Question Easy:
A 28-year-old pregnant woman at 24 weeks gestation presents to the antenatal clinic for a routine check-up. She has been experiencing mild swelling in her feet and hands. What is the most likely cause of her symptoms? 😃
A) Pre-eclampsia
B) Urinary tract infection
C) Normal pregnancy-related changes
D) Gestational diabetes
E) Deep vein thrombosis
Question Medium:
A 32-year-old woman presents with heavy menstrual bleeding and pelvic pain. An ultrasound shows a fibroid located submucosally. Which of the following is the most appropriate initial management for her symptoms according to NICE guidelines?
A) Levonorgestrel-releasing intrauterine system (LNG-IUS)
B) Oral tranexamic acid
C) GnRH analogues
D) Myomectomy
E) Hysterectomy
Question Hard:
A 36-year-old woman is 39 weeks pregnant and arrives in the labour ward with painless vaginal bleeding. Her ultrasound findings show a placenta covering the os. What is the recommended mode of delivery? 🤰
A) Spontaneous vaginal delivery
B) Vacuum-assisted delivery
C) Forceps delivery
D) Planned caesarean section
E) Induction of labour
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: Mild swelling of the feet and hands during pregnancy, especially by the second trimester, is usually due to increased fluid retention and is a normal physiological change. Comprehensive assessment is essential to rule out pathological causes, but in this scenario, the symptoms are more likely benign. NICE guidelines emphasize monitoring and reassurance unless other symptoms such as hypertension or proteinuria indicate more serious conditions like pre-eclampsia.
Question Medium Answer: A
Question Medium Explanation: The NICE guidelines advocate the use of a levonorgestrel-releasing intrauterine system as the first-line treatment for heavy menstrual bleeding if there is no cavity distortion. In this scenario, the fibroid is submucosal, which can potentially distort the uterine cavity, but an LNG-IUS is often still considered initially if placement is possible, prior to considering surgery.
Question Hard Answer: D
Question Hard Explanation: Placenta previa is a condition where the placenta covers the cervical os, making a vaginal delivery unsafe due to the risk of severe bleeding. NICE guidelines recommend a planned caesarean section as the safest delivery method to protect both the mother and baby in cases of placenta previa.
Medical fact of the day: Uterine fibroids are the most common benign tumours in women of reproductive age, affecting up to 70% of white women and 80% of black women by the age of 50, though not all will have symptoms. 🎯
Quote of the day: “In the tapestry of healthcare, every act of compassion threads a stronger bond between hope and healing.” 🌟