EBCOG Part 1 – General Gynaecology – Day 3(S.B.A)

1.Which progestogen has been shown to be effective in cases of PMS?

2. A 29-year-old woman presents with a constant ongoing pain in the pelvis.The pain does not occur exclusively with menstruation or inter- course and the woman is not pregnant.For what minimum duration should the pain occur before it is deemed chronic?

3.An 18-year-old girl presents with chronic lower abdominal pain. In what percentage of patients attending a gynaecology outpatient clinic with lower abdominal/pelvic pain would you expect to find irritable bowel syndrome (IBS)?

4. A 24-year-old girl attends the gynaecology clinic with persistent pain over her Pfannenstiel scar that has not settled since her cae- sarean section of 6 months.
What is the incidence of nerve entrapment (defined as highly localised, sharp, stabbing or aching pain, exacerbated by particular movements and persisting beyond 5 weeks or occurring after a pain free interval) after one Pfannenstiel incision?

5.A 22-year-old girl presents with lower abdominal pain, which is cyclical in nature.Which modality is the only way to reliably diagnose peritoneal endometriosis?

6. An 18-year-old girl with pelvic pain presents to the gynaecology outpatient clinic. An ultrasound scan is arranged, which demonstrates a normal pelvis. Hormonal treatment is discussed with the girl.How long should she persist with this therapy before contemplat- ing a laparoscopy?

7.A 19 year old has been seen in the gynaecology clinic with abdom- inal pain, which improves with defecation. It is associated with change in frequency of stool and change in form, for at least 3 days per month in the past 3 months.What are the criteria used to define IBS?

8. A 21 year old presents to the gynaecology outpatient clinic with pelvic pain. The general practitioner referral suggests possible endometriosis.What is the estimated prevalence of endometriosis in women of reproductive age?

9. A 40-year-old woman with BMI 32 kg/m2 is referred to the gynae- cology clinic with secondary amenorrhoea. She has two children and her partner had a vasectomy 5 years ago.An ultrasound scan is performed, which shows a normal uterus with endometrial thickness 6 mm.Both ovaries have a typical polycystic appearance. What would be the recommended management?

10. A 42-year-old woman with oligomenorrhoea and hirsutism presents to the gynaecology clinic. She recently had a prolonged episode of vaginal bleeding, but an ultrasound scan and endome- trial biopsy performed in primary care both reported normal results. She is obese with a BMI of 40kg/m2. She has mild hypertension but does not require antihypertensive therapy. She has no other medical problems.Her father suffered from Type 2 Diabetes mellitus. What further investigation is required?

11. The aetiology of premenstrual syndrome (PMS) remains unclear but appears to be related to the effect of cyclical ovarian activity on neurotransmitters.Which neurotransmitters are considered to have a key role?

12.What is the best predictor of cardiovascular risk in a 37-year-old woman who has been diagnosed with polycystic ovarian syndrome?

13. An amenorrhoeic woman with polycystic ovarian syndrome was given norethisterone acetate (20 mg/day for 5 days) to induce a withdrawal bleed and following the withdrawal bleed was commenced on clomifene citrate 50 mg/day from D2. She has come back saying that she has not had a period after 35 days. What would be your next step in her management?

14.What is the predominant cause of anovulatory infertility?

15. What is the first-line pharmacological treatment for anovulatory polycystic ovary syndrome?

16. What is the recommended test for the biochemical detection of hyperandrogenism?

17. What proportion of women with polycystic ovarian syndrome are overweight/obese?

18. What is the mechanism of action of Metformin?

19. Which ONE of the following clinical scenarios is considered diagnostic of polycys- tic ovarian syndrome?

20. Which ONE of the following clinical scenarios is considered diagnostic of polycystic ovarian syndrome?

21. All are true regarding Endocrinology in PCOS except

22. 32year old indian woman with BMI32 kg/m2 , with oligomenoorheoa and hirustism , on USg -she has bilateral polycystic ovaries. Her mother and sister do have similar complaints .all are true regarding inheritance of PCOS except

23.The resolution of ultrasound technology, it has more recently been suggested that the threshold number of follicles to define a polycystic ovary should be

24.What is the Prevalence of Gestational diabetes mellitus in woman with PCOS when compared to general population

25.Insulin resistance Is present in woman with PCOS

26. cardiovascular dysfunction is increased in both pre and post menopausal woman With PCOS Is linked to

27. High prevalence of PCOS Is common in woman of

28. All are true about Rorterdam criteria Except

29. Free androgen index is

30. All are true regarding Congenital adrenal hyperplasia (CAH) except

31. All are true regarding screening of type 2DM in woman with PCOS Except

33. Impaired glucose tolerance level is diagnosed when

33. Sleep apnoea in woman with PCOS

34. A Srilankan woman with Hirustism , Oligomenorrhoea .she is recently diagnosed diabetic and started with oral hypoglycaemics. Her Lipid profile is impaired.Her BMI is 28kg/m2.she is her for Oral contraceptive pills.Her Blood pressure is 130/84mm of Hg.What is the best treatment?

35. Regarding long term consequences of PCOS

36. All are true regarding PCOS except

38. Use of metformin in woman with PCOS reduces androgen levels by

39.Regarding Electrocautery in PCOS , all are true except

40. Up to what percentage of extra weight can be lost by bariatric surgery