1. The following are possible causes of primary amenorrhea in a 19 years old female with developed secondary sexual characteristics.

 
 
 
 
 

2. For the following scenario, select the most likely diagnosis from the list:

A 27-year-old woman with 2 previous early pregnancy losses presents with vaginal spotting 6 weeks after her last menstrual period. A transvaginal ultrasound scan shows a complex echogenic mass in uterine cavity containing multiple discrete cystic spaces. Both ovaries show small cysts. A urinary pregnancy test is positive.

 
 
 
 
 
 
 
 
 
 

3. A 50-year-old woman with a BMI of 22 kg/m 2 complains of severe hot flushes and sleep disturbance. On enquiry, she reports that she is currently suffering from heavy irregular periods and some discomfort during sexual intercourse. She is otherwise health and is on no medications.

Which one of the following treatment options would be the most appropriate for this woman?

 
 
 
 
 

4. For the following scenario select the most appropriate treatment from the list:

A 30-year-old single woman attends the gynaecological outpatient clinic complaining of intermittent lower abdominal pain over the last 2 months. Her past medical history is unremarkable. Bimannual vaginal examination shows a pelvic tumor, which in an ultrasound scan is a 12 cm cyst with characteristics typical of a dermoid and some solid components.

 
 
 
 
 
 
 
 
 
 

5. For the following scenario select the most appropriate treatment from the list:

A 64-year-old woman had been treated for a FIGO stage Ia endometrioid endometrial cancer with total hysterectomy and bilateral salpingo-oophrectomy. Two years later she presents with vaginal bleeding. Clinical examination with biopsy reveals the presence of a localized recurrence on the vaginal vault.

 
 
 
 
 
 
 
 
 
 

6. For the following scenario select the most appropriate management from the list:

A 28-year-old nulliparous woman in labour at 39 weeks has been in the second stage of labour for 75 minutes. The fetal head is at station +2 in direct occipito-anterior (DOA) position. The CTG is normal.

 
 
 
 
 
 
 
 
 
 

7. The following conditions are contraindications against the use of intrauterine contraceptive devices.

 
 
 
 
 

8. A 20-year-old woman in her first pregnancy at 39 weeks is rushed into the labour ward from the antenatal ward with a seizure. She had been noted to have developed a blood pressure of 140/95 mmHg with albuminuria the previous day and had been admitted for further assessments and management. Her biochemistry shows a haemoglobin of 10.5 mg/dL, platelets
of 9,000 x 10 9 /L, Lactate dehydrogenase 700 U/L [Normal<524], aspartate aminotransferase 85 U/L [Normal <32], serum creatinine 90 µmol/L [Normal: <80] and blood urea nitrogen 4.5 mmol/L [Normal: <3.9].

What one of the following management options is the most appropriate first-line measure?

 
 
 
 
 

9. For the following scenario select the most appropriate management from the list:

A 26-year-old nulliparous pregnant woman at 38 weeks is in the second stage of labour. After 60 minutes, there is no evidence of fetal head descent with each contraction. Ventouse delivery attempted without success (cup detached 3 times). The CTG is reassuring.

 
 
 
 
 
 
 
 
 
 

10. For the following scenario select the most appropriate treatment from the list:

A 28-year-old, para 2, woman with normal menstrual cycles attends the gynaecological outpatient clinic, because of vaginal bleeding 15 days after her last menstrual period. Her past medical history is unremarkable. Clinical examination shows no abnormality, although a transvaginal ultrasound scan shows a left-sided ovarian cyst of 7 cm in diameter with characteristics typical of a dermoid.

 
 
 
 
 
 
 
 
 
 

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