This book provides those studying for the MRCOG Part 2 examination with welcome practice in answering Extended Matching Questions (EMQs). Updated throughout to map onto the MRCOG syllabus from September 2016, the book is designed to test the candidate's theoretical and practical knowledge of obstetrics and gynaecology. An introductory section on exam techniques is followed by a collection of 41 EMQ themes, split into obsterics and gynaecology. The questions are based on common clinical scenarios and cover a variety of topics. Answers are included after each topic, and these include explanatory material and useful references.

The Project on Reproductive Laws for the 1990s began in 1985 with the realization that reports of scientific developments and new technologies were stimulating debates and discussions among bioethicists and policymakers, and that women had little part in those discussions either as participants or as a group with interests to be considered. With the help of a planning grant from the Rutgers University Institute for Research on Women, the Women's Rights Litigation Clinic at Rutgers University Law School-Newark held a planning meeting that June attended by approximately 20 theorists and activists in the area of reproductive rights. Project purposes, methods, and general shape took form at the meeting. Two goals have characterized the Project's work since then: first, to generate discussion, debate, and, where possible, consensus among those committed to reproductive autonomy and gender equality as to how best to respond to the questions raised by re ported advances in reproductive and neonatal technology and new modes of reproduction; and second, to ensure that those shaping reproductive law and policy appreciate the ramifications of these developments for gender equality. In meeting this twofold agenda, the Project focused on six areas: time limits on abortion; prenatal screening; fetus as patient; reproductive hazards in the workplace; interference with reproductive choice; and alternative modes of reproduction. The Project identified individuals to take respon sibility for drafting model legislation and position papers in the six areas (for the drafters, see the Appendix)."

Endometriosis - a condition in which the lining of the uterus grows in other abdominal locations - is one of the most common causes of severe period pain, pelvic pain, and abnormal bleeding in women. Untreated, it may result in long-term complications such as pelvic adhesions, ovarian cysts and infertility. At times, bowel, bladder, and ureters may also be damaged. Although medical options are available for some women, laparoscopy is always needed to confirm the diagnosis and often surgical intervention -- by removing the endometriotic implants, ovarian cysts and repairing tubal damage -- usually produces immediate results in terms of pain relief and improved fertility. This major new book, written by an internationally recognized team of experts, covers the full range of surgical interventions for diagnosing and treating endometriosis.

1 2 Peter Reeve and Lavelle Hanna lSmith Kline & French Laboratories, Research and Development, 709 Swedeland Road, Swedeland, PA 19479, USA 2Department of Microbiology, S-412, University of California, San Francisco, San Francisco, CA 94143, USA Trachoma, an infectious keratoconjunctivitis due to chlamydial infection, was one of the earliest recognized clinical entities. References to it have been noted in Egyp- tian papyri and in Greco-Roman medical treatises. Since those times it has remained a most important eye infection, and indeed trachoma is still a major cause of blindness in rural communities, affecting probably 6 million people (Dawson). The causal agent of trachoma was identified by Halberstaeter and von Provazek in a much-quoted but little-read paper published over 75 years ago. It was after the isolation and demonstration of the growth of the causal agent of trachoma, Chlamy- dia trachomatis, by Tang and his colleagues in China in the late 1950s that there was an enormous increase in our knowledge of these agents. The real explosion of knowledge and interest in Chlamydia, however, has been in the last decade. With the growing awareness of the extraordinary commonness of chlamydial infections, not only in developing countries but also in the highly developed countries, has come a considerable interest from all areas concerned with medical science, from clinicians to molecular biologists.

This book is a comprehensive guide to addressing, working with, and healing from emotional struggles related to fertility and eating disorders. Covering the emotional, psychological and physical impact of anorexia nervosa, bulimia and binge eating disorder, this book explores the lived experience of numerous women and men who have lived with eating disorders, fertility, and parenthood. It delves into research on medical complications that can affect fertility, attachment, the experience of shame, adjustment to the postpartum period, and offers clinical tools for therapists to use to support clients from a weight and body neutral perspective. Those who read this book will come away with a renewed sense of hope for recovery and healing from serious mental illnesses, and the notion that the value of having a family may be stronger than the eating disorder itself. The only book of its kind, The Clinical Guide to Fertility, Motherhood and Eating Disorders will be useful to practitioners, therapists, and scholars alike.

Clearly presented and thoroughly up to date, this important text provides an overview of current knowledge of the polycystic ovary syndrome (PCOS) - its etiology, pathology, and the implications for effective medical management. In contrast with existing titles, this book focuses on the difficulty in making an accurate diagnosis and the consequential problem of identifying the most effective program of management. Key features: * coherent approach, integrating international contributions * first book on PCOS since the Rotterdam Consensus meeting * focuses on clinical manifestations of disease, diagnostic criteria and options for management * illustrated with tables, graphs and charts to explain physiologic principles. Among the most important consequences of PCOS is infertility, and the authors provide clear guidance on the role of new assisted reproductive technologies to overcome this problem.

While radiology only reveals one aspect of the entire ana tomical picture, a certain diagnostic precision can be at tained by skillfully combining different techniques. The re sulting images often uncover the hidden reality. This near perfection is most clearly seen - and is also most essential - in the study of the breast. One must remember that in the western world, one woman in fifteen develops breast can cer. It follows that the key to effective treatment is early and precise diagnosis. An understanding of the various breast tissues and of benign pathology is also indispensable in determining local risk. How to achieve this goal of early and precise diagnosis is the problem addressed in this well-documented text demonstrating the considerable experience of Dr. CLAUDE ANNONIER. A fresh look at the technical aspects and a com plete clinical analysis together show the successes and limi tations of modern methods and the need to combine different techniques in most cases. Evaluation of the various methods provides justification, if still needed, for the author's con tention that mammography alone is insufficient. Progress in the field is making it possible to detect smaller and smaller lesions, whose malignancy cannot be determined without needle or surgical biopsy. More generally, the author un derlines the necessity for complete cooperation between diagnostician and therapist. Follow-up for the "treated" breast is largely in the hands of the radiologist, who must, however, work together with other specialists."

Real-time ultrasonography has entered office practice in obstetrics and gynecology. With increasing numbers of sonography systems entering the ambulatory office setting, obstetric sonography at a routine level (level I) has largely been the targeted area. Recent developments in gynecologic real-time sonography have, however, significantly enlarged the sphere of applicability of sonographic equipment in an office setting. The very rapid growth of follicular sonography in infertility assessment and management has made real-time sonography of increasing importance to the gynecologic practitioner. In office settings like the authors', gynecologic office sonography represents close to 50% of all ordered sonography. This handbook of office sonography in obstetrics and gynecology was conceived to reflect these changes in practice patterns. This volume is not meant to replace standard sonography texts for the full-time sonographer but is instead directed toward the practicing obstetrician/gynecologist who uses real-time sonography in the office setting within the framework of daily practice. Technical comments were therefore restricted to a minimum, with practical advice and photographic examples taking their place. Most of the sonographic real-time images were retrieved from the authors' own files. However, some were obtained through the generosity of friends and colleagues, for which we would like to extend acknowledgment and appreciation. Similar appreciation is extended to Dr. Haim Elrad and Dr. Jari Friberg, who also participated in the editorial process; to Sheila Martin, who performed superbly as our editorial assistant, a most difficult responsibility; and to Hilary Evans, our editor at Plenum Publishing Corporation.

Neurology and Pregnancy provides a comprehensive multidisciplinary guide to best practices for research and practicing neurologists, as well as obstetricians and other specialists caring for women with an acute or chronic neurological disorder. The book encompasses preconception care, genetic counseling, pregnancy in patients with chronic neurological disorders, and acute pregnancy-related neurological complications. Postpartum care and complications, including lactation concerns, are also addressed, as well as the long-term effects of pregnancy and its complications on maternal brain health. Vol 1 summarizes the complex neurophysiological changes in pregnancy from a basic and translational science perspective. This includes neuroimaging, principles of neuro-obstetric critical care, and ethical and medicolegal concerns, describes normal fetal cerebral development and summarizes the management of the most common prenatal neurological diagnoses. Vol 2 focuses on chronic neurological conditions in pregnancy such as epilepsy, migraine, and multiple sclerosis, as well as acute neurological disorders including preeclampsia/ eclampsia, ischemic and hemorrhagic stroke, and CNS infections. Each chapter introduction includes data on epidemiology, when applicable. In discussing management, comments of safety profiles of medications preconceptionally, during pregnancy and lactation are summarized. Each chapter includes 1-2 illustrative cases.

The more you practice, the better you get. Written by an experienced team of Member, Royal College of Obstetricians and Gynaecologists (MRCOG) question setters, this book contains 500 practice single best answer questions (SBAs) and extended matching questions (EMQs) for candidates undertaking the Part 2 MRCOG examination. It includes detailed explanations and key references to enable candidates to understand the reasoning and knowledge base behind the questions. All modules of the core curriculum are included, and detailed further sources are recommended for the inquisitive learner. The candidate can test their knowledge across the breadth of modules and identify areas for improvement and further revision. Following the 2015 format change to include SBAs, this book equips candidates with a full range of testing to develop familiarity with the format and prepare for high examination standards. Up to date, comprehensive and written by highly experienced examiners, this is a crucial resource for all Part 2 MRCOG candidates.

Of 646 cases involving first trimester chromosome analysis of chorionic villi sam- ples obtained by trans cervical aspiration, we found 34 abnormal unbalanced karyo- types. In six of these, fetal fibroblast cultures obtained after termination of the preg- nancy failed to confirm the abnormality. Three cases were mosaics identified from direct preparations: 46,XY/45,X; 46,XX/47,XX,+3; and 46,XY/47,XY,+18. In two cases of trisomy 16 (46,XY/47,XY,+16; 46,XX/47,XX,+16) and one oftriso- my18 (46,XX/47,XX,+18), no mosaicism was detected. In the other 28 cases with unbalanced abnormal karyotypes, there was karyotypic correspondence between villous cells at diagnosis and fetal fibroblasts. References 1. Benn P, Hsu L YF, Perlis T, Schonhaut A (1984): Prenatal diagnosis of chromosome mosaicism. Prenat Diagn 4: 1-9 2. Binkert F, Schmid W (1977) Pre-implantation embryos of Chinese hamster. I. Incidence ofkaryo- type anomalies in 226 control embryos. Mutat Res 46: 63-76 3. Boue J, Nicolas H, Barichard F, Boue A (1979) Le clonage des cellules du liquide amniotique, aide dans l'interpretation des mosaiques chromosomiques en diagnostic prenatal. Ann Genet 22:3-9 4. Hahnemann N (1973) Chromosome studies in induced abortions. Clin Genet 4: 328-332 5. Kalousek DK, Dill FJ (1983) Chromosomal mosaicism confined to the placenta in human con- ceptions. Science 221 : 665-667 6. Loft A, Tabor A (1984) Discordance between prenatal cytogenetic diagnosis and outcome of pregnancy. Prenat Diagn 4: 51-59 7. Markert CL, Petters RM (1978) Manufactured hexaparental mice show that adults are derived from three embryonic cells.

"Conclusions are usually considered guesses" Henry S. Haskins, American writer in Meditations in Wall Street Students' minds, whether undergraduate or postgraduate, soon become stale when faced with lectures or even not so large textbooks. Supplementing lecture notes and textbooks with multiple-choice questions, therefore, attunes the mind to this style of examination which the student will certainly meet and yet also relieves the tedium and monotony of the conventional learning route. This multiple-choice textbook, therefore, should be used side by side with lecture notes, textbooks and clinical teaching material. The book covers a wide field of genitourinary medicine. This necessarily overlaps with general medicine, urology, bacteriology, virology, psychiatry, sexual medicine, im munology and proctology. With regard to immunology, a basic set of teaching questions are included so that HIV disease may be more easily understood without recourse to immunology textbooks. The answers to the questions are not given in a uniform style. This is partly to relieve monotony, and partly because some questions need no explanation, others need a prose answer and yet others are best answered by a point-by-point explanation. We also provide references for those interested. There is some overlap between questions but only enough, we hope, to facilitate learning but not produce somnolence."

In 1920, Hirose demonstrated the luteinising effect of placental tissue and one year later, Evans and Long described luteinised ovaries in rats treated with hypophysial extracts. In 1926, Zondek and Aschheim as well as Smith, independently of each other, showed that a gonad-stimulating hormone was secreted by the adenohypophysis. In 1927, Aschheim and Zondek found their "Prolan" in human pregnancy urine and the first reliable pregnancy test was available. In the following years it could be demonstrated that the gonadotropic hormones from pituitary and from pregnancy urin were not of identical structure. During the years 1931 - 1933 Fevold and coworkers prepared follicle stimulating hormone from sheep pituitaries which were free of other hormone activities. Already in 1934, Collip found "antihormones" in animals treated with proteinhormones from animals of another species. It could be shown that they were antibodies against these hormones and this was the future basis for the immunological era starting in 1960. The quantitative determination of gonadotropins has been performed over several decades by difficult bioassays and since 1960 immunological and later radioimmunological assays became available. Since that time a new field was opened for the studies of gonadotropins. During this time, highly purified preparations of gonadotropins were available for research and clinical treatment. I recall the first successful attempt of inducing follicle growth and ovulation by Gemzell and coworkers 1958 as well as by Lunenfeld and Bettendorf at about the same time.

Der innersekretorische EinfluB auf Stimmung, Befindlichkeit und Leistungsfahigkeit des Menschen ist ein faszinierendes Aufga- benfeld der forschenden und praktizierenden Medizin; er ist auch fOr die betroffenen Menschen von groBtem Interesse und groBer Bedeutung. Mit den damit zusammenhangenden Fragen befassen sich besonders die Arbeitsmedizin und in den letzten Jahren zuneh- mend auch die Sportmedizin. Dieses Engagement ergibt sich einmal aus der Bedeutung der Leistungsfahigkeit fOr diese Berei- che, zum anderen methodisch aus der Moglichkeit, innersekreto- rischen Parametern exakte Werte der Arbeit und des Leistens gegen 0 berzustellen. Gerade beim weltweiten Phanomen stark ansteigender Zahlen im Frauensport und der gleichzeitigen rasanten Entwicklung der Spitzenleistungen treten verstarkt Probleme innersekretorischer Regulationen aus frauenheilkundlicher Sicht in Erscheinung. Vielerorts wird von Arzten, Trainern und Sportlern mit Hormon- wirkungen argumentiert, ohne daB solchen Aussagen immer auch gesicherte Fakten zugrundeliegen. Der Deutsche Leichtathletikverband, darOber hinaus aber der Sport schlechthin haben allen AnlaB, der Universitatsfrauenklinik in TObingen fOr ihr Engagement auf diesem Sektor zu danken. Die im Rahmen dieses Symposiums ausgetauschten Kenntnisse, Erfahrungen und Anregungen werden dazu beitragen, die in Frage stehenden Zusammenhange aufzuklaren. Das aber wirQ nicht nur fOr den Sport von Nutzen sein, sondern Vorteile fOr Diagnostik und Therapie in Klinik-, Fach- und Aligemeinpraxis bringen konnen.

In 1980 the Directorate-General of Labor, Ministry of Social Affairs and Employment, the Netherlands, requested the Coronel Laboratory for Occupational and Environmental Health, Faculty of Medicine, University of Amsterdam, to carry out "a critical study of literature on health risks to women from industrial and occupational exposure to chemical agents which are different from risks to male workers, or which have only been observed in female workers. " The principal investigator was Mrs. A. Stijkel, medical biologist; a part of the study was carried out by R. L. Zielhuis, physician. M. M. Verberk, physician, and Mrs. M. v. d. Poel-Bot, librarian, provided continuous assistance. The final report (in Dutch) covering the literature up to and including 1981, was submitted to the government in October 1982. A somewhat abridged and modified English text, updated to include 1982, was prepared. The Editorial Board and the publisher of the International Archives of Occupational and Environmental Health kindly made possible the publishing of this text in a special issue of the journal. The authors express their thanks to the Directorate-General of Labor, the Editorial Board and the publisher for making this publication possible. We sincerely hope that this report will be of assistance in making the industrial and occupational environment safer. Prof. Dr. R. L. Zie1huis Table of Contents Introduction 1 1 1. 1 Objective 1 Theoretical Possibilities for Extra Health Risks in Female 1. 2 Workers. 2 1. 2. 1 Differences Between Women and Men Apart from Reproduction .

The "ABC of Breast Diseases" provides comprehensive guidance to the assessment of symptoms, and how to manage all common breast conditions and provides guidelines on referral. It covers congenital problems, breast infection and mastalgia, before addressing the epidemiology, prevention, screening and diagnosis of breast cancer. It outlines the treatment and management options for breast cancer within different groups and includes new chapters on the genetics, prevention, management of high risk women and the psychological aspects of breast diseases.

Edited and written by internationally renowned experts in the field and highly illustrated in full colour, this fourth edition remains a practical guide for general practitioners, family physicians, practice nurses and breast care nurses as well as for surgeons and oncologists both in training and recently qualified as well as medical students.

Klinefelter's syndrome occurs relatively frequently, being diagnosed for one in 600 male infants, yet it is probably very rare that it is recognized early enough to make effective treatment possible. Often the person afflicted does not go to a doctor until physical and emotional disturbances have developed on the ba sis of the syndrome. The appropriate therapy at the correct time can prevent many of these disturbances. In our andrology outpatient clinic we encountered Klinefelter's syndrome almost three decades ago in patients suffering from impotentia generandi. It was not until later that we dealt with it in our capacities as dematologists. It was observed at a rate too high to be coincidental among younger men suffer ing from ulcera crurum. On the other hand, we failed to see the condition during our work as con sultants in other specialities, especially internal medicine, although we re peatedly attempted to identify it. We should have encountered it at least occa sionally in our 10 years working in the Munich hospitals with their more than 4000 beds. It was this imbalance between the allegedly relative frequency of this condition and its rare detection which led us to plan a Klinefelter sympo sium. We soon determined, during a first search of the literature, that there was information in many more subject areas that we had expected or even guessed."

This practical guide covers all aspects of gynaecological ultrasound, focusing on good technique, the ultrasound machine and reporting. Written by experts with a strong reputation for training in the field, this book takes a 'tips and tricks' approach. Chapters cover topics such as equipment familiarization, principles of transvaginal ultrasound, the awkward uterus, the difficult ovary, and ART-related procedures. The authors discuss the use of both basic ultrasound and 3D machines, and provide tips on how to optimize the image and gain useful clinical information even in the most challenging of assessments. With a multitude of images included to train the eye to identify normal anatomy and common pathologies, chapter summary boxes and case-based examples also provide an easy reference for assessing conditions and lesions. This book will greatly improve the scanning technique of trainees in obstetrics and gynaecology, sonographers, reproductive medicine practitioners, and gynaecologists of any level.