Question Easy:
A 28-year-old primigravida presents with a blood pressure of 150/95 mmHg at her 34-week antenatal check-up. What is the most appropriate initial investigation to conduct?
A) Liver function tests
B) Fetal heart rate monitoring
C) Urine dipstick for protein
D) Complete blood count
E) Glucose tolerance test
Explanations & Answers:
Question Easy Answer:
C) Urine dipstick for protein
Question Easy Explanation:
In pregnant women with high blood pressure, it is essential to check for proteinuria to assess for pre-eclampsia. According to NICE guidelines, the presence of proteinuria alongside hypertension warrants further evaluation and management.
Question Medium:
A 36-year-old woman presents with a 6-month history of menorrhagia and dysmenorrhea. On pelvic examination, an enlarged, irregularly shaped uterus is noted. What is the most likely diagnosis?
A) Adenomyosis
B) Endometrial hyperplasia
C) Uterine fibroids
D) Polycystic ovary syndrome (PCOS)
E) Endometriosis
Explanations & Answers:
Question Medium Answer:
C) Uterine fibroids
Question Medium Explanation:
Uterine fibroids (leiomyomas) are benign smooth muscle tumors of the uterus that can cause menorrhagia, dysmenorrhea, and an enlarged, irregularly shaped uterus. NICE guidelines recommend considering fibroids as a differential in such presentations.
Question Hard:
A 29-year-old woman, G2P1, at 32 weeks of gestation, presents with painless vaginal bleeding. Which of the following is the most likely diagnosis?
A) Placenta previa
B) Abruptio placentae
C) Vasa previa
D) Cervical ectropion
E) Uterine rupture
Explanations & Answers:
Question Hard Answer:
A) Placenta previa
Question Hard Explanation:
Placenta previa is a condition where the placenta lies low in the uterus, covering the cervix partially or completely. This can cause painless vaginal bleeding in the second or third trimester. NICE guidelines suggest immediate ultrasound to confirm the diagnosis and appropriate management to ensure maternal and fetal well-being.
Medical fact of the day: In the UK, estimated fetal weight should be serially measured using ultrasound in cases of fetal growth restriction to monitor adequate growth and inform delivery planning, as per RCOG and NICE guidelines.
Quote of the day: “The best way to predict your future in healthcare is to create it. Embrace learning, practice with empathy, and ignite change through knowledge.”