Question Easy:
A 28-year-old woman, who is 10 weeks pregnant, presents with severe morning sickness. She feels constantly nauseated and is struggling to keep any food or drink down. What is the most appropriate initial management for her condition?
A) Lifestyle modifications
B) Promethazine
C) Ondansetron
D) Pyridoxine
E) Corticosteroids
Explanations & Answers:
Question Easy Answer: B) Promethazine
Question Easy Explanation: In cases of severe nausea and vomiting in early pregnancy (hyperemesis gravidarum), first-line pharmacological treatment recommended by NICE is antihistamines such as promethazine. Lifestyle modifications should also be advised, but pharmacotherapy like antihistamines can provide more immediate relief.
Question Medium:
A 32-year-old woman presents at 35 weeks of gestation with mild hypertension and a mild proteinuria. Her blood pressure is 145/95 mmHg. What should be the next step in her management?
A) Admit to hospital for close monitoring
B) Start antihypertensive therapy
C) Reassure and schedule for bi-weekly antenatal visits
D) Arrange for urgent delivery
E) Monitor blood pressure at home
Question Medium Answer: A) Admit to hospital for close monitoring
Question Medium Explanation: The presence of hypertension and proteinuria in pregnancy could indicate pre-eclampsia. According to NICE guidelines, women with suspected pre-eclampsia after 34 weeks’ gestation should be considered for inpatient care for close monitoring of both mother and fetal wellbeing.
Question Hard:
Following a normal vaginal birth a woman presents one week postpartum with fever, uterine tenderness, and a foul-smelling vaginal discharge. What is the most likely diagnosis?
A) Urinary tract infection
B) Endometritis
C) Retained placental tissue
D) Mastitis
E) Pelvic inflammatory disease
Question Hard Answer: B) Endometritis
Question Hard Explanation: The combination of fever, uterine tenderness, and foul-smelling lochia one week postpartum is highly suggestive of endometritis. NICE guidelines recommend considering endometritis in postpartum women presenting with these symptoms and initiating broad-spectrum antibiotic therapy.
Medical fact of the day: The UK has some of the lowest rates of maternal mortality in the world, largely due to the robust antenatal care systems and guidelines from organizations like NICE, which ensure early detection and management of potential complications.
Quote of the day: “Through each heartbeat of compassion, you inspire a world of healing.”