Obstetrics and Gynaecology Flashcards

A 45-year-old reports heavy menstrual bleeding with a bulky, irregular uterus on examination. What is the most likely diagnosis?

Answer: Uterine fibroids

A bulky, irregularly enlarged uterus with menorrhagia is most consistent with uterine fibroids.

A 24-year-old with 6 weeks amenorrhoea presents with left iliac fossa pain and a positive pregnancy test, but no intrauterine sac on transvaginal ultrasound. What must be excluded?

Answer: Ectopic pregnancy

A positive test with an empty uterus and adnexal pain mandates exclusion of ectopic pregnancy.

Which organism is the most common cause of pelvic inflammatory disease in young sexually active women?

Answer: Chlamydia trachomatis

Chlamydia trachomatis is the leading cause of PID, often asymptomatic until complications arise.

A postmenopausal woman presents with vaginal bleeding. What is the most important investigation?

Answer: Transvaginal ultrasound and endometrial sampling

Postmenopausal bleeding requires endometrial assessment to exclude endometrial carcinoma.

What is the first-line investigation for suspected polycystic ovary syndrome alongside clinical features?

Answer: Pelvic ultrasound and hormonal profile

PCOS diagnosis uses the Rotterdam criteria, supported by pelvic ultrasound and hormonal testing.

A woman on the combined oral contraceptive pill develops a unilateral swollen, painful calf. What is the priority action?

Answer: Stop the pill and investigate for DVT

Combined oral contraceptives increase venous thromboembolism risk, so suspected DVT requires stopping the pill and urgent investigation.

Which test is used in the antenatal screening combined test for trisomy 21?

Answer: Nuchal translucency with PAPP-A and beta-hCG

The first-trimester combined test uses nuchal translucency, PAPP-A and free beta-hCG to estimate Down syndrome risk.