Med Student Finals Category: Gynaecology

MSFinals-1709

A 56-year-old woman presents to her primary care physician with a complaint of urinary incontinence. She recently experienced a significant episode when she leaked urine while running to catch a bus. Previously, she had only noticed small leaks when coughing or laughing, and did not want to make a fuss. She reports no abdominal pain and has not had a menstrual period in 3 years. She has two children, both of whom were delivered vaginally and were large babies. Physical examination is unremarkable and a urine dipstick test is negative.

What is the most appropriate course of action for managing this patient’s condition?

MSFinals-1710

A 65-year-old postmenopausal woman with three previous vaginal deliveries presents to her general practitioner (GP) with a 2-week history of urinary incontinence. She was recently diagnosed with hypertension and was commenced on doxazosin therapy one month ago. She reports that these episodes occur during the day when she is walking to work and while she is working. She is a volunteer at the hospital shop and frequently lifts boxes as part of this role. She denies any preceding symptoms.
Which of the following is the most likely diagnosis?

MSFinals-1711

A 30-year-old woman presents with complaints of irregular and unpredictable uterine bleeding over the past 6 months. The bleeding varies in amount, duration, and timing. She reports recent weight gain despite a low appetite and generalized weakness. Her work performance has suffered due to fatigue and poor concentration. She has no significant past medical history and takes bulk-forming laxatives for constipation. She is married, lives with her husband, and has one child. On pelvic examination, the vagina and cervix appear normal, and there is no adnexal mass or tenderness. What is the most likely diagnosis?

MSFinals-1712

A 25-year-old woman presents with a history of scant abnormal vaginal bleeding for 5 days before menses during each cycle over the past 6 months. She has been married for a year but has been unable to conceive. She experiences lower abdominal cramps during her menses and takes naproxen for relief. Additionally, she complains of pelvic pain during intercourse and defecation. On examination, mild tenderness is noted in the right adnexa. What is the most likely diagnosis?

MSFinals-1713

A 56-year-old woman presented with pruritus in the perineal area, associated with pain on micturition and dyspareunia. She had thin, hypopigmented skin, with white, polygonal patches which, in areas, formed patches.
She returns for review after a 3-month trial of clobetasol proprionate, which has failed to improve symptoms. There is no evidence of infection, and her observations are stable.
Which of the following is the next most appropriate step in this patient’s management?

MSFinals-1714

A 64-year-old postmenopausal woman visits her General Practitioner (GP) complaining of dyspareunia, increased urinary frequency, and vaginal dryness. She reports no vaginal bleeding, discharge, or haematuria, and there are no signs of vasomotor or psychological menopausal symptoms. What is the accurate statement about treating vaginal atrophy in postmenopausal women?

MSFinals-1715

A 68-year-old woman has undergone a radical hysterectomy and bilateral salpingo-oophorectomy for endometrial carcinoma. She is attending her follow-up clinic to receive her results, and the consultant reports that the tumour was found to involve the right fallopian tube and ovary, but the vagina and parametrial tissue were free of tumour. All nodes submitted were negative for carcinoma. No distant metastases were present. According to the above description, how would you stage the tumour using the TNM 8 classification?

MSFinals-1716

A 32-year-old woman presents with vaginal bleeding, abdominal pain, and right shoulder tip pain. She has a history of PID, a miscarriage, and two terminations. A urine pregnancy test confirms pregnancy. What is the most appropriate next step in management?

MSFinals-1717

A 56-year-old woman is admitted to the Gastroenterology Ward with abdominal distension due to ascites. On examination, there is symmetrical distension of the abdomen and a palpable pelvic mass in the left iliac fossa. On closer questioning, she also admits to being ‘off her food’ and has lost a stone in weight over the last 3 weeks.
Which one of the following types of ovarian mass is the most likely diagnosis?

MSFinals-1718

A prospective study is designed to compare the risks and benefits of combined oestrogen and progesterone replacement therapy versus oestrogen-only replacement therapy in patients aged < 55 years, who are within 10 years of their menopause. One group of women will receive systemic oestrogen and progesterone for 4 years (HRT group) and the second group will receive the same systemic dose of oestrogen (without progesterone) for the same period (ERT group). The levonorgestrel intrauterine system is placed in women of the second group to counterbalance the effect of systemic oestrogen on the endometrium. The study will only include women who have not undergone a hysterectomy.
Which one of the following outcomes is most likely to be observed at the end of this study?