PLAB PLAB Obstetrics & Gynecology 2

Question 1

A 45-year-old woman presents with heavy menstrual bleeding, pelvic pressure, and urinary frequency. Pelvic examination reveals an enlarged, irregular uterus. What is the most likely diagnosis?

Accepted Answer

Uterine fibroids (leiomyomas)

Answer

Uterine fibroids (leiomyomas) are benign smooth muscle tumors causing uterine enlargement with irregular contour, heavy menstrual bleeding, and bulk symptoms such as pelvic pressure and urinary frequency.

Question 2

Which hormone is measured in a serum pregnancy test, and at what level does a transvaginal ultrasound typically visualize an intrauterine gestational sac?

Accepted Answer

hCG; >1500–2000 mIU/mL

Answer

Human chorionic gonadotropin (hCG) is produced by the syncytiotrophoblast after implantation, and a transvaginal ultrasound can typically identify an intrauterine gestational sac when hCG exceeds 1500–2000 mIU/mL (the discriminatory zone).

Question 3

A 50-year-old postmenopausal woman presents with vaginal bleeding. What is the most important first investigation?

Accepted Answer

Endometrial biopsy

Answer

Postmenopausal bleeding must be evaluated with endometrial biopsy (or transvaginal ultrasound measuring endometrial thickness) to exclude endometrial carcinoma, which is the most concerning cause.

Question 4

Which condition is characterized by endometrial glands and stroma found within the myometrium, causing dysmenorrhea and a uniformly enlarged uterus?

Accepted Answer

Adenomyosis

Answer

Adenomyosis is defined by ectopic endometrial glands and stroma embedded within the myometrium, resulting in a symmetrically enlarged, globular uterus and severe dysmenorrhea with heavy menstrual bleeding.

Question 5

What is the mechanism of action of combined oral contraceptive pills (COCPs) in preventing pregnancy?

Accepted Answer

Inhibiting ovulation via suppression of LH and FSH

Answer

COCPs primarily work by suppressing the LH surge and FSH release through negative feedback on the hypothalamic-pituitary axis, thereby inhibiting ovulation; secondary mechanisms include cervical mucus thickening and endometrial changes.

PLAB - Professional and Linguistic Assessments Board Practice Test

PLAB - Professional and Linguistic Assessments Board Practice Test

PLAB PLAB Obstetrics & Gynecology 2