Question Easy:
A 28-year-old woman is 8 weeks pregnant and experiencing morning sickness 🤢. What is the most appropriate first-line treatment for her symptoms according to current UK guidelines?
A) Promethazine
B) Ondansetron
C) Metoclopramide
D) Cyclizine
E) Ginger supplements
Question Medium:
A 32-year-old woman presents with postcoital bleeding and dyspareunia. She has no significant past medical history and her last cervical screening was normal. What is the most likely diagnosis?
A) Endometrial hyperplasia
B) Cervicitis
C) Endometriosis
D) Cervical ectropion
E) Ovarian cyst
Question Hard:
A 39-year-old woman complains of severe menstrual pain and heavy periods. She has been trying to conceive for the past two years without success. An ultrasound reveals an enlarged uterus with a heterogeneous myometrial appearance. What is the most likely diagnosis?
A) Uterine fibroids
B) Adenomyosis
C) Endometriosis
D) Polycystic ovary syndrome (PCOS)
E) Primary dysmenorrhoea
Explanations & Answers:
Question Easy Answer:
A) Promethazine
Question Easy Explanation:
Promethazine is recommended by NICE as a first-line treatment for nausea and vomiting in pregnancy. Ginger supplements can be beneficial and are often used as complementary therapy, but promethazine, an antihistamine, is the first-line medication option according to UK guidelines.
Question Medium Answer:
D) Cervical ectropion
Question Medium Explanation:
Cervical ectropion is a common and benign condition that often causes postcoital bleeding and dyspareunia. The condition is due to the eversion of the endocervical columnar epithelium onto the ectocervix, which can cause increased mucus production and sensitivity.
Question Hard Answer:
B) Adenomyosis
Question Hard Explanation:
Adenomyosis is characterized by the presence of endometrial tissue within the myometrium and can lead to a diffusely enlarged uterus. It is associated with severe menstrual pain, heavy menstrual bleeding, and can be a cause of infertility, which fits this patient’s presentation.
Medical fact of the day:
Did you know that the UK was the first country in the world to offer a national HPV vaccination programme? This program significantly reduced the rates of cervical cancer, emphasizing the effectiveness of large-scale preventive healthcare initiatives.
Quote of the day:
“In the world of healing, every moment of empathy is a step towards a better tomorrow. Keep lighting the path, one patient at a time.”