EBCOG Part 1 Free Library High Yield Questions Day 3

For each of the following clinical scenario, choose the single diagnosis most suitable from the list provided. Each option may be used once, more than once or not at all.
A. CA bladder
B. Mixed urinary incontinence
C. Neurogenic bladder
D. Overactive bladder
E. Overflow incontinence
F. Painful bladder syndrome
G. Urethral caruncle
H. Urethral diverticulum
I. Urethral prolapse
J. Urinary stress incontinence
L. Urogenital atrophy
M. Vesico-vaginal fistula
1.  A 59-yr old nullip woman presents with recurrent dysuria and frequency worsening over the past six months. She smokes 20 cigarettes per day. Repeated MSUs at her GP have never demonstrated infection. Urinalysis demonstrates ++ haematuria. You have sent repeat MSU for microscopy, culture, and sensitivity.
2. A 28-yr old woman presents ten days after an anterior
colporrhaphy for cystocele. She complaints of feeling constantly damp vaginally and is having to wear pads continuously.
3. A 62-yr old postmenopausal woman presents with an 8 months history of dysuria and vulval pain. On examination, a pink exophytic lesion is observed at the urethral meatus.
4. A 46-yr old woman who has had 3 previous vaginal delivery presents with a 2 yrdeteriorating history of leakage of urine on coughing, sneezing, and during exercise. On examination a moderate cystocele and rectocele is observed.
5. A 58-yr old woman presents with a 9 month history of urinary frequency, urgency, and pelvic pain. Investigations including urodynamic have been normal.
For each of the following clinical scenario, choose the single most appropriate management option from the list provided. Each option may be used once, more than once or not at all.
A. Diagnostic Laproscopy
B. Etoposide, Methotrexate, Actinomycin, Paclitaxel
C. Etoposide, Methotrexate, Dactinomycin, cyclophosphamide and vincristine
D. Evaluation of the uterus with mifepristone, misoprostol and systocinon
E. Evaluation of the uterus with misoprostol
F. Hysteroscopy
G. Laproscopy
H. Methotrexate
I. Methotrexate and folic acid
J. Refer to tertiary hospital
K. Refer to local specialist centre
L. Register with regional centre and ask for advice
M. Repeat evacuation of the uterus
N. Repeat HCG 48 hr
O. Repeat serum HCG
P. Syntocinon infusion
Q. Treat as normal
R. USG scan

6. A 21-yr old woman attended the hospital at 6 wks of amenorrhea and a +ve home pregnancy test. A likely miscarriage was diagnosed on USG and she opted for surgical evacuation. Product of conception demonstrated partial H. mole.
7. The same 21-yr old woman re-attends hospital 15 weeks later with persistent vaginalbleeding. Her serum HCG has risen to 6000 mIU/ml.
8. A 43-yr old multiparous woman is diagnosed with gestational neoplastic disease 3 months
following a surgical termination. Her serum HCG is 10,000 mIU/ml. she has 2 small (1 cm)
metastases in the lung.
9. A 24-yr old multiparous woman is diagnosed with GTN 6 months following a partial mole and has a single 6 cm metastasis in the liver.

A 21-yr old primiparous woman who has had a previous molar pregnancy is now pregnant one year later. Herpregnancyappears to be progressing well. How would u manage her following delivery?