeding between periods or bleeding after sex, if you’re pap smear was normal, then you are fine and don’t need to be re-assessed
4. If you had cancer you would have obvious symptoms
5. If you don’t have a family history of cervical cancer, then you are safe

Answer 2

If you don’t have a family history of cervical cancer, then you are safe

Question 3

The following infection should be treated with antibiotics in pregnancy

• Urinary infections only if the mother has pain on passing urine
• Viral upper respiratory infections because they might harm the developing fetus
• Rubella infection
• d.Presence of bacteria in the urine even if the patient is asymptomatic

Answer 3

a.Presence of bacteria in the urine even if the patient is asymptomatic

Question 4

Which of the following clinical scenarios is most worrying for breast cancer?

In a patient whose mother had breast cancer age 70years old

• Mobile, smooth, lump
• Nipple retraction in one breast that is not fixed
• Bilateral breast pain
• Persistent progressive rash on the breast

Answer 4

e.Persistent progressive rash on the breast

Question 5

Which of the following features would indicate pyelonephritis is more likely than cystitis in a patient?

• Haematuria
• Fever, vomiting, loin pain
• Malodorous urine
• History of recurrent urinary tract infection
• Severity of dysuria (pain with passing urine)

Answer 5

• Fever, vomiting, loin pain

Question 6

A stone 10mm in size is likely to spontaneously pass

Answer 6

False

Question 7

There is no point in referring a patient with acute scrotal swelling if more than 60 minutes have elapsed as the testicle cannot be saved after that time

Answer 7

F

Question 8

A patient thinks they are depressed but you want to exclude the possibility of thyroid disease. What features of the history would suggest hypothyroidism?

Answer 8

Symptoms of hypothyroidism
Hypothyroidism is 10 times more common in females & occurs mainly in middle life.Mnemonic: MOMʼS SO TIRED
M Memory loss
O Obesity
M Malar flush/Menorrhagia
S Slowness
S Skin and hair become dry
O Onset is gradual
T Tired
I Intolerance to cold
R Raised blood pressure
E Energy levels are low
D Depressed

Symptoms of hyperthyroidism

Mnemonic: SWEATING
S Sweating
W Weight loss
E Emotional lability
A Appetite is increased
T Tremor/Tachycardia due to AF
I Intolerance to heat/Irregular menstruation/Irritability N Nervousness

G Goitre and Gastrointestinal problems (loose stools/diarrhoea)

Question 9

35y.o. Patel wants a check up blood test. His fasting sugar was 7.8 (reference range <5.5). What are the risk factors for having diabetes? How is it diagnosed?

Answer 9

fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured.