EBCOG P1 High Yield ques – General Gyneacology-29 April(S.B.A)

1. An 18-year-old girl has presented with abnormal vaginal discharge. Cultures of the purulent discharge confirm Neisseria gonorrhoea and Chlamydia trachomatis coinfection. What is the most cost-effective treatment?

2.A 16-year-old girl presents to the gynaecology outpatient clinic with primary amenorrhoea. Her breast development is Tanner stage IV. She has a blind vaginal pouch and no cervix. Which of the following describes the most likely diagnosis?

3. A 48-year-old multiparous woman presents with heavy menstrual bleeding. Her ultrasound scan is normal. What should the next step in her management be?

4. Tranexamic acid belongs to one of the following groups:

5.A 31-year-old woman had a large loop excision of the transformation zone (LLETZ) for high grade abnormality of her cervix 3 months ago. What is the most appropriate follow up?

 6.A 54-year-old woman presents to the general gynaecology clinic with an incidental finding of a 4 cm simple right ovarian cyst. Her CA-125 is 24 kU/L. What is the best option for her?

7. Which of the following findings on transvaginal scan is a definitive of the diagnosis of missed miscarriage?

8.Methotrexate can be offered as the first line treatment for ectopic pregnancy in which of the following scenarios?

9.A 32-year-old nulliparous woman presents with heavy menstrual bleeding. Ultrasound scan shows a grade 0 submucosal fibroid of 5 cm. The patient is keen to have children. What management option are you most likely to consider for her?

 10.A 40-year-old woman presents with cyclical mood swings and abdominal bloating in the premenstrual phase of the menstrual cycle. Which of these these modalities of treatment will you not consider?

11. 24-year-old woman is diagnosed with an ectopic pregnancy on ultrasound. serum -hCG level measured on the day was 1100 mIU/mL and she was en 50 mg/m2 of methotrexate intramuscularly. Five days later, she complains of increased lower abdominal pain. Her blood pressure is 120/78 mmHg and ulse is 78 beats per minute. Her abdomen shows some tenderness in the left iliac fossa with no guarding or rebound. Which of the following is the best course of action?

12.A 37-year-old woman presented with vaginal spotting at 7 weeks’ gestation. Transabdominal ultrasound scan suggests a mean sac diameter of 24 mm with no fetal pole seen. What is the most appropriate course of action?

13. Which of the following management options for a miscarriage are associated with reduced rate of fever and rigors, and improved patient satisfaction?

14. A 65-year-old woman presented with an episode of post-menopausal bleeding lasting one week. An outpatient hysteroscopy finds a 3 cm endometrial polyp. What would be your next line of management?

15.Which clinical feature is diagnostic of the menopause?

16.Which of the following conditions is not associated with an early menopause?

17.Which enzyme is responsible for the peripheral conversion of androgens to oestradiol in the menopausal patient?

18. A 48-year-old patient with a body mass index of 24 is referred to the gynaecology department because her periods have become more unpredictable and are sometimes heavier than she is used to. Her cycle is now 4-8/28-38. Her last period, which lasted for 8 days and was associated with clots, was 3 weeks ago. Her follicle stimulating hormone level is 12 IU/L. What STRAW +10 criteria best fit her current menopausal status?

19.A 48-year-old patient with a body mass index of 28 is referred to the gynaecology department because she is experiencing vasomotor symptoms. Her last period was 3 months ago and her general practitioner was uncertain whether cyclical hormone replacement therapy or the combined oral contraceptive pill would be most appropriate.What STRAW +10 criteria best fit her current menopausal status?

20. A 66-year-old woman presents to the rapid-access gynaecology clinic with a small episode of postmenopausal bleeding. A pelvic ultrasound (transvaginal) scan shows an endometrial thickness of 12 mm but no polyps or fibroids, and her adnexa looks normal. A pelvic examination shows atrophic changes but is otherwise normal. A pipelle biopsy reveals scanty endometrial cells only but no neoplasia, hyperplasia or atypia. What is the single most appropriate management step?