Question Easy:
A 28-year-old woman who is 36 weeks pregnant comes to the clinic with swollen feet and hands, persistent headaches, and visual disturbances 🌟. Blood pressure is 150/100 mmHg, and urinalysis shows proteinuria (++). What is the most probable diagnosis?
A) Gestational hypertension
B) Pre-eclampsia
C) Chronic hypertension
D) Eclampsia
E) HELLP syndrome
Question Medium:
A 30-year-old woman presents with heavy menstrual bleeding lasting 10 days, occurring every 28 days, over the last six months 🌸. She reports feeling increasingly tired. Serum ferritin is low. Which of the following is the most appropriate first-line treatment according to NICE guidelines?
A) Norethisterone
B) Mefenamic acid
C) Tranexamic acid
D) Levonorgestrel-releasing intrauterine system (LNG-IUS)
E) Combined oral contraceptive pill
Question Hard:
A 42-year-old woman with a past medical history of epilepsy presents with amenorrhea for 4 months and galactorrhea 👀. She has been taking carbamazepine and phenytoin for several years. Her pregnancy test is negative. Which of the following is the most likely cause of her symptoms?
A) Prolactinoma
B) Hypothyroidism
C) Medication-induced hyperprolactinaemia
D) Ovarian failure
E) Stress-induced amenorrhea
Explanations & Answers:
Question Easy Answer:
B) Pre-eclampsia
Question Easy Explanation:
Pre-eclampsia is characterised by new-onset hypertension and proteinuria after 20 weeks of gestation. The symptoms of swollen extremities, headaches, and visual disturbances further support this diagnosis. According to NICE guidelines, blood pressure ≥140/90 mmHg and proteinuria after 20 weeks gestation raises suspicion for pre-eclampsia. 🚑
Question Medium Answer:
D) Levonorgestrel-releasing intrauterine system (LNG-IUS)
Question Medium Explanation:
NICE guidelines recommend the levonorgestrel-releasing intrauterine system as the first-line treatment for heavy menstrual bleeding if there’s no underlying pathology, such as fibroids or polyps. It works by thinning the endometrial lining and reducing menstrual blood loss. 🌿
Question Hard Answer:
C) Medication-induced hyperprolactinaemia
Question Hard Explanation:
Carbamazepine and phenytoin are known to increase prolactin levels, leading to hyperprolactinaemia, which can cause amenorrhea and galactorrhea. Other conditions like prolactinoma are less likely given the medications she’s taking. NICE guidelines mention checking medication side effects when investigating hyperprolactinaemia. 🔍
Medical fact of the day:
Did you know that the UK has seen significant reductions in maternal mortality rates over the past decades, thanks to advancements in obstetric care and adherence to NICE guidelines? This improvement highlights the importance of evidence-based practice in enhancing maternal health. 🤰
Quote of the day:
“In the tapestry of healthcare, every thread you weave, no matter how small, contributes to the strength and beauty of the entire fabric. Keep weaving with compassion and dedication.” 🌟