Gynecology Final Examination with
Questions and Answers-Guaranteed
Success
what is menorrhagia? - Correct Answer excessive bleeding during menstruation
(this is not a strict number but what a women perceives as excessive)
what are the ix for menorrhagia? - Correct Answer none may be required however
FBCS is commonly done and depending on suspected cause you may want to do
US for fibroids or clotting for clotting disorder if they were always excessively heavy
Causes of menorrhagia - Correct Answer dysfunctional uterine bleeding: this
describes menorrhagia in the absence of underlying pathology. This accounts for
approximately half of patients
an ovulatory cycles: these are more common at the extremes of a women's
reproductive life
uterine fibroids
hypothyroidism
IUDs
pelvic inflammatory disease
bleeding disorders, e.g. von Will brand disease
a patient presents with menorrhagia and persistent IMB what investigation should be
offered? - Correct Answer hysteroscopy to rule out endometrial pathology polyps
and fibroids
what is the management of HMB? - Correct Answer IUS should be offered 1rst line
however if women want to get pregnant then tranexmic acid or mefanamic acid
should be offered as an alternative
norethisterone daily day 5-26 of cycle an alternative
what are the surgical options for HMB? - Correct Answer endometrial ablation
(should use contraception after and avoid getting pregnant)
hysterectomy
primary dysmenorrhea - Correct Answer painful menstruation that begins at
puberty and has no clear cause it is very common
,tx primary dysmenorrhea? - Correct Answer NSAIDs such as mefanmic acid 1rst
line
COCP 2nd line
secondary dysmenorrhea - Correct Answer painful menstruation that begins during
adult life, usually as a consequence of a pelvic disorder starting a couple of days
before mentation
causes secondary dysmenorrhea - Correct Answer - endometriosis
fibroids
adhesions
PID
primary amenorrhoea causes - Correct Answer Refers to a patient of any age who
has never menstruated.
causes include:
turner’s syndrome
CAH
CAIS
congenital malformations (imperforate hymen)
central hypogonadism
kalians
physical stress (exercise anorexia)
secondary amenorrhea causes - Correct Answer -pregnancy
-hypothyroidism
-sheen Hans syndrome
-ashermanns syndrome
-anorexia physical stress
-PCOS
-Premature ovarian failure
Ix 2ndry amenorrhea - Correct Answer 1 pregnancy test
then test for other causes history dependent commonly
TFTS
gonadotropins: low levels indicate a hypothalamic cause whereas raised levels
suggest an ovarian problem (e.g. Premature ovarian failure)
prolactin
androgen levels: raised levels may be seen in PCOS
oestradiol
when should women with primary dysmenorrhea be referred to specialist care? -
Correct Answer symptoms severe and failure to respond to treatment after 3-6
months or the diagnosis is in doubt
, what are the general process occuring in the 1rst trimester? - Correct Answer initial
formation of the body’s organs and structures
what are the general process occurring in the 2nd trimester? - Correct Answer
development of the fetal nervous system and maturation of organs
what are the general process occurring in the 3rd trimester? - Correct Answer
development of fat and skin required for warmth in external environment and
maturation of the lungs for breathing
what organs broadly form from then endoderm? - Correct Answer GI, bladder and
urethra, liver and rasp tracts thyroid gland
what organs broadly form from ectoderm? - Correct Answer skin and CNS
what organs broadly form from mesoderm? - Correct Answer muscle heart, kidneys
and gonads
chorionic - Correct Answer Outermost layer of the two membranes surrounding the
embryo; it forms the fetal part of the placenta.
amnion - Correct Answer Innermost membranous sac surrounding the developing
fetus enclose amniotic fluid. cushions the fetus and allows place for it to move and
grow
why is placental bleeding so problematic? - Correct Answer lacks ability to auto
regulate so can be torrential (noting that the blood flow to the placenta is 500ml/min
at term)
maternal circulation changes during pregnancy? - Correct Answer increased Hob
and Blood volume (relative dilution of hub)
increases in SV and CO
BP decreases to nadir at 20 weeks (normal by term)
rasp changes in pregnancy? - Correct Answer gravid uterus decreases tidal volume
but compensated by increased rasp rate
coagulation system changes in pregnancy? - Correct Answer hypercoagulable
factor's II VII X and fibrinogen all increase
change in renal function? - Correct Answer increased GFR and renal size
(decreasing urea and creatinine)
oxytocin - Correct Answer hormone secreted form the ant pituitary that stimulates
uterine contraction and milk ejection
Questions and Answers-Guaranteed
Success
what is menorrhagia? - Correct Answer excessive bleeding during menstruation
(this is not a strict number but what a women perceives as excessive)
what are the ix for menorrhagia? - Correct Answer none may be required however
FBCS is commonly done and depending on suspected cause you may want to do
US for fibroids or clotting for clotting disorder if they were always excessively heavy
Causes of menorrhagia - Correct Answer dysfunctional uterine bleeding: this
describes menorrhagia in the absence of underlying pathology. This accounts for
approximately half of patients
an ovulatory cycles: these are more common at the extremes of a women's
reproductive life
uterine fibroids
hypothyroidism
IUDs
pelvic inflammatory disease
bleeding disorders, e.g. von Will brand disease
a patient presents with menorrhagia and persistent IMB what investigation should be
offered? - Correct Answer hysteroscopy to rule out endometrial pathology polyps
and fibroids
what is the management of HMB? - Correct Answer IUS should be offered 1rst line
however if women want to get pregnant then tranexmic acid or mefanamic acid
should be offered as an alternative
norethisterone daily day 5-26 of cycle an alternative
what are the surgical options for HMB? - Correct Answer endometrial ablation
(should use contraception after and avoid getting pregnant)
hysterectomy
primary dysmenorrhea - Correct Answer painful menstruation that begins at
puberty and has no clear cause it is very common
,tx primary dysmenorrhea? - Correct Answer NSAIDs such as mefanmic acid 1rst
line
COCP 2nd line
secondary dysmenorrhea - Correct Answer painful menstruation that begins during
adult life, usually as a consequence of a pelvic disorder starting a couple of days
before mentation
causes secondary dysmenorrhea - Correct Answer - endometriosis
fibroids
adhesions
PID
primary amenorrhoea causes - Correct Answer Refers to a patient of any age who
has never menstruated.
causes include:
turner’s syndrome
CAH
CAIS
congenital malformations (imperforate hymen)
central hypogonadism
kalians
physical stress (exercise anorexia)
secondary amenorrhea causes - Correct Answer -pregnancy
-hypothyroidism
-sheen Hans syndrome
-ashermanns syndrome
-anorexia physical stress
-PCOS
-Premature ovarian failure
Ix 2ndry amenorrhea - Correct Answer 1 pregnancy test
then test for other causes history dependent commonly
TFTS
gonadotropins: low levels indicate a hypothalamic cause whereas raised levels
suggest an ovarian problem (e.g. Premature ovarian failure)
prolactin
androgen levels: raised levels may be seen in PCOS
oestradiol
when should women with primary dysmenorrhea be referred to specialist care? -
Correct Answer symptoms severe and failure to respond to treatment after 3-6
months or the diagnosis is in doubt
, what are the general process occuring in the 1rst trimester? - Correct Answer initial
formation of the body’s organs and structures
what are the general process occurring in the 2nd trimester? - Correct Answer
development of the fetal nervous system and maturation of organs
what are the general process occurring in the 3rd trimester? - Correct Answer
development of fat and skin required for warmth in external environment and
maturation of the lungs for breathing
what organs broadly form from then endoderm? - Correct Answer GI, bladder and
urethra, liver and rasp tracts thyroid gland
what organs broadly form from ectoderm? - Correct Answer skin and CNS
what organs broadly form from mesoderm? - Correct Answer muscle heart, kidneys
and gonads
chorionic - Correct Answer Outermost layer of the two membranes surrounding the
embryo; it forms the fetal part of the placenta.
amnion - Correct Answer Innermost membranous sac surrounding the developing
fetus enclose amniotic fluid. cushions the fetus and allows place for it to move and
grow
why is placental bleeding so problematic? - Correct Answer lacks ability to auto
regulate so can be torrential (noting that the blood flow to the placenta is 500ml/min
at term)
maternal circulation changes during pregnancy? - Correct Answer increased Hob
and Blood volume (relative dilution of hub)
increases in SV and CO
BP decreases to nadir at 20 weeks (normal by term)
rasp changes in pregnancy? - Correct Answer gravid uterus decreases tidal volume
but compensated by increased rasp rate
coagulation system changes in pregnancy? - Correct Answer hypercoagulable
factor's II VII X and fibrinogen all increase
change in renal function? - Correct Answer increased GFR and renal size
(decreasing urea and creatinine)
oxytocin - Correct Answer hormone secreted form the ant pituitary that stimulates
uterine contraction and milk ejection
