Question Easy:
A 27-year-old woman, 34 weeks pregnant, comes to the clinic with complaints of headaches and visual disturbances. On examination, you find her blood pressure is 160/100 mmHg, and there is proteinuria (3+ on dipstick). What is the most likely diagnosis?
A) Gestational diabetes
B) Chronic hypertension
C) Eclampsia
D) Pre-eclampsia
E) Placenta previa
Explanations & Answers:
Question Easy Answer: D) Pre-eclampsia
Question Easy Explanation: Pre-eclampsia is characterized by hypertension (≥140/90 mmHg) and significant proteinuria (≥2+ on dipstick) after 20 weeks of gestation. Headaches and visual disturbances can be associated symptoms. NICE guidelines recommend that women with pre-eclampsia are closely monitored to manage blood pressure and prevent complications. 🚨
Question Medium:
A 31-year-old woman presents with heavy menstrual bleeding that has significantly affected her quality of life. She is seeking medical advice for managing her symptoms. She has no desire for future fertility. What is the most appropriate initial management?
A) Tranexamic acid
B) Oral contraceptive pill
C) Endometrial ablation
D) Levonorgestrel-releasing intrauterine system (LNG-IUS)
E) Hysterectomy
Explanations & Answers:
Question Medium Answer: D) Levonorgestrel-releasing intrauterine system (LNG-IUS)
Question Medium Explanation: According to NICE guidelines, the LNG-IUS is a highly effective first-line treatment for heavy menstrual bleeding, especially for those who do not wish to conceive. It provides long-term symptom relief by reducing menstrual blood loss.
Question Hard:
A 28-year-old woman presents with an acute onset of left-sided pelvic pain, nausea, and vomiting. On examination, she has tenderness in the left adnexa. Transvaginal ultrasound shows an ovarian cyst with no vascular flow. What is the most appropriate next step in management?
A) Conservative management with analgesia
B) Oral contraceptive pills
C) Laparoscopic surgery
D) Intramuscular methotrexate
E) Antibiotics
Explanations & Answers:
Question Hard Answer: C) Laparoscopic surgery
Question Hard Explanation: The presentation suggests ovarian torsion, indicated by the acute onset of pelvic pain and the ultrasound finding of an ovarian cyst without vascular flow. Laparoscopic surgery is the recommended treatment to untwist the ovary and restore blood flow or to possibly remove the affected ovary if it’s non-viable. This is critical to prevent further complications as recommended by NICE and NHS guidelines. 🏥
Medical fact of the day: In the UK, the rate of caesarean sections has been rising steadily. Currently, around 26-30% of all deliveries are performed via caesarean section, with elective caesareans accounting for about half of these.
Quote of the day: “Caring for others is an act of strength and compassion. You are the backbone of healing and hope.” 🌟