Question Easy:
A 28-year-old woman attends your clinic in early pregnancy. She has been experiencing nausea and vomiting, commonly referred to as morning sickness. What is the first-line treatment option according to NICE guidelines? 😊
A) Ginger supplements
B) Promethazine
C) Metoclopramide
D) Ondansetron
E) Pyridoxine
Question Medium:
A 32-year-old woman is diagnosed with polycystic ovary syndrome (PCOS) and is concerned about her increased risk of endometrial hyperplasia due to chronic anovulation. What is the recommended first-line management to reduce this risk? 🤔
A) Regular physical exercise
B) Metformin
C) Cyclical progestogen
D) Clomifene citrate
E) Ovarian drilling
Question Hard:
A 35-year-old woman with a history of deep vein thrombosis (DVT) is planning to start combined oral contraceptive pills. What is the most appropriate contraceptive method for her, considering her medical history? ⚠️
A) Combined oral contraceptive pills
B) Copper IUD
C) Progestogen-only implant
D) Depot medroxyprogesterone acetate
E) Natural family planning
Explanations & Answers:
Question Easy Answer: B) Promethazine
Question Easy Explanation: According to NICE guidelines, first-line pharmacological treatment for nausea and vomiting in pregnancy is an antihistamine, such as promethazine. Ginger and pyridoxine are often suggested but have less robust clinical evidence as first-line treatments.
Question Medium Answer: C) Cyclical progestogen
Question Medium Explanation: NICE guidelines recommend the use of cyclical progestogen therapy to counteract the risk of endometrial hyperplasia in women with PCOS. Regular administration of progestogen helps to induce withdrawal bleeding, thereby reducing the risk of endometrial changes due to long periods of unopposed oestrogen.
Question Hard Answer: B) Copper IUD
Question Hard Explanation: In women with a history of DVT, oestrogen-containing contraceptives are contraindicated due to the increased thrombotic risk. The copper IUD is a non-hormonal method and is suitable for women with a history of thromboembolic events. Progestogen-only methods, while generally safer, may still pose a risk and should be considered with caution.
Medical fact of the day: Did you know that the UK has one of the most detailed maternity surveillance systems in the world, aimed at improving maternal outcomes through in-depth data analysis and policy development?
Quote of the day: “A heart dedicated to healing can face any storm with the strength of compassion and the light of hope.” 🌟