EBCOG Part 1 – General Gynaecology – Day 5(S.B.A)

1. A 70-year-old woman presents to the gynaecology clinic complaining of vulval pruritus. On examination the vulva has lesions which are sharply bordered with a red and velvety texture and islands of hyperkeratosis.
A biopsy was done and histology shows large round atypical cells with oval nuclei and pale cytoplasm within clusters among the basal cells of the epidermis.What is the most likely diagnosis?

2. A 28-year-old woman presents with dyspareunia. On examination, the vulva has lesions which are red and raw with features of erosion extending into vagina with scarring stenosis and adhesions. There ae purple nodules with overlying white lacy patterned appearance on inner surface of wrists and lower legs. There is a small lesion in the mouth.What is the most likely diagnosis?

3. A 45-year-old lady presents with vulval symptoms. The diagnosis is not clear-cut on examination.Which of the following features makes lichen planus more likely than lichen sclerosus?

4. A 52-year-old woman has a vulval burning sensation. On examination you find symmetrical fissuring and scaling.What is the most likely diagnosis?

5. 32 year old presented with vulval itching and soreness . It’s aggravated during her periods. It’s relieved during summer On examination Pitted nails noted

Skin lesions on scratching shows minute Haemorrhages

Thick red plaques with silvery scales seen over vulva Same lesions seen under breast

Pitted nails noted

Skin lesions on scratching shows minute Haemorrhages Choose correct diagnosis

6. 32 year old Penny, presents with vulval itching and soreness .She s noticed these symptoms with stress when her PHD exams were nearing.On examination
Polygonal purple topped lesions present over hand Wickham striae noted in buccal mucosa as well as well On vulval examination
plain topped polygonal lesions seen .

Choose correct diagnosis?

7.You are seeing 56 year old post-menopusal Amy , in clinic , has been referred for uncontrollable vulval itch & soreness which is worse at night .  She has visited her GP and she has given her some lubricants which was of no benefit . On examination thinning of skin, labial adhesions seen Skin looks like cigarette paper.vulval biopsy showed thinned epidermis with sub-epidermal hyalinization and deeper inflammatory infiltrate.Choose correct diagnosis?

8. A woman with biopsy-proven lichen sclerosus is not responding to topical ultra-potent steroids.What is the second line of treatment?

9. What is the karyotype of a woman with Mayer–Rokitansky– Kuster–Hauser (MRKH) syndrome (mullerian agenesis)?

10. A 20-year-old girl attends the gynaecology clinic with her mother. She presents with primary amenorrhoea.On examination she is tall with a BMI of 19 kg/m2 . She has normal breast development, but a short blind-ending vagina. There is no axillary or pubic hair.What is the most likely diagnosis?