Question Easy:
A 28-year-old woman, who is 32 weeks pregnant, presents with mild ankle swelling. She has no other symptoms and her blood pressure is 118/76 mmHg. What is the most likely cause of her ankle swelling? 🤰
A) Preeclampsia
B) Deep vein thrombosis
C) Physiological oedema of pregnancy
D) Heart failure
E) Anaemia
Explanations & Answers:
Question Easy Answer:
C) Physiological oedema of pregnancy
Question Easy Explanation:
In pregnancy, mild peripheral oedema is common due to increased blood volume and changes in venous pressure from the growing uterus. Given the normal blood pressure and absence of other concerning symptoms, physiological oedema is the most likely explanation. NICE guidelines regard this as a common finding rather than an abnormal one.
Question Medium:
A 34-year-old woman presents with a 2 cm Bartholin’s cyst that is asymptomatic. She is concerned about her symptoms and asks for advice on management. What is the most appropriate initial management?
A) Incision and drainage
B) Antibiotic therapy
C) Marsupialisation
D) Word catheter insertion
E) Reassurance and observation
Question Medium Answer:
E) Reassurance and observation
Question Medium Explanation:
According to NICE guidelines, asymptomatic Bartholin’s cysts typically do not require active treatment and can be managed with reassurance and observation. Intervention such as a Word catheter or surgical techniques like marsupialisation are generally reserved for symptomatic or infected cysts.
Question Hard:
A 42-year-old woman with a history of heavy menstrual bleeding (HMB) is being assessed for treatment options. She has no contraindications to hormonal therapies and expresses a preference for long-term solutions. According to current guidelines, which of the following is the most effective long-term treatment for HMB that also provides contraception?
A) Tranexamic acid
B) Levonorgestrel-releasing intrauterine system (LNG-IUS)
C) Combined oral contraceptive pill
D) Endometrial ablation
E) Danazol
Question Hard Answer:
B) Levonorgestrel-releasing intrauterine system (LNG-IUS)
Question Hard Explanation:
NICE guidelines recommend the LNG-IUS as a first-line treatment for heavy menstrual bleeding in women who are considering a long-term solution with the added benefit of contraception. It is highly effective in reducing menstrual blood loss and has been shown to be a well-tolerated option with contraceptive benefits.
Medical fact of the day: Did you know that the UK has one of the highest rates of multiple births in Europe, largely due to increased use of assisted reproductive technologies? 🌟 Twin births in particular have increased significantly since the 1990s.
Quote of the day: “In the heart of every caregiver is a desire to make a difference, one patient at a time. Keep the empathy alive.” 💙