UPSC-CMS 2018 — Obstetrics and Gynecology

Q: A 47 year old post menopausal lady was on adjuvant hormonal treatment with Tamoxifen for 3 years for Carcinoma Breast. She came to Outpatient Department with history of passing blood clots per vagina. She is probably suffering from:

Carcinoma Endometrium. ***Carcinoma Endometrium*** - **Tamoxifen** acts as an **estrogen agonist** in the endometrium, increasing the risk of **endometrial hyperplasia** and **carcinoma**. - Postmenopausal vaginal bleeding or passing blood clots is a significant warning sign for **endometrial cancer**. *Uterine fibroid* - While fibroids can cause abnormal uterine bleeding, they are less likely to cause sudden, significant bleeding with clots in a **postmenopausal woman** on Tamoxifen without other symptoms. - Tamoxifen is not a direct cause of uterine fibroid development or enlargement. *Carcinoma Vagina* - **Vaginal carcinoma** is rarer than endometrial carcinoma and typically presents with a **vaginal mass** or bleeding with intercourse, not usually significant clotting in this context. - Tamoxifen is not directly linked to an increased risk of primary vaginal carcinoma. *Carcinoma Vulva* - **Vulvar carcinoma** presents as a **lesion** or **sore on the vulva** and symptoms like itching, pain, or bleeding from the lesion itself, not typically as vaginal blood clots. - The use of Tamoxifen does not significantly increase the risk of vulvar carcinoma.

31 Questions — Page 4 of 4

All Subjects Anatomy (5)Biochemistry (1)Community Medicine (35)ENT (2)Forensic Medicine (1)Internal Medicine (5)Obstetrics and Gynecology (31)Orthopaedics (1)Pathology (2)Pediatrics (5)Pharmacology (2)Physiology (2)Radiology (1)Surgery (26)

Q31

A 47 year old post menopausal lady was on adjuvant hormonal treatment with Tamoxifen for 3 years for Carcinoma Breast. She came to Outpatient Department with history of passing blood clots per vagina. She is probably suffering from: