A 55-year-old woman with a body mass index of 32 kg/m² and type 2 diabetes mellitus presents to you. She has had a Mirena coil (levonorgestrel-releasing intrauterine system) for the past 3 years and has been without periods since 4 months after insertion. Recently, she has experienced 2 episodes of post-coital bleeding and a 4-day episode of vaginal bleeding. What is the best course of action for management?
A 22-year-old female patient presents to you after missing a dose of her combined oral contraceptive pill (COCP). She is currently on day 10 of her packet and missed the pill approximately 26 hours ago. The patient confirms that she has taken all other pills on time and has not experienced any recent vomiting or diarrhoea. She also reports having had unprotected sexual intercourse 10 hours ago. The patient contacts you seeking advice on whether she requires emergency contraception. What would be the most suitable course of action for this patient?
A 65-year-old woman without previous pregnancies visits her GP complaining of abdominal bloating and diarrhea. She has a family history of irritable bowel syndrome. During the examination, the doctor notes a soft and non-tender abdomen with a detectable pelvic mass. What is the most appropriate next course of action?
A 22-year-old woman comes in for her dating scan after discovering she was pregnant 6 weeks ago through a urine pregnancy test. However, her ultrasound reveals that the pregnancy is ectopic and located in her left fallopian tube. The size of the pregnancy is 20mm, unruptured, and has no cardiac activity. The patient is not experiencing any symptoms such as bleeding, cramping, vomiting, or systemic symptoms, and her vitals are normal. Her blood test results show that her β-hCG levels have decreased from 940 IU/L at her booking appointment to 740 IU/L today. She has no significant medical history. What is the most appropriate management plan for this patient?
A 59-year-old woman presents to the GP with vaginal dryness for the past 4 weeks and occasional small amounts of vaginal bleeding after intercourse. She denies any pain, dysuria, or changes in bowel habits. Her last period was 2 years ago and she has unprotected sexual intercourse with her husband, who is her only partner. She has a history of type 2 diabetes mellitus and obesity.
On examination, her abdomen and pelvis appear normal. What would be the most suitable course of action in managing her condition?
A 16-year-old male comes to your clinic and asks for the contraceptive pill. He appears to have Gillick competency, but he reveals that his girlfriend is 24 and a teacher at a nearby private school. He confirms that she is not pregnant and that her last period was 3 weeks ago. He specifically requests that you do not inform anyone, including his mother who is also a patient of yours. How do you proceed?
A 15-year-old girl is brought in by her parents who are concerned about her lack of menstruation. They have noticed that all her friends have already started their periods and are worried that something may be wrong with her. Upon conducting blood tests, the following results were obtained:
FSH 12 IU/L (4-8)
LH 13 IU/L (4-8)
What is the probable diagnosis for this patient?
A 17-year-old girl presents with amenorrhoea for 6 months. She has a history of irregular periods with a cycle ranging from 25-39 days long and has missed a whole cycle before. She is concerned about the potential impact on her future fertility. The patient denies being sexually active and has no syndromic features on examination. There is no significant acne or excess body hair. She has a BMI of 20 kg/m² and is currently training for a half marathon. What is the probable cause of her condition?
A 35-year-old woman visits the gynaecology clinic with a history of endometriosis diagnosed 3 years ago after laparoscopic surgery. She complains of chronic pelvic pain that intensifies during her menstrual cycle and deep dyspareunia. Despite trying ibuprofen, the progesterone-only pill, and the combined oral contraceptive pill, she has not found relief. The patient has no medical history, allergies, or current desire to conceive. What would be the recommended course of action for treatment?
A 25-year-old woman visits her GP complaining of fatigue, breast tenderness, and bloating in the week leading up to her period. She also experiences mild difficulty concentrating and occasional mood swings during this time, but not at any other point in the month. The patient has a medical history of migraines with aura and takes sumatriptan as needed, without known allergies. Although her symptoms do not significantly impact her daily life, she finds them bothersome and wishes to find a way to alleviate them. What is the most appropriate approach to managing these symptoms?