Gynecology Final Exam with Correct
Answers
Normal menstrual volume and duration - Correct Answer 30mls for 3-7 days
How much vaginal bleeding during period will give iron deficiency? - Correct
Answer 60ml
Definition of menorrhagia - Correct Answer >80mls
Polymenorrhea - Correct Answer Interval <24 days
Decrease in length of time between menses
An ovular
Oligomenorrhea - Correct Answer Interval >35 days
Increase in length of time between menses
Menorrhagia - Correct Answer Regular prolonged (flow lasts >8 days) and/or XS
bleeding >80mls
May lead to anemia
Metrorrhagia - Correct Answer Bleeding between periods
Irregular prolonged and XS bleeding
Causes of abnormal uterine bleeding in women of reproductive age - Correct
Answer PALM COIEN
Polyp
Adenomyosis
Leiomyoma
Malignancy + hyperplasia
Coagulopathy
Ovulatory dysfunction
Iatrogenic
Endometrial
Not yet classified - chronic inflammation/ AVMs
Rotterdam criteria - Correct Answer Diagnostic criteria for PCOS
Amenorrhea/oligomenorrhea
USS - ovarian size >10cc or 9-12 cysts on either ovary
Clinical/biochemical signs of hyperandrogenism
PCOS in pregnancy asset with what risks? - Correct Answer PET
,GDM
Microsomal
Reproductive components of PCOS - Correct Answer Oligomenorrhea
Subfertility
Hyperandrogenism
Psychological components of PCOS - Correct Answer Depression
Anxiety
Low self esteem
Eating disorders
Sexual dysfunction
Did for abnormal uterine bleeding in adolescent - Correct Answer STI
Pregnancy
An ovulatory cycles
Bleeding disorders
Dads of post-menopausal bleeding - Correct Answer Atrophy
Endometrial hyperplasia/cancer
Polyp
Chronic inflammation
RFs for hyperplasia/malignancy in context of abnormal vaginal bleeding - Correct
Answer Age
obesity;
chronic anovulation; underlying ovarian disease (PCOS, E2 producing tumors)
infertility, null parity
history of breast cancer; tamoxifen use;
failure to respond to treatment for uterine bleeding
exogenous hormone exposure - unopposed estrogen (and intact uterus): risk X 10
hereditary non-polyposis colon cancer
presence of glandular cells on pap smear
presence of endometrial cells on pap smear post-menopausal (1/3 will already have
CA)
family history of endometrial, ovarian, breast, or colon cancer
Nix for abnormal uterine bleeding - Correct Answer hCG - RULE OUT
PREGNANCY
FBC (anemia, ITP)
Fe studies + ferritin (IDA)
Cogs (vowed)
Pap smear
HVS and end cervical swabs (STI, PID)
Endometrial papilla
TV USS (polyps, fibroids, ovaries, endometrial thickness)
, Hysteroscopy and D&C
Thyroid function, PRL, Cortisol, testosterone, LH, FSH, day 21 progesterone
Treatment of abnormal uterine bleeding - Correct Answer Correct anemia (Fe, Fe
tx, RBCs, hormonal suppression of menses)
NSAIDs - mefanamic acid, ibuprofen, naproxen
Antifibrinolytic - tranexamic acid
Hormonal - COCP, POP, marina, depo, Janelle, Gnarl - diazole
Surgical - ablation, polypectomy, myomectomy, hysterectomy
Treatment of abnormal uterine bleeding with NSAIDS - Correct Answer Mefanamic
acid, Ibuprofen, Naproxen
Reduce endometrial PG levels by inhibiting cyclooxygenase 20-50%
Take 24-48 hours prior to period
Decreases dysmenorrhea
ADRs - GI bleeds, renal impairment, allergy
CIs - asthma, allergy, peptic ulcer
Treatment of abnormal uterine bleeding with Antifibrinolytic - Correct Answer
Tranexamic acid
Plasminogen activator inhibitor - prevents fibrin degradation
ADRs - GI, dizzy, headaches, thrombosis, ureteric
obstruction
CIs - active intravascular clotting, pregnancy
Surgical ablation for abnormal uterine bleeding - Correct Answer Premenopausal
Abnormal uterine bleeding due to benign disease
(egg, dysfunctional or an ovulatory bleeding)
No plans for future childbearing
A desire to retain their uterus
What is endometriosis - Correct Answer Endometrial tissue outside of uterus that
responds to hormonal stimulation - leads to scarring, hemorrhage, adhesions etc
Etiology of endometriosis - Correct Answer Retrograde menstruation
Haematogenous or lymphatic spread
Mulleriosis
RFs for endometriosis - Correct Answer FHx
Late childbearing
Polymenorrhea
Longer periods
No use of hormonal contraception
Primary dysmenorrhea - Correct Answer Menstrual pan assoc with ovulatory cycles
in absence of pathological findings
Answers
Normal menstrual volume and duration - Correct Answer 30mls for 3-7 days
How much vaginal bleeding during period will give iron deficiency? - Correct
Answer 60ml
Definition of menorrhagia - Correct Answer >80mls
Polymenorrhea - Correct Answer Interval <24 days
Decrease in length of time between menses
An ovular
Oligomenorrhea - Correct Answer Interval >35 days
Increase in length of time between menses
Menorrhagia - Correct Answer Regular prolonged (flow lasts >8 days) and/or XS
bleeding >80mls
May lead to anemia
Metrorrhagia - Correct Answer Bleeding between periods
Irregular prolonged and XS bleeding
Causes of abnormal uterine bleeding in women of reproductive age - Correct
Answer PALM COIEN
Polyp
Adenomyosis
Leiomyoma
Malignancy + hyperplasia
Coagulopathy
Ovulatory dysfunction
Iatrogenic
Endometrial
Not yet classified - chronic inflammation/ AVMs
Rotterdam criteria - Correct Answer Diagnostic criteria for PCOS
Amenorrhea/oligomenorrhea
USS - ovarian size >10cc or 9-12 cysts on either ovary
Clinical/biochemical signs of hyperandrogenism
PCOS in pregnancy asset with what risks? - Correct Answer PET
,GDM
Microsomal
Reproductive components of PCOS - Correct Answer Oligomenorrhea
Subfertility
Hyperandrogenism
Psychological components of PCOS - Correct Answer Depression
Anxiety
Low self esteem
Eating disorders
Sexual dysfunction
Did for abnormal uterine bleeding in adolescent - Correct Answer STI
Pregnancy
An ovulatory cycles
Bleeding disorders
Dads of post-menopausal bleeding - Correct Answer Atrophy
Endometrial hyperplasia/cancer
Polyp
Chronic inflammation
RFs for hyperplasia/malignancy in context of abnormal vaginal bleeding - Correct
Answer Age
obesity;
chronic anovulation; underlying ovarian disease (PCOS, E2 producing tumors)
infertility, null parity
history of breast cancer; tamoxifen use;
failure to respond to treatment for uterine bleeding
exogenous hormone exposure - unopposed estrogen (and intact uterus): risk X 10
hereditary non-polyposis colon cancer
presence of glandular cells on pap smear
presence of endometrial cells on pap smear post-menopausal (1/3 will already have
CA)
family history of endometrial, ovarian, breast, or colon cancer
Nix for abnormal uterine bleeding - Correct Answer hCG - RULE OUT
PREGNANCY
FBC (anemia, ITP)
Fe studies + ferritin (IDA)
Cogs (vowed)
Pap smear
HVS and end cervical swabs (STI, PID)
Endometrial papilla
TV USS (polyps, fibroids, ovaries, endometrial thickness)
, Hysteroscopy and D&C
Thyroid function, PRL, Cortisol, testosterone, LH, FSH, day 21 progesterone
Treatment of abnormal uterine bleeding - Correct Answer Correct anemia (Fe, Fe
tx, RBCs, hormonal suppression of menses)
NSAIDs - mefanamic acid, ibuprofen, naproxen
Antifibrinolytic - tranexamic acid
Hormonal - COCP, POP, marina, depo, Janelle, Gnarl - diazole
Surgical - ablation, polypectomy, myomectomy, hysterectomy
Treatment of abnormal uterine bleeding with NSAIDS - Correct Answer Mefanamic
acid, Ibuprofen, Naproxen
Reduce endometrial PG levels by inhibiting cyclooxygenase 20-50%
Take 24-48 hours prior to period
Decreases dysmenorrhea
ADRs - GI bleeds, renal impairment, allergy
CIs - asthma, allergy, peptic ulcer
Treatment of abnormal uterine bleeding with Antifibrinolytic - Correct Answer
Tranexamic acid
Plasminogen activator inhibitor - prevents fibrin degradation
ADRs - GI, dizzy, headaches, thrombosis, ureteric
obstruction
CIs - active intravascular clotting, pregnancy
Surgical ablation for abnormal uterine bleeding - Correct Answer Premenopausal
Abnormal uterine bleeding due to benign disease
(egg, dysfunctional or an ovulatory bleeding)
No plans for future childbearing
A desire to retain their uterus
What is endometriosis - Correct Answer Endometrial tissue outside of uterus that
responds to hormonal stimulation - leads to scarring, hemorrhage, adhesions etc
Etiology of endometriosis - Correct Answer Retrograde menstruation
Haematogenous or lymphatic spread
Mulleriosis
RFs for endometriosis - Correct Answer FHx
Late childbearing
Polymenorrhea
Longer periods
No use of hormonal contraception
Primary dysmenorrhea - Correct Answer Menstrual pan assoc with ovulatory cycles
in absence of pathological findings
