Question Easy:
A 28-year-old primigravida at 10 weeks gestation presents with nausea and vomiting. Despite trying small, frequent meals and ginger tea, her symptoms persist. She asks for safe antiemetic options during pregnancy. Which drug should be considered first-line according to NICE guidelines? 🤰
A) Metoclopramide
B) Ondansetron
C) Cyclizine
D) Promethazine
E) Doxylamine
Explanations & Answers:
Question Easy Answer: D) Promethazine
Question Easy Explanation: According to NICE guidelines, for mild to moderate nausea and vomiting in pregnancy, antihistamines such as promethazine or cyclizine are often considered first-line options. These medications are generally regarded as safe during pregnancy and are effective in alleviating symptoms.
Question Medium:
A 35-year-old woman presents with menorrhagia and pelvic pain. A pelvic ultrasound shows a submucosal fibroid. She wishes to preserve her fertility and is considering treatment options. Which one of the following is the most appropriate management option? 💊
A) Hysterectomy
B) Myomectomy
C) Uterine artery embolization
D) Endometrial ablation
E) GnRH analogues
Question Medium Answer: B) Myomectomy
Question Medium Explanation: Myomectomy is the preferred surgical treatment for women with fibroids who wish to preserve their fertility. It involves the removal of fibroids while leaving the uterus intact. Other options like hysterectomy and uterine artery embolization might compromise fertility or are not typically recommended for women desiring future pregnancies.
Question Hard:
A 40-year-old woman at 30 weeks gestation presents to the emergency department with sudden severe abdominal pain and vaginal bleeding. On examination, the uterus is tender and tense. The fetal heart rate tracing is concerning for fetal distress. What is the most likely diagnosis? ⚠️
A) Placenta previa
B) Abruptio placentae
C) Uterine rupture
D) Preterm labor
E) Vasa previa
Question Hard Answer: B) Abruptio placentae
Question Hard Explanation: Abruptio placentae (placental abruption) is characterised by the premature separation of the placenta from the uterine wall, leading to abdominal pain, vaginal bleeding, and uterine tenderness. The presentation of a tense uterus with fetal distress in the third trimester highly suggests this diagnosis. Immediate management and delivery may be necessary, depending on the maternal and fetal status.
Medical fact of the day: Did you know that the UK has one of the strictest guidelines for the management of hypertensive disorders in pregnancy? The NICE guidelines recommend aspirin for women at high risk of pre-eclampsia from 12 weeks until birth to reduce the risk of the disorder developing.
Quote of the day: “In the journey of healing, every small step forward is a giant leap. Keep moving, keep caring – your work shapes a healthier tomorrow.” 🌟