A 28-year-old woman presents to the Surgical Assessment Unit with acute abdominal pain, pain in her right shoulder, and pain during bowel movements. She reports that her last menstrual period was about 8 weeks ago. A pregnancy test is performed and comes back positive. An urgent ultrasound scan is ordered, which confirms an ectopic pregnancy in the Fallopian tube. What is the most frequent location for implantation of an ectopic pregnancy?
A 16-year-old woman presents with primary amenorrhoea. She is of normal height and build and has normal intellect. Her breast development is normal, and pubic hair is of Tanner stage II. Past history revealed an inguinal mass on the right side, which was excised 2 years ago. Ultrasonography of the lower abdomen reveals no uterus.
Which of the following tests will help in diagnosis of the condition?
A 30-year-old married woman has been struggling with infertility for a while. Upon undergoing an ultrasound, it was discovered that her ovaries are enlarged. She has also been experiencing scant or absent menses, but her external genitalia appears normal. Additionally, she has gained weight without explanation and developed hirsutism. Hormonal tests indicate decreased follicle-stimulating hormone (FSH) and increased luteinising hormone (LH), increased androgens, and undetectable beta human chorionic gonadotropin. What is the most likely cause of her condition?
A 35-year-old woman visits her GP complaining of menstrual irregularity, ‘hot flashes’, nausea, palpitations and sweating, especially at night. The GP suspects that the patient may be experiencing premature menopause.
What is a known factor that can cause premature menopause?
A 30-year-old female presents with menorrhagia that has not responded to treatment with non-steroidal anti-inflammatory drugs.
She underwent sterilisation two years ago.
What would be the most suitable treatment for her?
A 28-year-old woman presents to the Emergency Department with sudden and severe lower abdominal pain and vaginal bleeding that started 2 hours ago. The pain is progressively worsening. Upon examination, she is hypotensive, tachycardic, and apyrexial, with tenderness in the lower abdomen and guarding and rebound. She had a positive pregnancy test a week ago and reports her last menstrual period was 6 weeks ago. An ultrasound scan shows haemoperitoneum and left tubal rupture. The patient has been advised to undergo laparotomy for a ruptured ectopic pregnancy. Which part of the fallopian tube is most likely to rupture due to ectopic pregnancies?
A 38-year-old African-Caribbean woman presents to Gynaecology Outpatients with heavy periods. She has always experienced heavy periods, but over the past few years, they have become increasingly severe. She now needs to change a pad every hour and sometimes experiences leaking and clots. The bleeding can last for up to 10 days, and she often needs to take time off work. Although there is mild abdominal cramping, there is no bleeding after sex. She is feeling increasingly fatigued and unhappy, especially as she was hoping to have another child. She has one child who is 7 years old, and she had a vaginal delivery. Her periods are regular, and she is not using any contraception. On examination, she appears well, with a soft abdomen, and a vaginal examination reveals a uterus the size of 10 weeks. Her blood tests show a haemoglobin level of 9, and the results of a pelvic ultrasound scan are pending.
What is the most appropriate management option based on the clinical information and expected ultrasound results?
A 27-year-old nulliparous woman presents to Accident and Emergency, accompanied by her partner. She complains of right iliac fossa pain that started yesterday and has progressively got worse. She feels nauseated and had one episode of diarrhoea. Her last menstrual period was six weeks ago; she takes the combined oral contraceptive pill for contraception, but is not always compliant.
She is mildly tachycardic at 106 bpm. Pelvic examination reveals a scanty brown discharge and cervical excitation. She mentions she had her left tube removed, aged 19, for torsion.
Which of the following is the most appropriate management?
A 27-year-old nulliparous woman has presented to her General Practitioner (GP), requesting an appointment to discuss contraceptive options. She has previously relied on condoms for contraception but would now prefer alternative means of contraception. Her last menstrual period was one week ago. Her previous cervical smears were normal, and she denies any symptoms consistent with a diagnosis of a sexually transmitted infection. She has a past medical history of epilepsy, for which she takes regular carbamazepine, and menorrhagia secondary to several large uterine fibroids, for which she takes tranexamic acid. She does not wish to have children in the near future. She does not smoke. The GP decides to take a blood pressure reading and calculates the patient’s body mass index (BMI):
Investigation Result
Blood pressure 132/71 mmHg
BMI 28 kg/m2
Which of the following would be the contraceptive most suited to the patient?
A 50-year-old woman presents with severe itching in the perineal region, accompanied by pain during urination and painful intercourse. During examination, you observe white, polygonal papules on the labia majora that merge into a patch that affects the labia minora. There is one area of fissuring that bleeds upon contact. The skin appears white, thin, and shiny, with mild scarring. There is no vaginal discharge, and no other skin lesions are present on the body. What is the most probable diagnosis?