Question Easy:
A 28-year-old woman in her first trimester presents with severe nausea and vomiting. She has been unable to keep any food or fluids down for the past 48 hours. What is the most appropriate first-line treatment for this condition according to NICE guidelines? 🤢
A) Ondansetron
B) Metoclopramide
C) Promethazine
D) Cyclizine
E) Dexamethasone
Explanations & Answers:
Question Easy Answer:
C) Promethazine
Question Easy Explanation:
NICE guidelines recommend antihistamines like promethazine as a first-line treatment for hyperemesis gravidarum. Promethazine has shown efficacy in controlling nausea and vomiting during pregnancy, and it has been widely used in clinical practice.
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Question Medium:
A 35-year-old woman presents with heavy menstrual bleeding which impacts her quality of life. An ultrasound scan reveals uterine fibroids. According to the NHS guidelines, what is the recommended first-line medical management for heavy menstrual bleeding due to fibroids? 🌸
A) Tranexamic acid
B) Levonorgestrel-releasing intrauterine system (LNG-IUS)
C) Combined oral contraceptive pill
D) NSAIDs
E) GnRH analogues
Explanations & Answers:
Question Medium Answer:
B) Levonorgestrel-releasing intrauterine system (LNG-IUS)
Question Medium Explanation:
NHS guidelines recommend the levonorgestrel-releasing intrauterine system (LNG-IUS) as the first-line treatment for heavy menstrual bleeding, including cases caused by fibroids, except submucosal fibroids or where the uterine cavity is distorted. It reduces menstrual blood loss and can be effective for up to 5 years.
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Question Hard:
A 40-year-old woman diagnosed with stage IIIB cervical cancer requires treatment. According to NICE guidelines, what is the most appropriate management plan for her condition? 🩺
A) Radical hysterectomy
B) Pelvic exenteration
C) Chemoradiotherapy
D) Brachytherapy alone
E) Neoadjuvant chemotherapy followed by surgery
Explanations & Answers:
Question Hard Answer:
C) Chemoradiotherapy
Question Hard Explanation:
NICE guidelines recommend concurrent chemoradiotherapy as the treatment of choice for stage IIIB cervical cancer. This approach combines external beam radiotherapy with chemotherapy to enhance the treatment’s efficacy and improve survival outcomes.
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Medical fact of the day: In the UK, approximately one in five women experience heavy menstrual bleeding (HMB) at some point in their lives, significantly affecting their quality of life and leading to about 20% of all outpatient referrals to gynaecology services. 🌸
Quote of the day: “In the complex world of healthcare, let every step you take be guided by compassion. For in this profession, kindness is as critical as knowledge.” 🌟