Question Easy:
A 27-year-old woman comes to her GP with concerns about her irregular menstrual cycles 🩸. She mentions that her cycles vary in length, often exceeding 35 days. Which of the following is the most likely cause of her symptoms?
A) Polycystic Ovary Syndrome (PCOS)
B) Endometriosis
C) Uterine fibroids
D) Primary ovarian insufficiency
E) Hypothyroidism
Question Medium:
A 30-year-old woman is 10 weeks pregnant 🤰 and presents to the A&E with vaginal bleeding and abdominal pain. An ultrasound confirms a miscarriage. Which of the following medications is recommended by NICE to medically manage this incomplete miscarriage?
A) Methotrexate
B) Mifepristone
C) Misoprostol
D) Oxytocin
E) Ergometrine
Question Hard:
A 32-year-old primigravida at 36 weeks’ gestation presents with intense itching on her palms and soles 🖐️🦶. Liver function tests reveal elevated bile acids. What is the most appropriate initial management to relieve her symptoms according to UK guidelines?
A) Oral corticosteroids
B) Chlorphenamine
C) Ursodeoxycholic acid
D) S-adenosylmethionine
E) Antihistamines
Explanations & Answers:
Question Easy Answer:
A) Polycystic Ovary Syndrome (PCOS)
Question Easy Explanation:
This woman is experiencing oligomenorrhea, a common symptom of Polycystic Ovary Syndrome (PCOS). PCOS is characterized by irregular or absent menstrual periods due to chronic anovulation, and is often associated with other symptoms such as hirsutism or acne. This is in line with NICE guidelines which highlight PCOS as a common cause of irregular menstrual cycles.
Question Medium Answer:
C) Misoprostol
Question Medium Explanation:
NICE guidelines recommend misoprostol for the medical management of incomplete miscarriage. It helps in expelling uterine contents by inducing uterine contractions, providing a non-surgical option to complete the miscarriage process. Misoprostol is preferred for its accessibility and effectiveness in this context.
Question Hard Answer:
C) Ursodeoxycholic acid
Question Hard Explanation:
The described symptoms are indicative of intrahepatic cholestasis of pregnancy, a liver disorder occurring late in pregnancy. Ursodeoxycholic acid is the first-line treatment recommended to alleviate pruritus and improve liver function test abnormalities. This is in accordance with the RCOG guidelines for managing ICP in pregnant women.
Medical fact of the day:
Endometriosis affects roughly 1 in 10 women in the UK, and it takes an average of 7.5 years from the onset of symptoms to receive a diagnosis. Raising awareness and improving diagnosis times is crucial for better management of this chronic condition.
Quote of the day:
“In the quiet moments of care, find the strength to heal, the courage to understand, and the dedication to make a difference.”