Question Easy:
A 28-year-old woman, 32 weeks pregnant, comes to the antenatal clinic with complaints of swelling in her hands and feet. 👐👣 She feels well otherwise and has no other significant symptoms. Her blood pressure is 110/70 mmHg, and her urine dipstick shows no proteinuria. What is the most likely cause of her swelling?
A) Pre-eclampsia
B) Deep vein thrombosis
C) Gestational diabetes
D) Physiological oedema of pregnancy
E) Cardiac failure
Question Medium:
A 30-year-old woman presents to her GP with a 3-month history of irregular menstrual bleeding. She is otherwise healthy and is not on any hormonal medication. On examination, her pelvic ultrasound shows multiple small follicles in the ovaries. What is the most likely diagnosis?
A) Endometrial cancer
B) Polycystic ovarian syndrome (PCOS)
C) Uterine fibroids
D) Ovarian torsion
E) Ovarian cyst
Question Hard:
A 34-year-old woman in the UK has been diagnosed with endometriosis. Despite trying multiple treatment options, she continues to experience severe pelvic pain. She has two children and wishes to avoid future pregnancies. What would be the definitive surgical treatment for her condition?
A) Hysterectomy
B) Laproscopic excision of endometriotic lesions
C) Oophorectomy
D) Use of Gonadotropin-releasing hormone (GnRH) analogues
E) Extended course of oral contraceptive pills
Explanations & Answers:
Question Easy Answer: D)
Question Easy Explanation:
The most likely cause of swelling in a pregnant woman at this gestational age with normal blood pressure and no proteinuria is physiological oedema. This is common in pregnancy due to increased blood volume and changes in circulation. NICE guidelines suggest monitoring symptoms and ensuring there are no signs of pre-eclampsia or other complications.
Question Medium Answer: B)
Question Medium Explanation:
The clinical presentation and ultrasound findings suggest polycystic ovarian syndrome (PCOS), characterized by irregular menstrual cycles and multiple small follicles, often referred to as a “string of pearls” on ultrasound. Managing PCOS involves lifestyle changes, considering insulin resistance, and possibly hormonal treatment if needed.
Question Hard Answer: A)
Question Hard Explanation:
The definitive surgical treatment for endometriosis, particularly when childbearing is completed, is hysterectomy. NICE guidelines indicate that a hysterectomy, with or without oophorectomy, can alleviate symptoms but comes with significant considerations, including the permanence of the procedure and its implications.
Medical fact of the day:
Did you know that in the UK, gestational diabetes affects up to 18% of pregnancies? It’s crucial to screen between 24 to 28 weeks of gestation as per NICE guidelines to prevent complications for both mother and baby.
Quote of the day:
“In the care of others, remember to care for yourself. For in wellness, both patient and healer find strength.”