gynecology

A 17-year-old teenage girl presents with menorrhagia and a family history of heavy periods and hysterectomy, suggestive of Von Willebrand Disease (VWD). Which statement about VWD is correct?

A 62-year-old woman presents with a 4-month history of increasing abdominal distension, bloating, and a sensation of early fullness after eating. She has also noticed a gradual increase in her waist circumference and reports feeling more fatigued than usual. Her medical history includes well-controlled type 2 diabetes mellitus and hypercholesterolaemia, managed with metformin and atorvastatin respectively. She is post-menopausal, having completed menopause 10 years ago. On physical examination, her vital signs are stable: blood pressure 128/78 mmHg, heart rate 68 bpm, respiratory rate 14/min, and temperature 36.6°C. Abdominal examination reveals moderate distension and a firm, irregular mass is palpable extending from the pelvis into the lower abdomen. Bowel sounds are present and normal. A recent transvaginal ultrasound was inconclusive due to the size of the mass, prompting a CT scan of the abdomen and pelvis, an axial image from which is shown. Given the clinical presentation and the findings on the image, what is the most appropriate immediate next step in the management of this patient?

A patient has a pathogenic variant in MLH1 identified via genetic testing. What cancer screening is most strongly indicated?

A 28-year-old female presents to the ED with acute onset right lower quadrant pain. She reports nausea and vomiting. Her last menstrual period was 6 weeks ago, and she denies any vaginal bleeding. She is hemodynamically stable. A CT scan of the abdomen and pelvis is performed, with a relevant image shown. Considering the clinical presentation and the imaging findings, what is the MOST appropriate next step in the management of this patient?

A 55-year-old woman presents to her general practitioner with a 3-month history of increasing abdominal bloating, early satiety, and a vague, intermittent dull ache in her lower abdomen. She reports a 5 kg weight loss over the same period, which she attributes to reduced appetite. Her last menstrual period was 5 years ago. She has a past medical history of well-controlled hypertension and osteoarthritis. She is on perindopril and paracetamol as needed. On physical examination, her vital signs are stable (BP 130/80 mmHg, HR 72 bpm, RR 16/min, Temp 36.8°C). Abdominal examination reveals mild distension and a firm, non-tender mass palpable in the suprapubic and left iliac fossa regions, estimated to be about 8 cm in size. Bowel sounds are normal. Pelvic examination is deferred due to patient discomfort and preference for imaging first. Routine blood tests, including full blood examination, urea and electrolytes, liver function tests, and C-reactive protein, are all within normal reference ranges. A CT scan of the abdomen and pelvis is performed to investigate her symptoms, an axial image from which is shown. Considering the clinical presentation and the findings on the image, what is the most appropriate immediate next step in the management of this patient?

A 55-year-old woman presents to her general practitioner with a 3-month history of increasing abdominal bloating, early satiety, and a vague, intermittent dull ache in her lower abdomen. She reports a 5 kg weight loss over the same period, which she attributes to reduced appetite. Her last menstrual period was 5 years ago. She has a past medical history of well-controlled hypertension and osteoarthritis. She is on perindopril and paracetamol as needed. On physical examination, her vital signs are stable (BP 130/80 mmHg, HR 72 bpm, RR 16/min, Temp 36.8°C). Abdominal examination reveals mild distension and a firm, non-tender mass palpable in the suprapubic and left iliac fossa regions, estimated to be about 8 cm in size. Bowel sounds are normal. Pelvic examination is deferred due to patient discomfort and preference for imaging first. Routine blood tests, including full blood examination, urea and electrolytes, liver function tests, and C-reactive protein, are all within normal reference ranges. A CT scan of the abdomen and pelvis is performed to investigate her symptoms, an axial image from which is shown. Considering the clinical presentation and the findings on the image, what is the most appropriate immediate next step in the management of this patient?