### Question Easy:
A 28-year-old pregnant woman presents for her routine antenatal visit at 10 weeks gestation. She asks about screening tests available for Down’s syndrome. What is the most appropriate initial screening test offered in the first trimester?
A) Maternal serum alpha-fetoprotein
B) Nuchal translucency scan combined with serum markers
C) Non-invasive prenatal testing (NIPT)
D) Amniocentesis
E) Chorionic villus sampling
### Question Medium:
A 34-year-old woman with a history of PCOS presents with a 3-month history of irregular periods and increased facial hair. She wishes to conceive in the near future. What is the first-line management to help her achieve pregnancy?
A) Lifestyle modifications
B) Clomifene citrate
C) Metformin
D) IVF
E) Ovarian drilling
### Question Hard:
A 42-year-old woman presents with postmenopausal bleeding. An ultrasound reveals an endometrial thickness of 6 mm. What is the most appropriate next step in the management of this patient?
A) Repeat ultrasound in 3 months
B) Hysteroscopy and biopsy
C) Hormonal therapy
D) Endometrial ablation
E) Pelvic MRI
### Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The combined test, which includes a nuchal translucency scan and serum markers (free β-hCG and PAPP-A), is recommended by NICE guidelines between 11 and 14 weeks of pregnancy to screen for Down’s syndrome.
Question Medium Answer: B
Question Medium Explanation: According to NICE guidelines, Clomifene citrate is the first-line treatment for anovulation associated with PCOS in women who wish to conceive, due to its ability to induce ovulation effectively.
Question Hard Answer: B
Question Hard Explanation: In postmenopausal women with endometrial thickness greater than 4 mm, further evaluation with hysteroscopy and endometrial biopsy is advised by NICE to rule out endometrial carcinoma.
### Medical fact of the day:
Did you know that the UK has one of the most comprehensive antenatal care systems in the world? Routine care includes screening and monitoring at different stages of pregnancy to ensure the health and wellbeing of both mother and baby. 🇬🇧👶
### Quote of the day:
“In the quiet moments of care and compassion, you find the true essence of healing. Keep shining, for every small act of kindness lights up the path of recovery.” 🌟