EBCOG PART 1 – FREE MINI MOCK (SBA)

1. Mrs. A, multiparous lady is postpartum clinic She has delivered 8months back with history of major postpartum hemorrhage (4500ml) now she complains of amenorrhoea. she stopped breast feeding, also complains of difficulty in lactation. She complains of weight loss, dry skin and breast atrophy. what is the probable cause of diagnosis ?

2. A 16-year-old girl presents to the gynaecology outpatient clinic with primary amenorrhoea. She is 148 cm tall and weighs 54 kg (BMI 24.7). Breast development is assessed as Tanner stage 2 and her pubic hair is noted to be sparse. Further examination identifies cubitus valgus. She has no other dysmorphic features. What is the most likely diagnosis?

3. Kenchamma, a 33-year-old Asian woman has been trying for pregnancy for 1 Year , now she complains of pelvic pain and amenorrhea For 3 months associated with low- grade fever and weight loss. Physical examination demonstrates a tender pelvic mass. Surgical findings include dense pelvic adhesions, segmental dilatation of the fallopian tubes, and everted fimbria. Microscopic examination of the right fallopian tube shows proliferation of tubal folds with giant cells within the tube. Which is the probable diagnosis ?

4. A 48-year-old woman attends the gynaecology clinic complaining of heavy menstrual bleeding (HMB) and occasional intermenstrual bleeding. Her haemoglobin level is 112 g/l. An ultrasound scan demonstrated no obvious abnormality. What other investigation is required?

5. A 35-year-old woman attends the gynaecology clinic complaining of worsening HMB. Investigations have been performed in primary care. Her haemoglobin level is 123 g/l and a pelvic ultrasound scan showed no obvious abnormality. What is the most appropriate first-line pharmacological treatment?

6. A 47-year-old Para 3 who has had three previous vaginal deliveries presents with a history of HMB that has not responded to medical treatment or the levonorgestrel-containing intrauterine system (LNG-IUS). The patient was offered endometrial ablation but declined. On examination, the uterus is bulky, no masses palpable in the adnexa and the cervix descends to about 2 cm above the hymenal ring. An ultrasound confirms the physical examination findings. Her BMI is 39. What is the most appropriate treatment option?

7. 40-year-old woman attends for a consultation in primary care complaining of HMB. She is otherwise fit and well and examination is unremarkable. What investigation should be undertaken?

8. Following referral to secondary care for HMB, a 38-year old woman undergoes pelvic examination, which confirms that the uterus is palpable abdominally. What is the first line diagnostic test to identify structural abnormalities in this situation?

9. 39-year-old woman presents to the gynaecology clinic with HMB and dysmenorrhoea. She is otherwise fit and well. Pelvic examination is unremarkable. She is not keen on hormonal methods of treatment. What treatment would you initially recommend?