A 25-year-old patient has a history of irregular menstrual cycles over the past few years. She is well known to you and has seen you regularly with regard to her weight problem, oily skin and acne. She presents to you on this occasion with a 6-month history of amenorrhoea and weight gain.
What is the most appropriate initial investigation in the above scenario?
A 32-year-old nulliparous woman is undergoing evaluation at the Infertility Clinic. Initial assessments, including thyroid function tests and mid-luteal phase progesterone and prolactin levels, are within normal limits. Semen analysis also shows no abnormalities. No sexually transmitted infections were found.
She experiences regular and heavy menstrual periods, accompanied by dysmenorrhoea that begins 1-2 days before the onset of bleeding. She also reports deep dyspareunia. A transvaginal ultrasound reveals no abnormalities.
Which investigation is most likely to provide a definitive diagnosis?
A 35-year-old woman visits her GP with complaints of worsening menstrual pain in recent months. The pain is not relieved by ibuprofen and is aggravated during sexual activity. During the clinical examination, adnexal tenderness is observed. The GP suspects that endometriosis may be the underlying cause of her dysmenorrhoea. What is the most suitable initial investigation for suspected endometriosis cases?
A 16-year-old girl presents with primary amenorrhoea. She has never had a menstrual period. Upon physical examination, downy hair is observed in the armpits and genital area, but there is no breast development. A vagina is present, but no uterus can be felt during pelvic examination. Genetic testing reveals a 46,XY karyotype. All other physical exam findings are unremarkable, and her blood work is normal. What is the most probable diagnosis?
A mother of three brings her youngest daughter, aged 15, to the general practitioner (GP) as she is yet to start menstruating, whereas both her sisters had menarche at the age of 12.
The patient has developed secondary female sexual characteristics and has a normal height. She reports struggling with headaches and one episode of galactorrhoea.
Magnetic resonance imaging (MRI) reveals an intracranial tumour measuring 11 mm in maximal diameter.
Given the most likely diagnosis, which of the following is the first-line management option?
A 29-year-old woman presents with two episodes of post-coital bleeding. She reports that she noticed some red spotting immediately after intercourse, which settled shortly afterwards. She is on the combined oral contraceptive pill, with a regular partner, and does not use barrier contraception.
Examination reveals a malodorous, green, frothy discharge and an erythematosus cervix with small areas of exudation. High vaginal and endocervical swabs were performed.
Given the most likely diagnosis, which of the following is the most appropriate management?
In the study of contraception modes, researchers examine the cell structure of sperm. In the case of the copper intrauterine device (IUD), which cellular structure is affected by its mode of action?
A 28-year-old woman with clinical signs of hyperandrogenism (hirsutism, severe acne and pigmented areas of skin in the axillae) and multiple ovarian cysts, demonstrated on ultrasound scan of both ovaries, has been trying to conceive for six months, but her periods are irregular. She has lost 2 stones in weight and attends clinic for further advice on management.
What is the most appropriate step in the management of this 28-year-old patient with clinical signs of hyperandrogenism, multiple ovarian cysts, irregular periods, and a desire to conceive, who has lost 2 stones in weight?
A 26-year-old patient presents with a 3-day history of vaginal discharge, without itching or bleeding. She is normally fit and well, without past medical history. There is no history of sexually transmitted infections. She is sexually active and has a progesterone implant for contraception.
Examination reveals a soft, non-tender abdomen. On pelvic examination, you notice the vagina has a white-grey coating on the walls and a fishy odour. A small amount of grey vaginal discharge is also seen. The cervix looks normal, and there is no cervical excitation. Observations are stable.
Which of the following is the most likely diagnosis?
A 25-year-old woman comes to her University Health Service complaining of a fishy-smelling vaginal discharge that she has noticed over the past few days. The discharge is yellow in colour and is accompanied by vulval itching. She has had protected sexual intercourse three times in the past six months and is not currently in a committed relationship. Upon investigation, her vaginal pH is found to be 6.0 and ovoid mobile parasites are observed on a wet saline mount. What is the most probable diagnosis?