EBCOG Part1 – General Gynaecology – Day 6(S.B.A)

1. You saw a 63-year-old woman with postmenopausal bleeding of 1 week duration in the gynaecology clinic. A pipelle endometrial biopsy was performed and reported as hyperplasia without atypia. An ultrasound was ordered, and the report is as follows: ‘normal size uterus with a thickened endometrium, which measures 5 mm in its widest diameter. There is a right ovarian cyst, which measures 6 x 7 cm. There is no increased vascularity around the cyst wall on colour Doppler’. What will be the next step in her management?

2. What will you recommend as the first-line treatment for a 55-year-old woman diagnosed with endometrial hyperplasia without atypia following a pipelle endometrial biopsy?

3. A 48-year-old woman presents with irregular and heavy bleeding of 6 months duration. Her BM is 32 kg/m2. An endometrial biopsy is performed and this has been reported as hyperplasia with atypia. What will be the first treatment option you will recommend for this patient?

4.You have seen a 59-year-old P2, all normal vaginal deliveries in the Gynaecology clinic with a 2-month history of irregular postmenopausal bleeding. What will be the indication for performing a diagnostic hysteroscopy and biopsy in this patient?

5.A woman is referred to the outpatient clinic with postmenopausal bleeding. A transvaginal ultrasound scan is performed, and the endometrial thickness is found to be 4 mm This is described as having an irregular profile at the fundus and a double layer in the body. No polyps are present. What would be the next step in the management of this woman?