QUERYOptions for Questions 4-5
A Tranexamic acid B Danazol
C GnRH analogues D TAH + BSO
E Diagnostic laparoscopy F Medroxyprogesterone acetate
G Pelvic ultrasound scan H MRI scan of the pelvis
I Dilatation and curettage J Endocervical and urethral swabs
K Combined oral contraceptive pill L Levonorgestrel releasing intra-uterine system
M Refer to pain clinic N Refer to gastroenterologist
, choose the single most appropriate management from the above list..
Question 4 A 22 year old woman is known to have endometriosis diagnosed at laparoscopy. She is referred to the gynaecology clinic because of progressively severe pelvic pain, dysmenorrhoea and deep dyspareunia. There is a past medical history of focal migraine. Clinical examination showed a tender pelvis with a normal size anteverted uterus and no adnexal masses.
Question 5
A 34 year old woman with severe endometriosis which has not responded to the combined oral contraceptive pill and progestogens has undergone laparoscopy with laser ablation of endometriosis. Six months later, she complains of a relapse with severe pelvic pain, dysmenorrhoea and deep dyspareunia
Answer Q4 F why not L
Q5 C why not L
According to green top GL Mirena is effective in relieving symptoms & is recommended postoperatively ….Please clarify…
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