MCCQE - OBGYN block Exam Questions
and Answers (Solved Papers)
ovulatory abnormal pre-menopausal menstrual bleeding
- definition - Correct Answers ✅normal cycle length (28
days +/- 7) but abnormal (excessive) volume of blood loss:
a) menses >7days
b) blood loss >80mL
-soak through menstrual products q1-2 hours
-passage of clots larger than a dime
-self reported 'very heavy' periods
shorter luteal phase & increased fibrinolysis contributes to
menorrhagia
anovulatory pre-menopausal menstrual bleeding
- DDx (3 categories) - Correct Answers ✅1. HPO issues
- Immature HPO axis (young)
- aging ovarian follicles (older)
- premature ovarian failure (e.g. chemo/rads to pelvis)
- stress, weight loss, exercise
2. Diseases
a) Hypothyroid
b) PCOS (androgen excess)
c) Cushing's (androgen excess)
,MCCQE - OBGYN block Exam Questions
and Answers (Solved Papers)
3. Tumors/masses
a) Prolactinoma
b) STRUCTURAL --> fibroids, tumors pushing into the cavity
can cause sketchy bleeding!ova
abnormal pre-menopausal menstrual bleeding
- DDx - Correct Answers ✅PALM COEIN
Structural:
Polyp
Adenomyosis
Leiomyoma (fibroids)
Malignancy
Non-structural
Coagulopathy
- e.g. VWD
Ovulatory
- weight loss/exercise, PCOS, etc.
Endometrial
,MCCQE - OBGYN block Exam Questions
and Answers (Solved Papers)
- hyperplasia/cancer
- endometritis
Iatrogenic
- e.g. anticoagulation, IUD, FB, trauma
Not otherwise classified:
- chronic disease: hypothyroidism, liver disease, CKD, obesity
- pregnancy
- infection: STI
pre-menopausal menstrual bleeding
- pregnancy related causes (4) - Correct Answers ✅1.
Implantation bleed
2. Miscarriage
3. Ectopic pregnancy
4. Gestational trophoblastic disease
PCOS
- risks with anovulatory cycles (3)
- Tx causing infertility (2)
- Tx for those desiring fertility (2) - Correct Answers ✅Risks
1. Infertility
, MCCQE - OBGYN block Exam Questions
and Answers (Solved Papers)
2. Dysfunctional uterine bleeding (DUB)
- Can be VERY heavy
- Obesity = increased peripheral E ("fertilizer") for the
lining**Impt to use OCP or IUD with these pts
3. Endometrial hyperplasia/endometrial cancer
Tx -
1. OCP
2. IUD
Fertility Tx:
1. Weight loss
2. Metformin
Abnormal ovulatory premenstrual bleeding
- Px (3 things to look for)
- Ix - blood (4)
- Ix - imaging (3 lines) - Correct Answers ✅Px:
1. Thyroid dysfunction - clinical exam signs
2. Abdo/Pelvic exam - bimanual, assess uterine size/masses
3. Anemia - pallor, fatigue, overall appearance
Ix:
and Answers (Solved Papers)
ovulatory abnormal pre-menopausal menstrual bleeding
- definition - Correct Answers ✅normal cycle length (28
days +/- 7) but abnormal (excessive) volume of blood loss:
a) menses >7days
b) blood loss >80mL
-soak through menstrual products q1-2 hours
-passage of clots larger than a dime
-self reported 'very heavy' periods
shorter luteal phase & increased fibrinolysis contributes to
menorrhagia
anovulatory pre-menopausal menstrual bleeding
- DDx (3 categories) - Correct Answers ✅1. HPO issues
- Immature HPO axis (young)
- aging ovarian follicles (older)
- premature ovarian failure (e.g. chemo/rads to pelvis)
- stress, weight loss, exercise
2. Diseases
a) Hypothyroid
b) PCOS (androgen excess)
c) Cushing's (androgen excess)
,MCCQE - OBGYN block Exam Questions
and Answers (Solved Papers)
3. Tumors/masses
a) Prolactinoma
b) STRUCTURAL --> fibroids, tumors pushing into the cavity
can cause sketchy bleeding!ova
abnormal pre-menopausal menstrual bleeding
- DDx - Correct Answers ✅PALM COEIN
Structural:
Polyp
Adenomyosis
Leiomyoma (fibroids)
Malignancy
Non-structural
Coagulopathy
- e.g. VWD
Ovulatory
- weight loss/exercise, PCOS, etc.
Endometrial
,MCCQE - OBGYN block Exam Questions
and Answers (Solved Papers)
- hyperplasia/cancer
- endometritis
Iatrogenic
- e.g. anticoagulation, IUD, FB, trauma
Not otherwise classified:
- chronic disease: hypothyroidism, liver disease, CKD, obesity
- pregnancy
- infection: STI
pre-menopausal menstrual bleeding
- pregnancy related causes (4) - Correct Answers ✅1.
Implantation bleed
2. Miscarriage
3. Ectopic pregnancy
4. Gestational trophoblastic disease
PCOS
- risks with anovulatory cycles (3)
- Tx causing infertility (2)
- Tx for those desiring fertility (2) - Correct Answers ✅Risks
1. Infertility
, MCCQE - OBGYN block Exam Questions
and Answers (Solved Papers)
2. Dysfunctional uterine bleeding (DUB)
- Can be VERY heavy
- Obesity = increased peripheral E ("fertilizer") for the
lining**Impt to use OCP or IUD with these pts
3. Endometrial hyperplasia/endometrial cancer
Tx -
1. OCP
2. IUD
Fertility Tx:
1. Weight loss
2. Metformin
Abnormal ovulatory premenstrual bleeding
- Px (3 things to look for)
- Ix - blood (4)
- Ix - imaging (3 lines) - Correct Answers ✅Px:
1. Thyroid dysfunction - clinical exam signs
2. Abdo/Pelvic exam - bimanual, assess uterine size/masses
3. Anemia - pallor, fatigue, overall appearance
Ix:
