Test yourself with this set of MCQs on a wide range of causes of abnormal mnenstrual bleeding. Remember anyone with a uterus can have abnormal menstrual bleeding, not just women!
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Approach to Patient with abnormal menstrual bleeding
Stem 1, question 1 of 5
Amina, a 16 year old female, presents to her GP worried that she has not started having periods.What is primary amenorrhoea?
A lack of menses in a non-pregnancy person with a uterus for at least 3 cycles of their previous interval
A lack of menses for 6 months in a patient who was previously menstruating
Any variance of the normal menstrual cycle defined on the basis of frequency, regularity, duration and volume
Uterine bleeding at irregular intervals, particularly between expected menstrual periods
A lack of menses at age 15 in a patient with appropriate development of secondary sexual characteristics or absent menses by age 13 years and no other pubertal maturation
Stem 1, question 2 of 5Which of the following can present with amenorrhoea? Select all that apply
Polycystic ovary syndrome
Premature ovarian failure
Stem 1, question 3 of 5
The GP performs some blood tests to investigate the cause of Amina's amenorrhoea. The results are: High serum LH High serum testosterone Elevated total cholesterol and LDL-cholesterol Low HDL-cholesterol Normal prolactinWhat is the most likely diagnosis based on these blood results?
Polycystic ovary syndrome
Female athlete triad
Stem 1, question 4 of 5
Amina is diagnosed with polycystic ovary syndrome. The GP calculates her BMI 32.What would be appropriate management for Amina?
Combined oral contractive pill
Supported weight loss
Stem 1, question 5 of 5What is the mechanism of the oral combined contraceptive?
Mimics ovulation, reduces LH and FSH
Mimics ovulation, reduces LH and FSH, endometrial changes
Suppresses ovulation, increases LH and FSH
Suppresses ovulation, reduced LH and FSH
Suppreses ovulation, no effect on LH and FSH
Stem 2, question 1 of 3
Priyanka, a 56 year old female, presents to GP with post menopausal bleeding. She went through menopause at 49, has had 3 pregnancies and takes HRT patches.What is post-menopausal bleeding?
Vaginal bleeding that occurs within 2 years of menopause establishment
Vaginal bleeding that occurs >6 months after menopause has been established
Vaginal bleeding that occurs >18 months after menopause has been established
Vaginal bleeding that occurs >12 months after menopause has been established
Vaginal bleeding that occurs 5 years after menopause has been established
Stem 2, question 2 of 3
Uterine malignancy is associated with an inherited genetic predisposition to uterine cancerWhich of the following inherited syndromes predisposes to uterine cancer?
Hereditary non-polyposis colon cancer
Familial adenomatous polyposis
Stem 2, question 3 of 3
The GP examines PriyankaWhat is the most likely examination finding of uterine malignancy?
Uterine tenderness on examination
Uterine enlargement and irregularity on bimanual examination
Uterine, cervical motion and adnexal tenderness
Excessive body hair, acne and obesity
Smooth muscle only
Fibrous connective tissue only
Smooth muscle and fibrous connective tissue
Cora, an 8 year old female, presents to GP with her worried parents. Cora has noticed blood in her underwear for 3 days and her parents have noticed she has started to develop breasts.What differential should the GP suspect?
Infection of the vagina