REPRODUCTIVE BLOCK CASE 1 Pn Miss, a 55 years old malay lady came to your clinics with chief complaints of postcoital

bleeding and painful during sexual intercourse. Her social history is significant for past practice of prostitution and her past medical history is significant for several STDs that were appropriately treated with recovery. A pap smear reveals an abnormal cell and she was diagnosed to have invasive cervical carcinoma 1. 2. 3. 4. 5. 6. 7. State the FIGO classification of cervical neoplasia State the pathogenesis of HPV infections which may leads to cervical ca State 2 types of HPV vaccination and which types of HPV virus does it effective State the microscopic findings of invasive cervical carcinoma What is pap smear? When is the Pap smear contraindicated? State the location and types of cell obtained from pap smear With the aid of diagram, draw the location of taking pap smear sample according to age (teens, 20-50 years old, postmenopausal lady)

CASE 2 A 24 years old lady presented to the clinics with complaining of increase pain and bleeding during menstruation. Her last menstruations have been accompanied with increasing intensity of cramping and larger amount of blood. She tells you that her menstrual cycle has been irregular for the last 6 months. On pelvic exam, you palpate fixed, bilateral ovarian masses and an MRI reveals chocolate cyst of the ovary 1. 2. 3. 4. 5. CASE 3 A 60 years old woman presented to the clinics with postmenopausal vaginal bleeding. After taking a complete history, you learn that she is nulliparous and suffer from type 2 diabetes that is well-controlled with diet and insulin. On physical exam, the woman is obese and has a blood pressure of 150/96. You expect to find welldefined gland patterns lined by malignant stratified columnar epithelial cells on endometrial biopsy. 1. 2. 3. 4. 5. CASE 4 A 27 years old woman present to the emergency room with lower abdominal pain, chills, fever and a purulent cervical discharge. After taking a history, you learn that she has had multiple sexual partners over the last year and has not practiced safe sex. She states that the pain started 1 week ago with subsequent fever, chills and o night sweats. On physical exam, she is febrile with a temperature of 38 C and has cervical motion tenderness with foul smelling, purulent discharge. 1. Draw a labelled diagram of uterus State 3 types of endometrial hyperplasia State your diagnosis State 3 risk factors of this disease possess by the patient and 1 other risk factor State the reasons why nulliparous women have increase tendency of developing endometrial ca State 2 treatment in this patient State your diagnosis State 3 gross pathological findings in this patients ovary Explain the changes during follicular phase of menstrual cycle State 1 complication if this condition not treated State 3 treatments in this patient

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2. 3. 4. 5.

State your diagnosis and define State most common organisms which can cause the above disease State 3 gross pathological findings in this patient fallopian tubes State 2 complications which may arise from this conditions

CASE 5 A 35 years old Malay woman presents to the clinic complaining of more frequent menstrual period and profuse menstruation. She also complains of increased weakness, increasing frequency of urination and fatigue during her menstruation. On physical exam, you find a firm abdominal mass in the pelvic region. She states that she was aware of the mass but it only appears during menstrual periods. 1. 2. 3. 4. 5. CASE 6 A 60 years old woman presents to your clinic after finding a mass on the upper outer quadrant of her left breast. You learn that her mother died from breast cancer and her maternal aunt was also diagnosed with breast cancer at an early age. The patient started her period at age 11, did not bear any children and has not been through menopause. On physical exam, she is markedly obese and you noticed retraction of the skin and nipple on her left breast. You locate a fixed, hard and non-tender mass during breast exam. You also feel palpable axillary lymph nodes. 1. 2. 3. 4. 5. 6. Draw region of the breast and state the frequency of distribution of breast carcinoma State briefly how a breast self examination is done Draw the surface anatomy of axillary lymph nodes Classify breast carcinoma based on TNM staging State predictive and prognosis factor in category 1 State the pathogenesis of breast ca State your diagnosis State 2 good reasons why did you state the above disease as your diagnosis State the pathophysiology of increase in frequency of urination in this patient State 1 gross pathological findings in this patient uterus State 2 microscopic finding in this patient uterus

CASE 7 A 31 years old woman currently presented with fever for 3 days duration and abnormal vaginal bleeding. She had just delivered baby last week via C-section. On pelvic exam, redness and inflammation are visible, but no discharge is apparent. He was prescribed with doxycyline 1. 2. 3. 4. 5. State your diagnosis Classify the disease and state 2 causative organism What are the risk factors possessed by this patient and why Define pueperial pyrexia What is doxycycline, state its MOA

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