Question Easy:
A 28-year-old woman, who is 34 weeks pregnant, attends the antenatal clinic for a routine check-up. She mentions feeling some swelling in her legs and hands, but has no headache, visual changes, or epigastric pain. Her blood pressure is 124/78 mmHg, and urinalysis shows negative proteinuria. What is the most likely diagnosis? 🙂
A) Pre-eclampsia
B) Gestational hypertension
C) Physiological oedema of pregnancy
D) Deep vein thrombosis
E) Hyperemesis gravidarum
Question Medium:
A 35-year-old woman presents with pelvic pain. Her last menstrual period was 6 weeks ago. She has had regular cycles previously. She is sexually active and does not use contraception. On examination, she is tachycardic and her blood pressure is 88/54 mmHg. Urine pregnancy test is positive. What is the most likely diagnosis? 🚑
A) Ectopic pregnancy
B) Miscarriage
C) Ovarian torsion
D) Ruptured ovarian cyst
E) Pelvic inflammatory disease
Question Hard:
A 32-year-old woman, G2P1, is undergoing a routine anomaly scan at 20 weeks of gestation. The ultrasound reveals a single fetus with a small head circumference, structural heart defect, and microphthalmia. The patient had an episode of mild rash 12 weeks ago, which she thought was mild eczema. What is the most likely underlying cause of these fetal anomalies?
A) Maternal hypothyroidism
B) Chromosomal abnormality
C) Rubella infection
D) Fetal alcohol syndrome
E) Phenylketonuria
Explanations & Answers:
Question Easy Answer:
C) Physiological oedema of pregnancy
Question Easy Explanation:
Physiological oedema of pregnancy is common due to increased blood volume and fluid retention, especially in the third trimester. Without hypertension or proteinuria, pre-eclampsia is unlikely. NICE guidelines indicate that isolated swelling alone is often benign and not concerning unless accompanied by other symptoms like hypertension or proteinuria.
Question Medium Answer:
A) Ectopic pregnancy
Question Medium Explanation:
The patient’s presentation of pelvic pain, positive pregnancy test, hypotension, and tachycardia raises suspicion of a ruptured ectopic pregnancy, an urgent medical condition treated in accordance with NHS guidelines. These symptoms, coupled with the absence of intrauterine pregnancy on examination, suggest ectopic pregnancy as the most likely diagnosis.
Question Hard Answer:
C) Rubella infection
Question Hard Explanation:
The fetal anomalies presented in the scan, along with the mother’s history of a rash during pregnancy, suggest congenital rubella syndrome. The characteristic combination of microcephaly, cardiac defects, and eye abnormalities aligns with rubella infection effects per NHS guidance. Proper vaccination history review and fetal monitoring are essential in such cases.
Medical fact of the day:
Did you know the NHS targets a 70% reduction in maternal mortality by 2025 through initiatives focused on reducing disparities in healthcare access and emphasizing continuity of care?
Quote of the day:
“In every gentle touch, there is a story of healing and hope. Continue to inspire and strive for greatness, for you hold the power to change lives one patient at a time.” 🌟