Question Easy:
A 28-year-old woman presents to the GP with complaints of a burning sensation when urinating, increased frequency, and lower abdominal pain. Her last menstrual period was four weeks ago, and she has no significant past medical history. What is the most likely diagnosis?
A) Bacterial vaginosis
B) Cystitis
C) Endometriosis
D) Pelvic inflammatory disease
E) Ovarian cyst
Explanations & Answers:
Question Easy Answer:
B) Cystitis
Question Easy Explanation:
The symptoms described—burning sensation during urination, increased frequency, and lower abdominal pain—are classic for cystitis, a common urinary tract infection. Other options such as bacterial vaginosis and endometriosis present with different symptoms and pelvic inflammatory disease typically has more systemic signs.
Question Medium:
A 34-year-old woman at 28 weeks of gestation presents with sudden onset breathlessness and chest pain. Her oxygen saturation is 89% on room air. Considering her stage of pregnancy, what is the most appropriate initial management?
A) Administer oxygen and perform a chest X-ray
B) Prescribe oral antibiotics
C) Start low molecular weight heparin
D) Schedule a CT pulmonary angiography
E) Perform an ECG
Explanations & Answers:
Question Medium Answer:
C) Start low molecular weight heparin
Question Medium Explanation:
In pregnant women with suspected pulmonary embolism, guidelines recommend initiating treatment with low molecular weight heparin as soon as a pulmonary embolism is suspected, even before a confirmed diagnosis, due to the high risk of complications. Administering oxygen and diagnostic imaging may follow, but treating potential thrombosis takes precedence in an acute setting where there is a high index of suspicion.
Question Hard:
A 45-year-old woman comes to the clinic with a history of heavy menstrual bleeding over the past few months. She also reports feeling tired and dizzy frequently. Laboratory tests reveal haemoglobin of 9 g/dL. What is the most suitable next step in management according to NICE guidelines?
A) Prescribe tranexamic acid
B) Refer for endometrial ablation
C) Initiate oral iron supplementation
D) Start combined oral contraceptive pill
E) Recommend uterine artery embolization
Explanations & Answers:
Question Hard Answer:
C) Initiate oral iron supplementation
Question Hard Explanation:
The patient’s heavy menstrual bleeding has led to symptomatic anaemia with a haemoglobin level of 9 g/dL. While treating the bleeding is important, the immediate concern is to address her anaemia. NICE guidelines favor the initiation of oral iron supplementation to address iron deficiency anaemia, coupled with investigating and managing the underlying cause of bleeding.
Medical fact of the day:
Did you know that in the UK, nearly 1 in 4 pregnancies ends in miscarriage? It highlights the importance of providing compassionate, supportive care and counseling for those affected.
Quote of the day:
“In the midst of the rush, remember, the greatest little acts of kindness save the largest hearts.” ✨