Question Easy:
A 28-year-old pregnant woman in her first trimester complains of severe morning sickness. She has been unable to keep any food or fluids down for the past 48 hours. What is the most appropriate initial management?
A) Start IV fluids
B) Prescribe cyclizine
C) Recommend ginger supplements
D) Advise bed rest
E) Perform an ultrasound
Explanations & Answers:
Question Easy Answer: A) Start IV fluids
Question Easy Explanation: According to NICE guidelines, in cases of severe morning sickness leading to significant dehydration, the first step is to rehydrate the patient using IV fluids. This should be followed by antiemetic medication once the hydration status has been addressed.
Question Medium:
A 35-year-old woman presents with heavy menstrual bleeding (menorrhagia) that is significantly affecting her quality of life. Her pelvic ultrasound is normal. What is the most appropriate first-line treatment?
A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Combined oral contraceptive pill
C) Levonorgestrel intrauterine system (LNG-IUS)
D) Tranexamic acid
E) Endometrial ablation
Question Medium Answer: C) Levonorgestrel intrauterine system (LNG-IUS)
Question Medium Explanation: NICE guidelines recommend the levonorgestrel intrauterine system (LNG-IUS) as the first-line treatment for menorrhagia in women without structural or histological abnormalities. This choice effectively reduces menstrual blood loss and improves the patient’s quality of life.
Question Hard:
A 40-year-old woman is diagnosed with ovarian cancer and is about to start chemotherapy. She is concerned about future fertility. Which fertility preservation option should be discussed?
A) Egg freezing
B) Oophoropexy
C) GnRH analogues
D) Ovarian transposition
E) Ovarian tissue cryopreservation
Question Hard Answer: E) Ovarian tissue cryopreservation
Question Hard Explanation: According to NHS guidelines, ovarian tissue cryopreservation is a recommended option for fertility preservation in women undergoing chemotherapy for ovarian cancer. This technique involves the removal and freezing of ovarian tissue for later reimplantation, allowing the potential for natural conception post-treatment.
Medical fact of the day:
Did you know? The UK’s maternal mortality rate has significantly decreased over the years due to improved obstetric care and guidelines ensuring timely interventions during pregnancy and childbirth.
Quote of the day:
“Medicine is not just a science; it is the art of soothing the human heart and nurturing the body.”