MCCQE - OBGYN block Exam Questions

MCCQE - OBGYN block  Exam Questions and Answers (Solved Papers) ovulatory abnormal pre-menopausal menstrual bleeding

• definition - Correct Answers ✅normal cycle length (28

days +/- 7) but abnormal (excessive) volume of blood loss:

• menses >7days
• blood loss >80mL

-soak through menstrual products q1-2 hours -passage of clots larger than a dime -self reported 'very heavy' periods shorter luteal phase & increased fibrinolysis contributes to menorrhagia anovulatory pre-menopausal menstrual bleeding

• DDx (3 categories) - Correct Answers ✅1. HPO issues
• Immature HPO axis (young)
• aging ovarian follicles (older)
• premature ovarian failure (e.g. chemo/rads to pelvis)
• stress, weight loss, exercise
• Diseases

a) Hypothyroid

b) PCOS (androgen excess)

c) Cushing's (androgen excess) 1 / 4

MCCQE - OBGYN block  Exam Questions and Answers (Solved Papers)

• Tumors/masses

a) Prolactinoma

b) STRUCTURAL --> fibroids, tumors pushing into the cavity

can cause sketchy bleeding!ova abnormal pre-menopausal menstrual bleeding

• DDx - Correct Answers ✅PALM COEIN

Structural:

Polyp Adenomyosis Leiomyoma (fibroids) Malignancy Non-structural Coagulopathy

• e.g. VWD

Ovulatory

• weight loss/exercise, PCOS, etc.

Endometrial 2 / 4

MCCQE - OBGYN block  Exam Questions and Answers (Solved Papers)

• hyperplasia/cancer
• endometritis

Iatrogenic

• e.g. anticoagulation, IUD, FB, trauma

Not otherwise classified:

- chronic disease: hypothyroidism, liver disease, CKD, obesity

• pregnancy

- infection: STI

pre-menopausal menstrual bleeding

• pregnancy related causes (4) - Correct Answers ✅1.

Implantation bleed

• Miscarriage
• Ectopic pregnancy
• Gestational trophoblastic disease

PCOS

• risks with anovulatory cycles (3)
• Tx causing infertility (2)
• Tx for those desiring fertility (2) - Correct Answers ✅Risks
• Infertility 3 / 4

MCCQE - OBGYN block  Exam Questions and Answers (Solved Papers)

• Dysfunctional uterine bleeding (DUB)
• Can be VERY heavy
• Obesity = increased peripheral E ("fertilizer") for the

lining**Impt to use OCP or IUD with these pts

• Endometrial hyperplasia/endometrial cancer

Tx -

1. OCP

2. IUD

Fertility Tx:

• Weight loss
• Metformin

Abnormal ovulatory premenstrual bleeding

• Px (3 things to look for)
• Ix - blood (4)

- Ix - imaging (3 lines) - Correct Answers ✅Px:

• Thyroid dysfunction - clinical exam signs
• Abdo/Pelvic exam - bimanual, assess uterine size/masses
• Anemia - pallor, fatigue, overall appearance

Ix:

• / 4