27/07/2024 – Obstetrics and Gynaecology

Question Easy:
A 28-year-old woman, gravida 1 para 0, at 34 weeks of gestation, presents with painless vaginal bleeding. What is the most likely diagnosis? 🌟

A) Placenta previa
B) Placental abruption
C) Vasa previa
D) Uterine rupture
E) Cervical polyp

Explanations & Answers:

Question Easy Answer: A)

Question Easy Explanation: Placenta previa is a common cause of painless vaginal bleeding in the third trimester. NICE guidelines recommend ultrasonography to confirm the diagnosis. Immediate hospital admission and careful monitoring are essential.

Question Medium:
An 18-year-old woman presents with a 2-year history of irregular, painful periods and increasing lower abdominal pain, particularly during menstruation. An ultrasound reveals an ovarian mass. What is the most likely diagnosis?

A) Polycystic Ovary Syndrome (PCOS)
B) Endometriosis
C) Ovarian cancer
D) Ectopic pregnancy
E) Pelvic inflammatory disease (PID)

Explanations & Answers:

Question Medium Answer: B)

Question Medium Explanation: Endometriosis is characterized by painful menstruation, chronic pelvic pain, and ovarian masses (endometriomas). NICE guidelines recommend laparoscopy for definitive diagnosis and treatment.

Question Hard:
A 35-year-old woman presents with secondary amenorrhea for 6 months and galactorrhea. Her prolactin levels are markedly elevated. What is the first-line treatment for her condition?

A) Surgical resection
B) Hormone replacement therapy
C) Dopamine agonists
D) Transsphenoidal surgery
E) Radiation therapy

Explanations & Answers:

Question Hard Answer: C)

Question Hard Explanation: Elevated prolactin levels with secondary amenorrhea and galactorrhea suggest hyperprolactinemia, often managed initially with dopamine agonists like cabergoline or bromocriptine, as per BNF guidelines.

Medical fact of the day: The UK has one of the lowest rates of maternal mortality in the world, largely due to the accessibility and quality of antenatal care provided by the NHS.

Quote of the day: “In every setback, there’s a stepping stone; step on it, and you’ll be a step closer to your goal.” 🌈👩‍⚕️