Question Easy: A 28-year-old woman, who is 12 weeks pregnant, comes to your clinic for her first antenatal appointment. She is a resident in the UK and is concerned about folic acid supplementation. What is the recommended daily dose of folic acid for her at this stage of pregnancy? 🌱
A) 0.2 mg
B) 0.4 mg
C) 1 mg
D) 2 mg
E) 5 mg
Question Medium: A 30-year-old woman presents to her GP with complaints of heavy menstrual bleeding. She has no significant past medical history and is not currently on any medication. As per NICE guidelines, what is the first-line pharmacological treatment option? 💊
A) Combined oral contraceptive pill
B) Tranexamic acid
C) Levonorgestrel-releasing intrauterine system
D) Oral progesterone
E) GnRH analogues
Question Hard: A 35-year-old woman who is 36 weeks pregnant with her second child presents with severe pruritus and jaundice. On examination, her palms and soles are notably icteric. Her liver function tests show elevated bile acids. What is the most likely diagnosis? 🩺
A) Preeclampsia
B) Hyperemesis gravidarum
C) Acute fatty liver of pregnancy
D) Intrahepatic cholestasis of pregnancy
E) HELLP syndrome
Explanations & Answers:
Question Easy Answer: B) 0.4 mg
Question Easy Explanation: According to NHS guidelines, all women trying to conceive and up to 12 weeks of pregnancy should take a daily folic acid supplement of 0.4 mg (400 micrograms) to reduce the risk of neural tube defects. 🧠
Question Medium Answer: B) Tranexamic acid
Question Medium Explanation: NICE guidelines recommend tranexamic acid as a first-line pharmacological treatment for heavy menstrual bleeding when hormonal contraception is not desired. It works by promoting clot stability. 🌊
Question Hard Answer: D) Intrahepatic cholestasis of pregnancy
Question Hard Explanation: Intrahepatic cholestasis of pregnancy is characterised by intense pruritus and elevated bile acids, usually presenting in the third trimester. It requires prompt management to prevent complications. 🌟
Medical fact of the day: Did you know that the UK was the first country in the world to establish guidelines for midwifery dating back to the early 20th century? These guidelines have evolved into the comprehensive midwifery standards recognized today. 👶
Quote of the day: “In the heart of healthcare lies compassion – the unseen force that brings healing beyond medicine.” 🚑