Question Easy:
🤰 A 28-year-old woman who is 10 weeks pregnant comes to the GP with nausea and vomiting. She is otherwise well and reports that her symptoms are mainly in the morning. What is the most appropriate first-line treatment?
A) Ondansetron
B) Metoclopramide
C) Ginger supplements
D) Cyclizine
E) Promethazine
Question Medium:
A 32-year-old woman in her first pregnancy presents at 36 weeks with a sudden onset of severe abdominal pain and vaginal bleeding. She is known to have placenta previa. What is the immediate management priority in this situation?
A) Administer intravenous fluids
B) Perform an emergency C-section
C) Administer corticosteroids
D) Start magnesium sulfate
E) Perform a vaginal examination
Question Hard:
A 40-year-old woman presents with intermenstrual bleeding and pelvic pain. An ultrasound scan reveals a 3 cm endometrial polyp. What is the most appropriate next step in management?
A) Observation and follow-up in 6 months
B) Start oral contraceptive pills
C) Endometrial ablation
D) Hysteroscopic polypectomy
E) MRI of the pelvis
Explanations & Answers:
Question Easy Answer: E) Promethazine
Question Easy Explanation: According to NICE guidelines, for mild to moderate pregnancy-related nausea and vomiting, antihistamines like promethazine are recommended as first-line treatment. They are considered safe and effective for managing symptoms.
Question Medium Answer: B) Perform an emergency C-section
Question Medium Explanation: In a patient with placenta previa presenting with severe bleeding, the priority is to prevent maternal and fetal complications. An emergency C-section is indicated to safely deliver the baby and manage the bleeding, as vaginal delivery is contraindicated in cases of placenta previa.
Question Hard Answer: D) Hysteroscopic polypectomy
Question Hard Explanation: For symptomatic endometrial polyps, hysteroscopic polypectomy is the most appropriate management. It allows for direct visualization and removal of the polyp, providing both symptomatic relief and tissue for histological diagnosis, ruling out malignancy.
Medical fact of the day:
Did you know that the UK has one of the lowest maternal mortality rates in the world? This is largely due to the comprehensive antenatal care system, which includes routine screenings and access to emergency obstetric services.
Quote of the day:
“In every patient, there’s a story waiting to be heard and a life waiting to be transformed. Keep listening, keep learning.”