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Obstetrics and Gynaecology
Published in Seema Khan, Get Through, 2020
For each patient below, choose the SINGLE most likely diagnosis from the list of options. Each option may be used once, more than once or not at all. A 33-year-old multiparous woman of 32 weeks’ gestation complains of severe back pain. Urinalysis reveals red blood cells. She is apyrexial.A 25-year-old woman who is a primigravida of 8 weeks’ gestation presents with severe lower abdominal cramping, vaginal bleeding and the passage of clots. The internal os is open.A 28-year-old woman who is a primigravida of 10 weeks’ gestation presents with sudden, severe lower abdominal pain. The abdomen is rigid and the uterus tender.A 30-year-old multiparous woman of 16 weeks’ gestation presents with lower abdominal pain and tenderness. On examination she has a fundal height of 25 cm and you palpate a firm mass. She also complains of urinary frequency but denies dysuria. There is only one fetal heart beat.A 26-year-old nulliparous woman of 20 weeks’ gestation presents with headache and epigastric pain. BP is 150/100 and rising.
SBA Questions
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
A 40-year-old woman who presented with vague intermittent lower abdominal pain of 3 months duration has been diagnosed with a simple ovarian cyst on ultrasound scan. What is the approximately risk of this cyst being malignant?1:10002:10003:10004:10005:1000
Unexplained Fever In Gynecology
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Jacob R. Cohen, Michael Burke, Amos Ber
The clinical presentation is variable. Lower abdominal pain is frequently present and may be accompanied by fever, chills, nausea, vomiting, diarrhea, pain on defecation, dysuria, and dyspareunia. Physical examination may reveal abdominal distention and rebound tenderness. White blood cell count and ESR are usually elevated. Anemia is frequently found, especially in patients with a chronic abscess. Ultrasonography may be helpful in demonstrating pelvic abscess.33
Factors influencing USgHIFU ablation for adenomyosis with NPVR ≥ 50%
Published in International Journal of Hyperthermia, 2023
Jing-Wen Yu, Mei-Jie Yang, Li Jiang, Xue-Yao Su, Jin-Yun Chen
No major complications occurred in patients after treatment. The main complication reported by 73.2% of patients was lower abdominal pain. Other adverse events included sacral tail or hip pain (19.4%), vaginal discharge (18.4%), numbness and pain in the lower limb (2.0%), fever (0.7%), nausea or vomiting (0.7%), and pain and distension of the anus (0.7%). In addition, one patient with an old surgical scar on the abdominal wall developed an orange peel appearance (2 mm × 3 mm) of the skin within the ultrasonic pathway. Skin lesions healed with dressing change. Another patient had dysuria and urinated successfully on the night of the HIFU treatment. A total of 65 patients (21.7%) experienced nominal therapy determined by their SIR grade B complications. All patients recovered within 7 days after treatment. The incidence of sacral tail or hip pain was 25.0% in the NPVR <50% group and 14.5% in the NPVR ≥50% group, and there was a significant difference between the two groups (p < 0.05) (Table 2).
Intravascular leiomyomatosis; mimicking low grade endometrial sarcoma
Published in Journal of Obstetrics and Gynaecology, 2022
Negin Sadeghi, Susan Addley, Moiad Alazzam, Zoe Traill, Catherine A. Johnson, Mark McCole, Hooman Soleymani Majd
IVL forms within the vascular vessels of the uterus (Yano et al. 2020), and is usually confined to the venous system of the uterus. This should not be confused with benign metastasising leiomyoma, in which a benign uterine leiomyoma is associated with a benign smooth muscle tumour located in the parenchyma of a distant organ, such as the lung (Radswiki n.d.) For most cases, IVL does not migrate to large vessels and remains within the uterus, However, this benign tumour has the potential to invade further intravascularly and make its way to the right atrium through the inferior vena cava (IVC). The majority of the patients only present with pelvic symptoms, including lower abdominal pain and abnormal uterine bleedings. In unfortunate cases when IVL occludes the vessels significantly, patients experience degrees of exertional dyspnoea, shortness of breath, syncope, and right heart failure and even pulmonary embolism and sudden death (Shi and Shkrum 2018). The first case of IVL with intracardiac involvement was reported in 1907 and fewer than 300 cases have been reported worldwide so far (Yano et al. 2020).
The effect of adenomyosis on endometrial cancer: a university hospital-based cohort study
Published in Journal of Obstetrics and Gynaecology, 2022
Engin Celik, Hale Goksever Celik, Hamdullah Sozen, Semen Onder, Ozgur Aydin Tosun, Samet Topuz, Mehmet Yavuz Salihoglu
As one of our main results, we found that EC in women with adenomyosis had less invasive features. The main reason why EC is diagnosed at a less advanced stage in these patients is that women with adenomyosis consult the clinics due to their adenomyosis-related complaints, especially in premenopausal period (Nelsen et al. 2018). These symptoms are usually abnormal uterine bleeding, and lower abdominal pain or discomfort. On the other hand, the diagnosis of EC in the patients without adenomyosis is usually due to postmenopausal bleeding at an older age. Although there was no statistical significance, the patients in the adenomyosis group were also younger comparing with those in the non-adenomyosis group in our study. Furthermore, only follow-up without the need for additional treatments was adequate for the postoperative follow-up of EC in the patients with adenomyosis due to the detection of EC at earlier stages.