EBCOG P1 – 3 Month -General gynecology – Day 1

EMQ

Options for Q 1-4

A.Combined oral contraceptives

B.Danazol

C.NSAIDs

D.Antifibrinolytic

E.Endometrial ablation

F.Oral progestogens

G.LNG-IUS

H.TAH +BSO

I.Myomectomy

J.Tranexamic acid

K.TAH

L.TLH

M.TLH +BSO

N.Ethamsylate

For each case described below, choose the single most likely management plan from the above

list of options. Each option may be used once, more than once, or not at all.

Q1. A 35-year old Para 2 woman presents with heavy menstrual bleeding. Her cycles are regular. On examination she has a normal size uterus. She had a trial of NSAIDs and tranexamic acid and she has family history of thromboembolism.

Q2. A 24 -year-old nulliparous woman presents with severe hirsutism. She also gives history of weight gain and irregular periods.

Q3. A 43-year-old woman has menorrhagia for last two years. She has completed her family and had a trial of Mirena coil which has not helped. On ultrasound scan she has 3 intramural fibroids measuring 2 X 2.5 cm. The uterus measured 8 x 6 x 5cm and the endometrial thickness is 6 mm.

Q4. A 44-year-old woman presents with severe menorrhagia for last 4 years. On ultrasound scan the uterus was 12 x10 x8cm endometrial thickness 8mm. She has tried Mirena IUS that has not been effective. She has severe premenstrual symptoms and has completed her family. Her BMI is 37.