Question Easy:
A 28-year-old woman who is 12 weeks pregnant attends her routine antenatal check-up. She expresses concern about the safety of eating certain types of fish during pregnancy. Which of the following types of fish should she be advised to avoid due to mercury content? 🐟
A) Salmon
B) Sardines
C) Cod
D) Shark
E) Plaice
Explanations & Answer:
Question Easy Answer:
D) Shark
Question Easy Explanation:
Pregnant women are advised to avoid fish that are high in mercury due to potential risks to the developing fetal nervous system. According to NHS guidelines, shark, swordfish, and marlin are to be avoided in pregnancy because of their high mercury content. Salmon and other commonly consumed fish such as sardines and cod are generally considered safe and beneficial due to their omega-3 fatty acids.
Question Medium:
A 32-year-old woman presents with heavy menstrual bleeding. After initial examination and history taking, a diagnosis of fibroids is suspected. Which of the following is the first-line treatment option to manage her heavy menstrual bleeding according to NICE guidelines? 💊
A) Tranexamic acid
B) Oral contraceptive pill
C) Uterine artery embolisation
D) Hysterectomy
E) Levonorgestrel-releasing intrauterine system (LNG-IUS)
Explanations & Answer:
Question Medium Answer:
E) Levonorgestrel-releasing intrauterine system (LNG-IUS)
Question Medium Explanation:
The NICE guidelines recommend the levonorgestrel-releasing intrauterine system (LNG-IUS) as the first-line treatment for managing heavy menstrual bleeding if the woman does not wish to conceive at present. It releases levonorgestrel directly into the uterine lining, reducing bleeding significantly for many women. Other options, including tranexamic acid and oral contraceptive pills, may be considered if LNG-IUS is not suitable or desired. Surgical options such as uterine artery embolisation and hysterectomy are usually considered last-line treatments.
Question Hard:
A 29-year-old nulliparous woman attends the gynaecology clinic with a 6-month history of pelvic pain exacerbating during menstruation, dysmenorrhea, and dyspareunia. A pelvic ultrasound suggests endometriosis. What is the most appropriate initial management strategy for this patient according to NICE guidelines? 🌸
A) Laparoscopic excision of endometriosis
B) Oral progestogens
C) Combined oral contraceptive pill
D) Gonadotropin-releasing hormone (GnRH) agonists
E) Non-steroidal anti-inflammatory drugs (NSAIDs)
Explanations & Answer:
Question Hard Answer:
C) Combined oral contraceptive pill
Question Hard Explanation:
NICE guidelines recommend offering hormonal treatment as the initial management to suppress ovulation and manage symptoms of endometriosis-related pain. The combined oral contraceptive pill is often the first-line treatment to manage symptoms such as dysmenorrhea and pelvic pain, provided there are no contraindications. Laparoscopic surgery, GnRH agonists, and other options come into consideration if there is no response to initial medical management or when surgical diagnosis and treatment are considered necessary.
Medical fact of the day:
Did you know? In the UK, approximately 1 in 6 couples face fertility issues, with one-third of cases attributed to male factors. With advancements in assisted reproductive technologies, many couples are able to achieve successful pregnancies. 🌱
Quote of the day:
“The essence of compassion lies in understanding the journey of another. Continue to care, heal, and aspire — for every life you touch, you hold the power to transform.” 🌟