OB/GYN

Question 1

What hormones are increased in granulose cell tumor

Answer 1

Increased estradiol and inhibin

Question 2

Clinical fts of adult granulosa cell tumor

Answer 2

breast tenderness, postmenopausal bleeding and abnormal uterine bleeding

Question 3

Clinical features of primary dysmenorrhea

Answer 3

pain first 2-3 days of menses, Nausea and vomitting, diarrhoea with normal pelvic exam

Question 4

Causes of Functional hypothalamic amenorrhea

Answer 4

Excessive weight loss
Strenuous exercise
eating disorder
Chronic illness

Question 5

Abnormal uterine bleeding in a premenopausal patient with painless regular menses .. most likely diagnosis?
and treatment

Answer 5

Endometrial polyp treat doing a hysteroscopic polypectomy

Question 6

Fused labia minor which appear thin and partially block the urethral meatus with multiple excoriations in a prepubertal female .. dx and ethology?

Answer 6

Labial adhesions due to low oestrogen and inflammation

Question 7

What screening is required in all postnatal women who are having difficulty at home with infant?

Answer 7

Edinburgh Postnatal Depression Scale (EPDS)

Question 8

What is the first line investigation in a women with pelvic pain and/or adnexal mass

Answer 8

U/S

Question 9

Clinical presentation of Epithelial Ovarian CA

Answer 9

SOB, Constipation/bloating, vomiting, Asx adnexal mass, pelvic/abdominal pain

Question 10

Lab and U/S findings of Epithelial Ovarian CA

Answer 10

Elevated CA-125, solid mass, thick septations and ascites

Question 11

Thin white, wrinkled skin over labia minora with excoriations, versions and fissures from severe pruritus, dysuria and dyparenuria in a prepubertal girl (also can happen in a peri/postmenopausal woman)

Answer 11

Lichen sclerosus

Question 12

1st line therapy for lichen sclerosus

Answer 12

Clobetasol (potent topical steroid)

Question 13

Mittelschmerz

Answer 13

Normal ovulation causing pain in the middle of the menstrual cycle

Question 14

High fever, hypotension, tachycardia and a diffuse red macular rash in the palms and soles in a female patient using tampons

Answer 14

Toxic Shock Syndrome

Question 15

Modifiable risk factors for breast cancer

Answer 15

HRT
Nulliparity
Increased age at first live birth
Alcohol

Question 16

Risk factors for cervical cancer that are not sexually related

Answer 16

Immunosuppresion
OCPs
Tobacco use
Low socioeconomic status

Question 17

Next best step in a patient with endometrial cells on Pap test >45

Answer 17

In contrast to women <45 this finding is abnormal and requires an endometrial biopsy

Question 18

In a female patient who requests contaception but has problems with anemia and heavy menstrual bleeding what is the contraception of choice and why?

Answer 18

Levonorgestrel-containing IUD (long acting 5 years)

a common side effect is amenhorrea which improves anemia and abnormal uterine bleeding

Question 19

Young female with cyclic pain and blue bulge tinged bulge between labia (bulging vaginal mass) (common cause of primary amenorrhea)

Answer 19

Imperforate hymen

Question 20

If patient is suspected with chorioamnionitis what is the next best step

Answer 20

Abx and deliver immediately

Question 21

Clinical features of chorioamnionitis

Answer 21

Maternal fever + >1 of the following
Fetal tachy (>160)
Purulent amniotic fluid
Maternal leukocytosis

Question 22

Emergency contraception for pregnancy prevention

Answer 22

Copper IUD (0-120hrs)
Ulipristal acetate (0-120hrs)
Oral levonorgestrel  (0-72hrs)

Question 23

Contraindications for copper IUD in emergency contraception

Answer 23

1. Wilsons disease
2. Complicated organ transplant failure
3. Acute pelvic infection
4. Severe uterine cavity distortion

Question 24

Contraindiation for taking emergency contraception

Answer 24

Patients that test positive for pregnancy

Question 25

Clinical feature of androgen-secreting tumors (Sertoli-Leydig cell)

Answer 25

``` Frank Virilization including Male pattern baldness Deepened voice Clitoromegaly Increased muscle bulk ```

Question 26

Postapartum hemorrahge with vaginal sidewall defect and minimal bleeding from cervical OS.

Answer 26

Vaginal Laceration

Question 27

Etiology and risk factors for Primary Dysmenorrhea

Answer 27

``` Excessive endometrial prostaglandin F2 Age <30 (Menarche <12) BMI <20 Tobacco Sexual abuse ```

Question 28

Women with Mullerian agenesis should undergo what evaluation due to which concurrent embryogenic source and development

Answer 28

Renal U/S due to renal abnormality development

Question 29

What is Uterine Tachysystole

Answer 29

>5 contractions every 10 mins

Question 30

How do you manage uterine tachysystole with late fetal decelerations

Answer 30

1. supportive measures (repositioning etc.) | 2. d/c utertonic agents (oxytocin) until abnormalities are resolved

Question 31

Patient has lower abdominal pain, fetal declarations and previous myomectomy repair what are you conserned about and what is the next best step

Answer 31

Uterine rupture | Urgent laparotomy and C/S

Question 32

What is postpartum urinary retention defines as and what is the mode of diagnosis and treatment

Answer 32

Urinary retention >6hrs | Uterine catherization is both diagnostic and therapeutic

Question 33

Contraindications for IUD placement

Answer 33

Endometrial or Cervical CA Pregnancy Unexplained Vaginal bleeding

Question 34

Test of diagnosis in vesicovaginal fistulas especially those not visible on PE

Answer 34

Bladder dye testing

Question 35

Increased risks of vaginal cancer

Answer 35

age >60 DES in utero (clear cell not squamous) smoking HPV

Question 36

When do you stop PAP testing if everything is normal

Answer 36

65

Question 37

What is the next best step in a patient with a greyish discharge from the breast

Answer 37

TSH and FSH