Question Easy:
A 30-year-old woman, pregnant for the first time at 33 weeks’ gestation, presents to the antenatal clinic with complaints of fatigue and shortness of breath. Her blood pressure is 100/60 mmHg, heart rate is 88 bpm, and haemoglobin is 9 g/dL. What is the most likely diagnosis? 🤰
A) Iron deficiency anaemia
B) Gestational hypertension
C) Pre-eclampsia
D) Thyroid dysfunction
E) Hyperemesis gravidarum
Question Medium:
A 28-year-old woman presents with a 6-month history of irregular menstrual cycles and recent weight gain. She is also experiencing acne and hirsutism. What is the most likely underlying biochemical abnormality in this patient? 🔍
A) Reduced oestrogen
B) Elevated androgen levels
C) Increased prolactin
D) Increased cortisol
E) Decreased insulin sensitivity
Question Hard:
A 35-year-old woman with a history of primary infertility presents with complaints of heavy menstrual bleeding and pelvic pain. Ultrasound reveals numerous cystic structures in the ovaries. What is the best first-line pharmacological treatment for her condition? 🎯
A) Clomifene citrate
B) Letrozole
C) Metformin
D) Gonadotropins
E) Spironolactone
Explanations & Answers:
Question Easy Answer: A) Iron deficiency anaemia
Question Easy Explanation: The symptoms of fatigue and shortness of breath along with a low haemoglobin level suggest iron deficiency anaemia, which is common in pregnancy due to increased iron requirements and plasma volume expansion. According to NHS guidelines, management may include dietary advice and iron supplementation.
Question Medium Answer: B) Elevated androgen levels
Question Medium Explanation: The clinical presentation of irregular periods, weight gain, acne, and hirsutism is typical of polycystic ovary syndrome (PCOS), which is associated with elevated androgen levels. NICE guidelines recommend lifestyle modifications and medical treatments for managing symptoms.
Question Hard Answer: C) Metformin
Question Hard Explanation: In a patient with polycystic ovary syndrome (PCOS) and heavy menstrual bleeding, metformin is often used to improve insulin sensitivity and help restore normal ovulation. NICE suggests metformin is beneficial in managing metabolic symptoms in PCOS, particularly if trying to conceive.
Medical fact of the day: The UK was the pioneer in implementing the first mass cervical screening programme in the 1960s, which has significantly reduced mortality rates from cervical cancer by identifying precancerous lesions early.
Quote of the day: “The best way to find yourself is to lose yourself in the service of others. Remember, every heartbeat you nurture is a step closer to a healthier world.” 💙