Медведєв Михайло ВолодимировичТестуванняMenstrual dysfunction. Neuroendocrine syndromes in gynecology

Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Медведєв Михайло Володимирович // 18 Ноября 2015

Вопросов в тесте: 21

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Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 13 y.o. delivered to gynecological department with bleeding from vagina during the first menstruation. A history of frequent nose bleedings. OBJECTIVE: pale skin with petechial rash, BP 100/60 mm Hg, PR - 86 bpm, Hb - 90 g / l, Ht - 28%, platelet count - 84x109 / l. Rectal examination: uterus 4x4x3 cm, dense, painless, adnexa are not palpated, heavy bloody vaginal discharge. Doctor’s tactics.

вопрос 1 из 21 //

Варианты ответа:

  1. D&C
  2. Gestagen hemostasis
  3. endometrial cryoablation
  4. Uterotonic and hemostatic drugs, consultation of hematologist
  5. Homonal hemostasis with monofasic oral contraceptives, consultation of hematologist
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

menopause 16 years, childbirth 3, abortions 8, has chronic hypertension, BP increased to 200/100 mmHg. Gynecological examination: cervix is clean, uterus of normal size, movable, painless, dense. Adnexa are not defined. Discharge abundant, bloody. Which research method should be used to clarify the diagnosis?

вопрос 2 из 21 //

Варианты ответа:

  1. Laparoscopy
  2. D&C
  3. Ultrasonography of the pelvis
  4. Histerography
  5. Colposcopy
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

33 y.o. patient presents with complaints of the absence of menstruation for 8 months after severe psycho-emotional stress. With a history: menarche since 12 years, menstruation for 4-5 days in 28 - 30 days, painless, 1 spontaneous abortion at 6 weeks. Gynecological exam: cervix is clean, uterus of ordinary size, movable, painless, dense. Adnexa were not defined. Discharge whitish. Diagnosis?

вопрос 3 из 21 //

Варианты ответа:

  1. Dysmenorrhea
  2. Hypomenstrual syndrome
  3. Psychogenic amenorrhea
  4. Physiologic amenorrhea
  5. Primary amenorrhea
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

A 51-year-old woman presents to your office amenorrhea for the past year. Since she has not had any hot flashes, she is wondering if she is menopausal. What blood test would confirm the diagnosis of menopause?

вопрос 4 из 21 //

Варианты ответа:

  1. Estrogen
  2. Testosterone
  3. Human chorionic gonadotropin (hCg)
  4. FSH
  5. Prolactin
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 27 y.o. undergone diagnostic D&C due to DUB, the result of histology: simple non-atypical hyperplasia; hormone therapy was not prescribed. After 1,5 months rebleeding. Gynecological research: cervix clean, normal size uterus, movable, painless, dense. Adnexa were not defined. An abundant bloody discharge from vagina. What should you do?

вопрос 5 из 21 //

Варианты ответа:

  1. Hormonal hemostasis with gestagens
  2. Hormonal hemostasis with androgens
  3. Hormonal hemostasis with combined estrogen-gestagenic drugs
  4. Hysterectomy
  5. D&C
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 54 y.o. referred with complaints of vaginal bleeding after 2 years of amenorrhea. Ultrasonic and vaginal examination didn’t reveal gynecological pathology. What doctor should do?

вопрос 6 из 21 //

Варианты ответа:

  1. Hysteroscopy, D&C
  2. Insertion of levonorgestrel-relising IUD
  3. Hemostasis with estrogens
  4. Hemostasis with androgens
  5. Hemostatic, uterotinic drugs
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

33 y.o. patient presents with complaints of the absence of menstruation for 8 months after severe psycho-emotional stress. With a history: menarche since 12 years, menstruation for 4-5 days in 28 - 30 days, painless, 1 spontaneous abortion at 6 weeks. Gynecological exam: cervix is clean, uterus of ordinary size, movable, painless, dense. Adnexa were not defined. Discharge whitish. Management?

вопрос 7 из 21 //

Варианты ответа:

  1. D&C
  2. Ultrasound, progesterone test
  3. Hysteroscopy
  4. Test with estrogen
  5. Monitoring
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 14 y.o. referred to gynecological department with complaints of bleeding from vagina for 4 days. From history: menstruations from 12 years, 7-9 days excessive, periodic delays up to 15-20 days, virgin. During ultrasound examination: normal size uterus, both ovaries enlarged, multifollicular. OBJECTIVE: Skin pale, clean. BP -90/60 mm Hg, PR - 82 bpm, HGB -92 grams per liter. Diagnosis?

вопрос 8 из 21 //

Варианты ответа:

  1. Adenocarcinoma
  2. Pregnancy (abortion)
  3. Endometrial hyperplasia
  4. Simmond's syndrome
  5. Dysfunctional uterine bleeding (AUB)
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

In the gynecological department referred 49 years old patient with complaints of heavy vaginal bleeding after delay of menstruation for 6 months. During last year an irregular menstruations and intermittent hot flushes and night sweating were observed. OBJECTIVE: pale skin, clear. BP - 90/60 mm. Hg, PR - 82 bpm. Gynecological examination: cervix is clean, uterus of ordinary size, movable, painless, dense. Adnexa are not defined. Discharge whitish. Diagnosis?

вопрос 9 из 21 //

Варианты ответа:

  1. uterine leiomyoma
  2. Endometrial cancer
  3. menopausal dysfunctional uterine bleeding
  4. adenomyosis
  5. Menorragia
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 30 y.o. addressed with complaints of lack of menstruation for 5 months. Notes the allocation of milk from the breast. Gynecological examination: cervix is clean, uterus of ordinary size, movable, painless, dense, no adnexa determined. Discharge is white. In X-ray of the skull revealed no pathology. In serum prolactin levels increased. Diagnosis?

вопрос 10 из 21 //

Варианты ответа:

  1. Pituitary adenoma
  2. Hyperprolactinemia
  3. Hypothyroidism
  4. PCOS
  5. Tuberculosis of endometrium
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 40 years after unsuccessful treatment in a neurologist for 2 years, referred to gynecologist with complaints of depression changing to aggression, weakness, sadness, numbness of hands, flatulence, breasts tenderness. These symptoms appear in 8 -10 days prior to menstruation and disappear after it. In gynecological exam no pathological changes of the genitals were found. Diagnosis was established: Premenstrual syndrome. What is the treatment?

вопрос 11 из 21 //

Варианты ответа:

  1. Diet, androgens, vitamins
  2. Diet, gymnastics, prostaglandine synthesis inhibitors, antidepressants
  3. Diet, agonist GnRH, vitamins
  4. Diet, diuretics, tranquilizers
  5. Diet, gestagens, vitamins
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 28 y.o. applied to a gynecologist with the primary infertility for 6 years. Marriage 1, no use of contraception. With a history: menarche age is 14 years, irregular, last 5 years notes scant painless menstruations for 5 – 6 days with intervals 60-90 days. Physical examination: obesity 2nd stage, increased hair growth on face, extremities. Ultrasound: cervix is clean, uterus decreased in size, on both sides ovaries increased in size - 4.5*4.5*3.5 cm, ovarian capsule thickened. What diagnostic test should be conducted to clarify the diagnosis?

вопрос 12 из 21 //

Варианты ответа:

  1. MRI of the pelvis
  2. Colposcopy
  3. hysteroscopy, hormonal studies
  4. hormonal testing, laparoscopy
  5. Tests of functional diagnostics
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Female 15 y.o. asthenic stature with weakly presented secondary sexual characteristics complains of irregular menstrual cycle in the autumn - spring period, with the beginning of the school years. Rectal examination normal. Pelvic ultrasound unchanged. What is prophylaxis of this juvenile disfunction of menstrual cycle in this case.

вопрос 13 из 21 //

Варианты ответа:

  1. Timely treatment of infections
  2. Monophasic OCs
  3. Reduction of psycho-emotional stress and mental overload, normal sleep and rest
  4. Nutrition with limited oily, spicy and sweet foods
  5. Induction of ovulation
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 15 y.o. referred to gynecologist with complaints of heavy menstruation for 7 days, in the past 2 hours bleeding started. From history: menarche since 12 years 6-7 days with intervals 40-50 days, no sexual life. Patient has thyroiditis since 12 years. Rectal exam: uterus of normal size, ovaries slightly enlarged, with abundant bloody discharge from vagina. Ultrasound: normal size uterus, M-echo 8 mm, both ovaries polycystic, size 4.0*3.5*3.0 cm. Diagnosis?

вопрос 14 из 21 //

Варианты ответа:

  1. Dysmenorrhea
  2. Inevitable abortion
  3. Endometrial hyperplasia
  4. DUB (AUB)
  5. Sheehan's syndrome
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 40 years after unsuccessful treatment in a neurologist for 2 years, referred to gynecologist with complaints of depression changing to aggression, weakness, sadness, numbness of hands, flatulence, breasts tenderness. These symptoms appear 8-0 days prior to menstruation and disappear after it. In gynecological exam there are no pathological changes of the genitals. Diagnosis was established: Premenstrual syndrome. What form of predmenstrual syndrome most probable in this case?

вопрос 15 из 21 //

Варианты ответа:

  1. Nothing of the mentioned
  2. Cephalgic
  3. Mixed
  4. Neuro-psychologic
  5. Edematous
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 32 y.o. referred to gynecologist with complaints of irregularities in the menstrual cycle the last 5 months. Notes the allocation of milk from mammary glands. With a history: menarche in 12 years, birth-1, complicated by weakness of labor activity. Gynecological exam: cervix is clean, with scars, uterus of normal size, movable, painless, dense. Adnexa are not defined. Discharge is white. X-ray of the skull revealed no pathology. Serum was determined with high levels of prolactin. What is the best treatment to this woman.

вопрос 16 из 21 //

Варианты ответа:

  1. Combined oral contraceptives
  2. Dofamin agonist drugs
  3. Agonists of GnRH
  4. Estrogens
  5. Gestagens
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 28 y.o. referred to a gynecologist with primary infertility for 2,5 years. Marriage 1, no use of contraception. With a history: menarche age 14 years, menses sporadic, irregular, last 5 years notes scant painless menstruations for 5-6 days with intervals 60-90 days. Ultrasound: cervix is clean, uterus decreased in size, on both sides ovaries increased in size - 4.5*4.5*3.5 cm, ovarian capsule thickened to 1,4 mm. Diagnosis?

вопрос 17 из 21 //

Варианты ответа:

  1. Dermoid cysts
  2. polycystic ovarian syndrome
  3. ovarian failure
  4. Follicular cysts
  5. ovarian endometriosis
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

To gynecologist referred 36 years old woman with complaints of mastalgia, breast tenderness, irritability, periodic headaches and heartbeats. These manifestations appear 14-15 days before menstruation, after which listed complaints disappear. Mentioned complaints notes within last 2 years. Menstruation is normal. Gynecological examinatiion: cervix is clean, uterus of normal size, movable, painless, dense, adnexa are not defined. Discharge whitish. Diagnosis?

вопрос 18 из 21 //

Варианты ответа:

  1. Ovarian failure syndrome
  2. Premenstrual syndrome
  3. Hipothalamic neuro-endocrine-metabolic syndrome
  4. Adrenal corrtex dysfunction
  5. Syndrome after gonadectomy
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

On admission to gynecologist woman 50 years old with complaints of periodic flushes, fever, sweating, palpitations, sleep disorders. Menstruations irregular, scant. Consulted in cardiologist, endocrinologist. No pathology was found. Gynecological exam: cervix is clean, uterus of ordinary size, movable, painless, dense. Adnexa are not defined. Discharge is white. Diagnosis?

вопрос 19 из 21 //

Варианты ответа:

  1. Pathologic menopause
  2. Diencephalic syndrome
  3. Premenstrual syndrome
  4. Cushing syndrome
  5. Pituitary tumor
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Patient 60 y.o. referred to gynecologycal department with complaints of periodic bloody discharge from vagina. From anamnesis: menopause 8 years P2, A4, since 46 years endometrial polyp, was not treated. Gynecological research: cervix is clean, normal uterus size, dense, adnexa are not defined. D&C was performed, histology: simple hyperplasia with atypia. What should you do?

вопрос 20 из 21 //

Варианты ответа:

  1. Hysterectomy with adnexa
  2. Hysterectomy without adnexa
  3. Chemotherapy
  4. Hormone therapy with agonist GnRH
  5. Hormone therapy with androgens
Menstrual dysfunction. Neuroendocrine syndromes in gynecology

Woman 24 y.o. referred to gynecologist with the lack of menstruation for 6 months after birth in breech presentation (live girl 3400.0 / 52 cm). Gynecological exam: cervix is clean, uterus of ordinary size, movable, painless, dense, adnexa are not palpated. Discharge is white. Diagnosis?

вопрос 21 из 21 //

Варианты ответа:

  1. Secondary amenorrhea
  2. PCOS
  3. Physiologic amenorrhea
  4. Hypotalamic amenorrhea
  5. Ovarian failure