MSFinals-1649
A 20-year-old woman complains of heavy and irregular periods, postcoital bleeding, and deep dyspareunia that have been present for the past six months.
What is the probable diagnosis for her symptoms?
Archives: Medical Student Finals
MSFinals-1650
A 30-year-old nulliparous patient presents to the Gynaecology Clinic with complaints of severe menstrual pain and pain during intercourse. She reports that the symptoms have been progressively worsening. An ultrasound of the pelvis reveals a 4-cm cyst in the right ovary. The serum CA-125 level is 225 (0–34 iu/ml). What is the probable diagnosis?
MSFinals-1651
A 20-year-old female comes to the clinic complaining of secondary amenorrhoea that has been going on for four months. She has also lost around 8 kg during this time and currently has a BMI of 17.4 kg/m2. What is the most probable diagnosis for her condition?
MSFinals-1652
A 26-year-old nulliparous woman presents to her General Practice for a routine cervical smear. Her previous smear was negative, and she is currently taking the combined oral contraceptive pill (COCP). She had one episode of gonorrhoeae treated two years ago. During the examination, the practice nurse observes a soft, pea-sized, fluctuant lump on the posterior vestibule near the vaginal opening. There is some minor labial swelling, but it is non-tender. What is the most probable diagnosis?
MSFinals-1653
A 52-year-old woman has been referred for colposcopy after her recent cervical smear cytology showed high-grade (moderate) abnormalities and tested positive for high-risk (HR) human papillomavirus (HPV). She underwent a loop excision of the cervix, and the histology report revealed cervical intra-epithelial neoplasia 1 + 2. What is the next best course of action for her treatment?
MSFinals-1654
A concerned father brings his 14-year-old daughter to see you because he has noticed in the last three months she is increasingly irritable, aggressive and withdrawn. She will refuse to go to school, misses her netball and guitar classes and does not go out with her friends. The symptoms seem to last for a couple of weeks and then abruptly resolve. They recommence a few days later. This has severely impacted on her education and function.
The patient denies any physical symptoms, loss of weight or change in appetite. She has regular bowel movements. Her observations are normal, and examination is unremarkable.
Which of the following is the most likely diagnosis?
MSFinals-1655
A 35-year-old woman visits her GP with complaints of worsening menstrual pain and heavier bleeding in the past year. During a bimanual pelvic exam, an enlarged, non-tender uterus is palpated. A transvaginal ultrasound reveals a 2 cm fibroid. The patient is nulliparous and desires to have children in the future but not within the next three years. What is the most appropriate initial treatment for this patient?
MSFinals-1656
A 28-year-old woman has been referred to the Infertility Clinic with her partner. They have been trying to conceive for almost one year now, having regular unprotected intercourse.
Initial investigations, including thyroid function tests and mid-luteal phase progesterone and prolactin, are normal. Semen analysis is also normal. No sexually transmitted infections were detected on testing. The patient reports regular periods and a history of endometriosis.
Which of the following is the next most appropriate investigation?
MSFinals-1657
A 16-year-old girl presents to the Emergency Department with right-sided lower abdominal pain that has been on and off for 3 days. Her mother brought her in, and the patient reports no vomiting or diarrhea. She has a regular menstrual cycle, which is 28 days long, and her last period was 10 days ago. The patient denies any sexual activity. On examination, her blood pressure is 120/70 mmHg, pulse 85 bpm, and temperature 37.7 oC. The abdomen is soft, without distension, and no rebound or guarding present. Laboratory tests show a haemoglobin level of 118 (115–155 g/l), white cell count of 7.8 (4–11.0 × 109/l), C-reactive protein of 4 (<5), and a serum b-human chorionic gonadotropin level of zero. An ultrasound of the abdomen reveals a small amount of free fluid in the pouch of Douglas, along with normal ovaries and a normal appendix. What is the most likely diagnosis?
MSFinals-1658
A 72-year-old woman has been diagnosed with stress incontinence. Her BMI is 30 kg/m2 and she has a history of hypertension and osteoporosis. She presents to you today with worsening symptoms despite reducing her caffeine intake and starting a regular exercise routine. She has had a normal pelvic exam and has completed three months of pelvic floor exercises with only mild improvement. She is hesitant to undergo surgery due to a previous severe reaction to general anesthesia. What is the next step in managing this patient?