A 16-year-old presents with pain in the right iliac fossa. She reports that the pain began a few hours ago while she was playing soccer and has been getting worse. The patient is negative for Rovsing’s sign. An ultrasound reveals the presence of free pelvic fluid with a whirlpool sign. What is the probable diagnosis?
A 31-year-old female patient complains of painful and heavy periods since discontinuing the combined oral contraceptive pill eight months ago. She is distressed as she desires to conceive but the pain is hindering sexual intercourse. The patient seeks to identify the underlying cause of her symptoms. During the examination, her abdomen is soft and non-tender without palpable masses. However, a bimanual pelvic examination is challenging due to the pain. What is the definitive diagnostic test for this patient?
A 29-year-old woman visits her GP complaining of worsening menstrual pain that starts a few days before her period. Despite taking paracetamol and ibuprofen, the pain persists. She also experiences discomfort during penetrative sex. During a digital vaginal examination, the GP notes nodularity and tenderness in the posterior fornix of the cervix. A bimanual examination reveals a retroverted uterus that is fixed in position. What is the gold standard investigation for this likely diagnosis?
A 38-year-old woman presents to her GP to discuss contraception. She has a medical history of hypertension, type 1 diabetes mellitus, and is currently undergoing treatment for breast cancer. She was also recently diagnosed with deep vein thrombosis in her left leg and is a heavy smoker with a BMI of 38 kg/m2. She is interested in receiving an injectable progesterone contraceptive. What aspect of her medical history would prevent the GP from prescribing this?
A 22-year-old female patient comes to see her doctor, 2 weeks after undergoing a medical abortion. She has concerns that the procedure may not have been successful as her home pregnancy test still shows a positive result. What is the expected timeframe for the pregnancy test to become negative if the abortion was effective?
A 19-year-old female patient visits her doctor urgently seeking emergency contraception after having unprotected sex 80 hours ago. She is currently on day 20 of her menstrual cycle. The doctor discovers that the patient was previously prescribed ellaOne (ulipristal acetate) for a similar situation just 10 days ago. What would be an appropriate emergency contraception method for this patient?
A 25-year-old primigravida patient at 6 weeks gestation presents with suprapubic pain and spotting. She also complains of shoulder-tip pain and nausea. Upon observation, her oxygen saturations are at 98% in room air, blood pressure is at 109/79 mmHg, heart rate is at 107 bpm, and temperature is at 36.9ºC. Further investigations reveal an empty uterine cavity with tubal ring sign on transvaginal ultrasound and evidence of a 41 mm complex adnexal mass. Her Hb levels are at 107 g/L (115 – 160), platelets at 380 * 109/L (150 – 400), WBC at 10.8 * 109/L (4.0 – 11.0), and b-HCG at 1650 IU/L (< 5). What is the most appropriate management plan for this patient?
A 55-year-old woman comes to the postmenopausal bleeding clinic complaining of light vaginal bleeding and mild discomfort during intercourse for the past two weeks. She reports feeling generally healthy. During a vaginal exam, she experiences tenderness and slight dryness. What is the next step to take in the clinic?
A 28-year-old woman has been experiencing severe dysmenorrhoea for a prolonged period and seeks consultation at the gynaecological clinic. The consultant suspects adenomyosis as the underlying cause but wants to confirm the diagnosis and exclude other possible pathologies before initiating treatment. What is the most appropriate imaging modality for diagnosing this condition?
A 29-year-old female patient visits her general practitioner complaining of dyspareunia and intermenstrual bleeding. She is not on any hormonal contraceptives. Following the exclusion of sexually transmitted infections and fibroids, she is referred for colposcopy. The diagnosis is a grade 1A squamous cell carcinoma of the cervix. The patient is married and desires to have children in the future. What is the best treatment option for her cancer?