Question Easy:
A 28-year-old woman in her first trimester presents with nausea and vomiting, which is significantly impacting her daily activities. What is the first-line pharmacological treatment according to NICE guidelines? 🤰🤢
A) Metoclopramide
B) Doxylamine
C) Ondansetron
D) Promethazine
E) Cyclizine
Question Medium:
A 34-year-old woman, G3P2, presents at 32 weeks gestation with symptoms of a headache, visual disturbances, and elevated blood pressure. Urinalysis reveals 2+ proteinuria. What is the most likely diagnosis? ⚠️
A) Gestational hypertension
B) Pre-eclampsia
C) Eclampsia
D) Chronic hypertension
E) HELLP syndrome
Question Hard:
A 29-year-old woman presents with heavy menstrual bleeding and severe dysmenorrhoea. Investigations show an enlarged uterus and ultrasound reveals a homogenous myometrium. What is the most likely diagnosis? 🔍
A) Uterine fibroids
B) Endometriosis
C) Adenomyosis
D) Polycystic ovary syndrome
E) Endometrial hyperplasia
Explanations & Answers:
Question Easy Answer: D) Promethazine
Question Easy Explanation: According to NICE guidelines, first-line pharmacological treatment for nausea and vomiting in pregnancy includes antihistamines such as promethazine. These are considered safe and effective options early in pregnancy.
Question Medium Answer: B) Pre-eclampsia
Question Medium Explanation: Pre-eclampsia is diagnosed when a pregnant woman develops high blood pressure and proteinuria after 20 weeks of gestation. The symptoms of headache and visual disturbances are also common in pre-eclampsia, distinguishing it from gestational hypertension, which lacks proteinuria.
Question Hard Answer: C) Adenomyosis
Question Hard Explanation: Adenomyosis is characterized by the growth of endometrial tissue into the myometrium, which can result in an enlarged uterus and heavy, painful periods. The homogenous appearance of the myometrium on ultrasound supports this diagnosis over uterine fibroids, which usually present with heterogeneous masses.
Medical fact of the day: The uterine cervix undergoes remarkable changes during childbirth, dilating from 0 to 10 centimetres — a transformation that is both a critical and miraculous component of the delivery process.
Quote of the day: “In the tapestry of medicine, every thread of compassion weaves resilience.”