Summary of All Answers Covered

Paper I - Uterovaginal Prolapse (P6L6, Postmenopausal, 66 years)

• Q1.1: Diagnosis = 3rd degree uterovaginal prolapse (Procidentia) + acute urinary retention
• Q1.2: 4 differentials listed (cervical elongation, fibroid polyp, urethral prolapse, Ca cervix)
• Q1.3: Management - emergency catheterization, edema reduction, vaginal hysterectomy + pelvic floor repair
• Q1.4: Supports of uterus - categorized into pelvic floor (levator ani), Mackenrodt's/cardinal ligaments, uterosacral, pubocervical, round, broad ligaments

Papers II, III - Carcinoma Cervix (Cauliflower growth, 45 y/o)

• Differentials for intermenstrual bleeding
• Diagnosis = Invasive carcinoma cervix
• Investigations for diagnosis (biopsy = gold standard) + staging workup (MRI/CT/PET as per FIGO 2018)
• Complications of radiotherapy (acute + late - VVF, RVF, cystitis, proctitis, stenosis, fistulas)
• Screening methods (Pap smear, VIA, VILI, HPV DNA testing, colposcopy)

Paper IV - SCC Cervix with Staging

• Causes of post-coital bleeding
• Patient evaluation
• FIGO 2018 staging investigations
• Stage = IB1 (6mm invasion, confined to cervix, no parametrial/vaginal involvement)
• Management = Wertheim's radical hysterectomy + PLND
• Complications of radical hysterectomy
• Surgery vs Radiotherapy comparison table

Paper (Last Image) - Screening + Prevention

• AUB differentials, screening guidelines (national + WHO)
• Next step after abnormal Pap = colposcopy + biopsy
• Prevention (HPV vaccine, safe sex, smoking cessation, screening)
• Radiotherapy complications (10 late complications listed)