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3,531 questions
A 34-year-old woman develops a significant post-partum haemorrhage and hypotensive shock following vaginal delivery of a healthy infant at term. The labour was uncomplicated. She recovers well with volume replacement and oxytocin and returns to the post-natal war She is unable to breast feed on the ward and 2 months later has neither started breastfeeding nor resumed her periods and is increasingly fatigue What is the most likely diagnosis?
A 30-year-old French woman delivers a live female infant by spontaneous vaginal delivery at term. In the eleventh week of pregnancy she developed a flu-like illness which resolved spontaneously a week later. Her newborn child has severe hydrocephalus and chorioretinitis. Four days after birth, she develops severeconvulsions and efforts to revive her are unsuccessful. Which pathogen is most likely to be responsible?
A 32-year-old woman has a routine cervical smear at her GP practice The result returns as severe dyskaryosis. Following colposcopy and cervical biopsy, formal histological examination reveals cervical intraepithelial neoplasia 3 (CIN 3). Which of the following pathogens is the most likely to have caused this disease?
A 15-year-old girl attends the paediatric gynaecology clinic with primary amenorrhoea and features of secondary breast development. She has intermittent abdominal bloating and is extremely worried that she is 'not like other girls'. On speculum examination of the vagina, which is normal externally, a bulging red disc is seen 3 cm proximal to the introitus. What is the most likely diagnosis?
A 19-year-old woman undergoes surgical evacuation of the retained products of conception (ERPC). Histological examination of the sample shows genetically abnormal placenta with a mixture of large and small villi with scalloped outlines, trophoblastic hyperplasia. What is the most likely diagnosis?
A 16-year-old girl attends the gynaecology clinic complaining of vaginal itching and lumpy labia. On examination the area is covered with vulva) warts. Which is the causative pathogen for vulval warts?
An 18-year-old woman attends clinic seeking contraceptive advice. She is currently using condoms only and is keen to start taking the combined oral contraceptive pill (COCP). Her sister used to take it but told her there were lots of problems with it. Her aunt has bowel cancer and she has no other past medical history. Appropriate counselling should cover all of the following except:?
A 41-year-old woman is about to undergo her first cycle of IVF. As part of the consultation, she is counselled about the maternal and fetal risks involved with !VF-conceived pregnancies. All of the following occur in such pregnancies except:?
A SO-year-old woman comes to your clinic with a 2-year history of no periods. Her GP has confirmed that her luteinizing hormone and follicle-stimulating hormone levels are menopausal. Her night sweats and hot flushes are unbearable and are preventing her from going to work. She would like to start hormone replacement therapy (HRT) but is very worried about the side effects. Which of the following is incorrect?
A 35-year-old woman is seen in the assisted conception unit. She has been trying to conceive for 4 years. In this period she has been having regular intercourse. Her periods have been irregular and recently she has had no periods at all. Her BMI is 19.5 kg/m2, she has had an appendectomy and is otherwise well. Her biochemistry comes back as follows: luteinizing hormone (LH) 0.5 IU/L, follicle-stimulating hormone (FSH) 1.0 IU/L, prolactin 490 mIU/L, thyroxine (T4) 12, thyroid stimulating hormone (TSH) 4.2 mIU/L, oestradiol 60 pmol/L. What is the most likely cause of her subfertility?
An 18-year-old girl is seen in the colposcopy clinic after having had persistent post-coital bleeding. She has been sexually active since the age of 14 and has no past medical history. She is studying for her A-levels and has been doing a lot of reading. She is concerned that she might have cervical cancer. Which of the following is not a risk factor for cervical cancer?
In a busy gynaecology clinic you are assessing a 22-year-old woman who has not had a period for 18 months. She is not pregnant and previously had regular periods. She has had two surgical terminations of pregnancies (STOP), an underactive thyroid gland and an appendectomy. Clinical examination is unremarkable with a BMI kg/m2 of 20. Biochemical investigations reveal a T4 of 17 pmol/L, TSH 4.6 kg/m2, prolactin of 570 mU/L, and testosterone of 42 ng/dL. LH and FSH are normal. Vaginal ultrasound shows a normal sized uterus and the left ovary contain four cysts. Which of the answers listed below is the most likely cause?
A 17-year-old girl comes to clinic with her mother as she has not started having periods yet and they are worried. On examination she is of short stature, with a slightly widened neck and has no secondary sexual characteristics and there is no obvious abnormality of the external genitale. What is the most likely diagnosis form this limited information?
A 22-year-old woman presents to the GUM clinic with an offensive smelling discharge. She is sexually active and is in a monogamous relationship. She describes no pain or soreness just an offensive smelling discharge. After examination and taking swabs for the second time she is diagnosed with bacterial vaginosis. Which of the following organisms is not likely to be the cause?
A 58-year-old woman presents to the clinic with post-menopausal bleeding. A pipelle biopsy confirms adenocarcinoma of the endometrium. Further imaging of the pelvis shows that there is spread of the tumour outside of the uterus into the left adnexa. There is no other spread. What is the most likely stage of the tumour?
A 62-year-old woman presents to accident and emergency with shortness of breath. Examination reveals reduced breath sounds and a swollen, distended abdomen. Chest x-ray demonstrates a left-sided pleural effusion. On further questioning the woman has had a poor appetite for the last 6 months and recently had some vaginal bleeding. An ultrasound revealed large quantities of ascites, which were drained. Analysis of the ascites shows a high protein content. What is the most likely diagnosis?
Following surgery to place a tension-free transobturator tape for stress incontinence, a 54-year-old woman loses some sensation in part of her labia anterior to the anus. Damage has most likely been caused to which nerve?
Two days after undergoing posterior exenteration for recurrence of cervical adenocarcinoma a 53-year-old woman develops a tachypnoea, tachycardia of 125 bpm and a fever of 39° Blood cultures have grown methicillin-resistant Staphylococcus aureus (MRSA). She requires intravenous vasopressors. What is the most appropriate diagnosis?
A 39-year-old woman attends the gynaecology clinic complaining of long-standing pelvic pain. Routine bimanual examination and abdominal ultrasonography do not detect any abnormality. At diagnostic laparoscopy, multiple tiny dark brown nodular lesions are noted covering the surface of the uterus, tubes and left ovary, as well as in the Pouch of Douglas. Which finding is most likely from histological examination of the excised lesions?
A 29-year-old female presents with dysuria and vaginal discharge which has deteriorated over the past week. She is in a steady relationship and uses the oral contraceptive pill. Her partner is asymptomatic. She has a temperature of 37.5° Vaginal examination reveals tenderness with an inflamed cervix and a purulent discharge, culture of which reveals Gram negative diplococci. What is the likely diagnosis?