Ginecología y Obstetricia Quiz

17-year-old patient without menarche, with Tanner III breast development. What initial study is a priority?

• FSH/LH dosage

• Karyotype

• Pelvic ultrasound

• Pituitary MRI

Answer explanation

In a 17-year-old with no menarche and Tanner III breast development, a pelvic ultrasound is prioritized to assess for anatomical abnormalities such as the presence of the uterus and ovaries, which is crucial for further evaluation.

What is the most common cause of secondary amenorrhea in women with BMI <18?

• Hyperprolactinemia

• PCOS

• Functional hypothalamic amenorrhea

• Premature ovarian failure

Answer explanation

Functional hypothalamic amenorrhea is the most common cause of secondary amenorrhea in women with a BMI <18, often due to stress, low body weight, or excessive exercise, leading to disrupted hormonal regulation.

In Sheehan's syndrome, the characteristic hormonal finding is:

• Increased TSH

• Decreased cortisol

• Elevated prolactin

• Undetectable LH/FSH

Answer explanation

In Sheehan's syndrome, the pituitary gland is damaged due to severe blood loss during or after childbirth, leading to decreased cortisol production. This is the characteristic hormonal finding in this condition.

According to Rotterdam criteria, which element is NOT required for the diagnosis of PCOS?

• Oligoovulation

• Elevated testosterone levels

• Polycystic ovaries on ultrasound

• Insulin resistance

Answer explanation

Insulin resistance is not a required element for diagnosing PCOS according to the Rotterdam criteria. The diagnosis can be made with any two of the following: oligoovulation, elevated testosterone levels, or polycystic ovaries on ultrasound.

Woman with PCOS and infertility. What is the first-line treatment for ovulation induction?

• Metformin

• Clomiphene citrate

• Gonadotropins

• Dexamethasone

Answer explanation

Clomiphene citrate is the first-line treatment for ovulation induction in women with PCOS and infertility, as it effectively stimulates ovulation by blocking estrogen receptors, leading to increased gonadotropin release.

What is the most common location of deep endometriosis?

• Ovaries

• Uterosacral ligaments

• Rectovaginal septum type II

• Vesical peritoneum

Answer explanation

The rectovaginal septum type II is the most common site for deep endometriosis, as it is frequently involved in the disease process, leading to significant pain and complications in affected individuals.

Patient with stage IV endometriosis (ASRM) and infertility. What surgical treatment is indicated?

• Hysterectomy

• Laparoscopic cytoreduction

• Bilateral oophorectomy

• Endometrial ablation

Answer explanation

Laparoscopic cytoreduction is indicated for stage IV endometriosis with infertility as it aims to remove endometriotic lesions and adhesions, potentially improving fertility, unlike hysterectomy or oophorectomy which remove reproductive organs.

45-year-old woman with metrorrhagia and ultrasound showing endometrium of 18 mm. What is the confirmatory study?

• Hysteroscopy with biopsy

• β-hCG dosage

• Cervicovaginal cytology

• Pelvic MRI

Answer explanation

Hysteroscopy with biopsy is the confirmatory study for evaluating abnormal endometrial thickness (18 mm) and metrorrhagia in a 45-year-old woman, allowing for direct visualization and tissue sampling.

What non-hormonal treatment is effective for abnormal uterine bleeding?

• Tranexamic acid

• Danazol

• NSAIDs

• Copper IUD

Answer explanation

Tranexamic acid is effective for abnormal uterine bleeding as it helps reduce heavy menstrual bleeding by inhibiting fibrinolysis. It is a non-hormonal option, making it suitable for patients who cannot use hormonal treatments.

What is the pathogen most associated with bacterial vaginosis?

• Candida albicans

• Gardnerella vaginalis

• Trichomonas vaginalis

• Chlamydia trachomatis

Answer explanation

The pathogen most associated with bacterial vaginosis is Gardnerella vaginalis. This bacterium is commonly found in the vaginal flora and is a key contributor to the imbalance that characterizes bacterial vaginosis.