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MRCOG PART 2 SBAs and EMQs

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Ovarian cysts in post-menopausal women

Ovarian cysts in post-menopausal women Posted by Farrukh G.

Question

A 63 year old woman has been referred to the gynaecology clinic by a physician. The woman has symptoms of irritable bowel syndrome that have not improved with first and second line therapies. CT scan of the abdomen and pelvis identified a 3 cm simple left ovarian cyst but no other abnormalities. The woman had a vaginal hysterectomy 12 years ago because of prolapse symptoms.  

A.    Reassure

B.    Diagnostic laparoscopy

C.   CA-125

D.   Trans-vaginal ultrasound scan

E.    CA-125 plus trans-vaginal ultrasound scan                  

Posted by Farrukh G.

Correct answer = E

RCOG Guidelines July 2016:

Where the initial imaging modality was a CT scan, unless this clearly indicated ovarian malignancy and widespread intra-abdominal disease, an ultrasound scan should be obtained in order to calculate the Risk of Malignancy Index (RMI)