Endometriosis.- General Gynaecology module part2
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22. A 32-year-old woman with pain is diagnosed to have endometriosis. She has been trying to conceive for over 18 months. Which of the following is true?
A 38-year-old woman presents to the gynaecology clinic with a two year history of worsening non-cyclical pelvic pain and dysmenorrhoea. An USS pelvis was normal. She has no other medical history of note and smokes 10 cigarettes per day. What is the most appropriate initial treatment?
3) Which carcinoma associated with endometriosis?
A 44-year-old woman had a total abdominal hysterectomy with bilateral salpingo-ophorectomy for long-standing pelvic pain due to severe endometriosis. On her return home she is struggling to climb the stairs. There is also some abnormal sensation over the thigh as well as her right calf. On examination, the GP has established a loss of the knee jerk reflex. Which nerve/s is most likely to have been injured during the operation?
A 30 yr old nulliprous womn married since 10 yrs came wth complain of lower abdominal pain dysmenorhea n dyspareunia ultrasoind shows complex adnexal mass of 10 cm ×10 xm the msot proble dignosis is
A 34-year-old woman presents with chronic pelvic pain. The pain is worse during the premenstrual period, associated with fatigue, and is exacerbated by standing, walking and gardening. The pain worsens after intercourse, resulting in a throbbing ache afterwards. This has resulted in significant relationship difficulties. What is the definitive investigation to establish the diagnosis in this case?
7) TAH+BSO done for endometriosis now depression and hot flushes
A 30-year-old presents to the clinic with lower abdominal pain, altered bowel habits, dyspareunia and dysmenorrhoea. Clinical examination fails to identify any signs of pathology. You suspect irritable bowel syndrome. What first treatment will you recommend?
Lady C/O chronic pelvic pain that worsens during menstruation . what are the chances that she has endometriosis
A 25-year-old woman has been trying to conceive for 2 years. She has painful periods and occasional dyspareunia. On examination, the GP felt that the uterus was retroverted with reduced mobility and there were palpable nodules in the rectovaginal septum. The GP has done the following investigations: full blood count – normal thyroid function – normal day 21 progesterone – normal FSH and LH level - normal rubella serology – immune Chlamydia swab – negative pelvic ultrasound – normal partner's semen analysis – normal. She is now referred to the gynaecology outpatient clinic. Which is the most appropriate management now?
11) RISK FACTORS OF ENDOMETRIOSIS
8. A 30-year-old nulliparous woman is referred to you complaining of cyclical pelvic pain and abdominal swelling. A pelvic ultrasound suggests a diagnosis of adenomyosis. What is your first-line management?
A 25-year-old presents with lower abdominal pain of 12 months duration. The pain is worse around her menses, which are also heavy. Sexual intercourse is painful. She has altered bowel habits especially around menstruation. You suspect that she may have either irritable bowel syndrome or endometriosis or both. What approach will you take to differentiate between the two conditions?
Ms XY is 38 years old and suffers from primary infertility and endometriosis. Her recent TV scan suggests the presence of a 2.5 cm endometrioma. Her pain is well controlled using simple analgesics. She is due to undergo IVF. Which treatment is best suited to deal with her endometrioma?
A 53-year-old woman is referred to gynaecology clinic with a 12 month history of bloating, change in stool frequency and intermittent pelvic pain. She is still having regular periods and has no other medical or surgical history of note. What is the most important first investigation to perform?
A 24-year-old woman, virgo intacta, presents to the gynaecology clinic with abdominal and pelvic pain, dysmenorrhoea and dyschezia. What is the most appropriate initial assessment for the diagnosis of endometriosis?
A 23 year old woman with a 3 year history of pelvic pain and deep dyspareunia has been consented for a diagnostic laparoscopy because her symptoms have not responded to medical treatment. At laparoscopy, she is found to have deposits of endometriosis in the ovarian fissae, utero-sacral ligaments and bilateral 3-4cm ovarian endometriomas with adhesions. t
H MRI pelvis I Dilatation and curettage J Endocervical and urethral swabs K Commence combined oral contraceptive pill L Levonorgestrel IUS M Refer to pain clinic N Refer to gastroenterologist
. A 35-year-old woman presents to the gynaecology clinic with pelvic pain and dysmenorrhoea. A pelvic examination demonstrates tenderness and fullness in the right iliac fossa. Which test should be used to diagnose or exclude an ovarian endometrioma?
A nulliparous woman had dysmenorrhea and history of subfertility. On laproscopy she was found to have grade 3 endometriosis. Which of the following would be the treatment of choice in her case?
You are consenting a patient prior to laparoscopic resection of extensive endometriosis. What is the most common major complication of gynaecological laparoscopic surgery?
Young patient with history of lower abdominal pain more intense near periods, intense dyschezia and relieved after that she wants to know whether it is IBS or endometriosis. What is your investigation?
A woman with a previous diagnosis of pelvic endometriosis presents to the clinic with cylical rectal bleeding. Vaginal and rectal examinations are inconclusive. What is the most appropriate initial assessment to identify or exclude rectal endometriosis
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