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频道帖子

تم بحمد الله وتوفيقه ما كان من صواب فمن الله وما كان من خطأ فمن نفسي، اسأل الله لكم التوفيق والتسيير والسداد 🍀

2	▪️EMQs (2020 - 2025) - Bleeding in Pregnancy - Medical Disorders in Pregnancy - Labour - Obstetrics Emergency - Antenatal care and Antenatal screening - Puerperium - Maternal Mortality - Endometriosis - Genital prolapse - Family planning - Menstrual Cycle - Vaginal Discharge - Hirsutism - Gynaecological conditions - Infertility - Amenorrhea - Gynaecological investigations - Sexual differentiation	941
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4	5. Mrs. G A, 18 y, newly married C/O difficult incomplete intercourse, she don't have menses before, O/E her height 172cm, good breast development, scanty axillary & pubic hair, inguinal hernia was felt, short blind vagina, by ultrasound no uterus or ovary. Answer: H. complete androgen insensitivity syndrome Explanation: Complete Androgen Insensitivity Syndrome (CAIS) is characterized by an XY individual who appears female but has scanty pubic and axillary hair (due to androgen receptor resistance) and a short, blind-ending vagina with an absent uterus. Inguinal hernias in these patients often contain the undescended testes. They are typically tall with excellent breast development because testosterone is converted peripherally to oestroge	198
5	4. new born with ambiguous genitalia, investigated plasma 17 α hydroxyprogesteron was high, uterus present, X-ray with gastografin vagina was seen. Answer: I. Congenital adrenal hyperplasia CAH Explanation: High levels of 17-hydroxyprogesterone are pathognomonic for the most common form of Congenital Adrenal Hyperplasia (CAH). This condition causes an excess of androgens in a 46,XX fetus, leading to ambiguous genitalia (virilization) at birth, while the internal Müllerian structures (uterus and vagina) remain present	139
6	3. 16 y, single, C/O primary amenorrhea, O/E poor breast development, normal hair, by US small uterus and ovaries was not visualized (streaks gonads). Answer: A. Gonadal dysgenesis (Swyer’s syndrome) Explanation: Swyer syndrome (46,XY complete gonadal dysgenesis) presents with primary amenorrhea and a uterus because the dysgenetic streak gonads produce no AMH to regress the Müllerian structures. Unlike Turner syndrome, these patients typically have normal stature and no associated somatic stigmata, but they lack breast development due to the absence of ovarian oestrogen	127
7	2. 13 y, girl, Presented with some ambiguous genitalia since birth with increasing virilization during last year, by ultrasound no uterus or ovary, testosterone level was high, karyotype XY. Answer: C. partial 5α-reductase deficiency Explanation: In 5-alpha-reductase deficiency, an XY fetus has functioning testes that produce AMH (causing Müllerian duct regression, hence no uterus/ovaries) and testosterone. However, the inability to convert testosterone to dihydrotestosterone (DHT) leads to ambiguous genitalia at birth. At puberty, the massive spike in testosterone causes significant virilization in a child previously assigned female	118
8	1. 19 y, C/O delayed menarchea, on examination her height 148cm, under developed breast wide spaced nipple, webbing of the neck. Answer: B. Turner's syndrome Explanation: Short stature (148 cm), a webbed neck, and wide-spaced nipples (shield chest) are classic phenotypic features of Turner’s syndrome (45,XO). Delayed menarche occurs because the ovaries are streak gonads that fail to produce the oestrogen required for breast development and menstruation	98
9	Choose the most likely diagnosis for the following cases:	102
10	Theme: Sexual differentiation A. Gonadal dysgenesis (Swyer’s syndrome). B. Turner's syndrome. C. partial 5α-reductase deficiency. D. Klinefelter syndrome. E. Asherman's syndrome. F. True hermaphrodite. G. AMH absent. H. complete androgen insensitivity syndrome. I. Congenital adrenal hyperplasia CAH. J. Triple X female.	101
11	Sexual differentiation ⬇️	99
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13	5. A 28-year-old woman is a known polycystic ovaries, unable to conceive for 3 years, infertility work up reveled anovulation, spermogram of her husband was normal. Answer: B. Clomiphene citrate Explanation: For women with anovulatory infertility due to PCOS, the goal is ovulation induction. Clomiphene citrate is a common first-line anti-oestrogen medication used for this purpose; it works by stimulating the release of FSH and LH to initiate the growth of ovarian follicles	108
14	4. A short stature 14-year-old girl, her chromosomal study revealed karyotyping 45XO (Turner's syndrome). Answer: D. Growth hormone Explanation: Turner syndrome (45,XO) typically presents with short stature and streak gonads. Management by a multidisciplinary team involves the use of growth hormone during childhood and adolescence to increase final height, alongside subsequent hormone replacement to induce and maintain puberty	88
15	3. A 24-year-old girl (unmarried) is a known case of polycystic ovaries (PCO) hirsutism and oligomenorrhea, her main concern is the excessive hair growth. Answer: G. Cyproterone acetate + ethinyl estradiol (Diane 35) Explanation: For women with hirsutism (excessive hair growth) who are not currently seeking pregnancy, the combined oral contraceptive pill (COCP) is the treatment of choice. Specifically, the combination of cyproterone acetate and ethinyl estradiol (brand name Diane 35 or Dianette) provides both cycle control and a potent anti-androgenic effect that reduces hair growth and acne	74
16	2. A 26-year-old woman has galactorrhea, a raised serum prolactin and amenorrhoea and she plan to conceive. Answer: F. Cabergoline Explanation: Galactorrhea and amenorrhoea in the presence of raised prolactin indicate hyperprolactinaemia, often caused by a pituitary prolactinoma. The first-line medical treatment is a dopamine agonist such as cabergoline or bromocriptine. These medications effectively lower prolactin levels, shrink the tumor, and restore ovulatory function and fertility	71
17	1. A 60-year-old woman has presented with urge incontinence and frequency 6 months duration, Urodynamic study revealed detrusor over activity. Answer: A. Oxybutynin Explanation: Detrusor overactivity is the urodynamic diagnosis associated with overactive bladder (OAB) syndrome. After conservative measures like bladder retraining, anticholinergic medications are the mainstay of medical treatment. Oxybutynin is an anticholinergic drug that works by blocking muscarinic receptors in the bladder to inhibit involuntary contractions	73
18	For each of the following conditions select the most appropriate drug treatment from the list above. Each drug may be used once, more than once or not at all.	76
19	Theme: Medical therapy in gynaecology A. Oxybutynin. B. Clomiphene citrate. C. Progestogens. D. Growth hormone. E. Tranexamic acid. F. Cabergoline. G. Cyproterone acetate + ethinyl estradiol (Diane 35). H. Mefenamic acid. I. Metformin. J. Tamoxifen.	78
20	Medical Therapy in Gynaecology ⬇️	74

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