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gynecology AND menopause
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MSD Manual menopause FSH endometriosis PCOS ectopic pregnancy ring of fire
Answer key with brief explanations
| Q | Answer | Brief explanation |
|---|---|---|
| 1 | B. FSH | Ovarian estrogen feedback declines after menopause, so pituitary FSH rises markedly. |
| 2 | D. Hydroxychloroquine | It is not a treatment for postmenopausal osteopenia. Alendronate, calcitonin, and strontium have been used for bone loss. |
| 3 | D. PCOS | Polycystic ovarian syndrome is the commonest cause of hirsutism in young women. |
| 4 | A. Two uterine cavities with one cervix | Bicornis unicollis means a bicornuate uterus with a single cervix. |
| 5 | C. Levonorgestrel | Levonorgestrel is used as emergency contraception. |
| 6 | D. Ectocervix | Acute gonococcal infection primarily involves columnar epithelium, especially endocervix, urethra, and paraurethral/Bartholin glands, not the ectocervix. |
| 7 | B. Round ligament | The round ligament mainly maintains uterine anteversion. Cardinal/Mackenrodt and pubocervical ligaments provide true uterine support. |
| 8 | B. Prolapse | Childbirth trauma can injure pelvic floor muscles and fascial supports, predisposing to genital prolapse. |
| 9 | A. 30 minutes | Semen normally liquefies in about 20-30 minutes. It should generally liquefy within 60 minutes. |
| 10 | B. Ectopic pregnancy | A peritrophoblastic vascular flow pattern on color Doppler produces the classic “ring of fire” appearance, though it may also be seen around a corpus luteum. |
| 11 | D. Red degeneration | Red degeneration of a fibroid in pregnancy is usually treated conservatively, not by myomectomy. |
| 12 | A. Implantation theory | Sampson’s implantation theory, involving retrograde menstruation and implantation of endometrial tissue, is the most accepted theory for endometriosis. |
| 13 | C. Hemophilus ducreyi | Chancroid is caused by Haemophilus ducreyi. |
| 14 | C. PCOS | Chronic anovulation in PCOS causes prolonged unopposed estrogen stimulation, leading to endometrial hyperplasia. |
| 15 | D. All | Posterior colpotomy provides access through the posterior vaginal fornix and can be used for drainage of pelvic collections, including pelvic abscess, ovarian abscess, and pelvic hematocele. |
| 16 | C. Endometriosis | Endometriosis is a common cause of secondary dysmenorrhea in young women. |
| 17 | C. Lateral wall | For hormonal cytology, the smear is taken from the lateral vaginal wall, which is sensitive to hormonal changes. |
| 18 | C. LH and FSH surge | Ovulation is preceded by a major LH surge and a smaller accompanying FSH surge. |
| 19 | C. Abnormal release of GnRH | Luteal phase defect results from inadequate luteal progesterone production, often related to abnormal hypothalamic-pituitary signaling including GnRH release. |
| 20 | C. 40-51 years | Menopausal transition generally begins in the 40s and ends around the final menstrual period, commonly near 50-51 years. |
Answer sequence:
1-B, 2-D, 3-D, 4-A, 5-C, 6-D, 7-B, 8-B, 9-A, 10-B, 11-D, 12-A, 13-C, 14-C, 15-D, 16-C, 17-C, 18-C, 19-C, 20-C.
1-B, 2-D, 3-D, 4-A, 5-C, 6-D, 7-B, 8-B, 9-A, 10-B, 11-D, 12-A, 13-C, 14-C, 15-D, 16-C, 17-C, 18-C, 19-C, 20-C.
For Q10, the “ring of fire” supports ectopic pregnancy but is not by itself diagnostic, because a corpus luteum can produce a similar Doppler appearance.
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