Question Easy:
A 28-year-old woman who is 12 weeks pregnant presents to her GP with nausea and vomiting 🤢. She has been managing her symptoms with ginger tea but finds it insufficient. What is the first-line pharmacological treatment recommended for nausea and vomiting in early pregnancy according to NHS guidelines?
A) Metoclopramide
B) Domperidone
C) Cyclizine
D) Ondansetron
E) Prochlorperazine
Explanations & Answers:
Question Easy Answer: C) Cyclizine
Question Easy Explanation: According to NICE guidelines, first-line treatment for nausea and vomiting in pregnancy is an antihistamine, such as cyclizine or promethazine. These medications are effective and have a safe profile for use in pregnancy. Ondansetron and metoclopramide are usually reserved for cases where first-line treatments are ineffective.
Question Medium:
A 32-year-old woman reports irregular menstrual periods 🚶♀️, pelvic pain, and has been trying to conceive for the past year without success. An ultrasound suggests the “string of pearls” appearance in the ovaries. Which of the following is the most likely diagnosis?
A) Endometriosis
B) Polycystic Ovary Syndrome (PCOS)
C) Ovarian cancer
D) Uterine fibroids
E) Pelvic inflammatory disease (PID)
Explanations & Answers:
Question Medium Answer: B) Polycystic Ovary Syndrome (PCOS)
Question Medium Explanation: The “string of pearls” appearance on ultrasound is characteristic of PCOS, which is diagnosed based on Rotterdam criteria including oligo- or anovulation, hyperandrogenism, and polycystic ovaries on ultrasound. PCOS is a common endocrine disorder affecting fertility.
Question Hard:
A 35-year-old woman at 40 weeks of gestation presents with a painful contraction and subsequent vaginal bleeding. The fetal heart rate pattern on CTG is consistent with fetal distress 👶🏽. On examination, the uterus is firm and tender. Which condition is most likely responsible for these findings?
A) Placenta previa
B) Placental abruption
C) Uterine rupture
D) Preterm labour
E) Vasa previa
Explanations & Answers:
Question Hard Answer: B) Placental abruption
Question Hard Explanation: Placental abruption involves the premature separation of the placenta, presenting with painful vaginal bleeding, uterine tenderness, and fetal distress. Uterine rupture usually occurs in women with previous uterine surgery and is less common than placental abruption.
Medical fact of the day: The UK’s Maternity Services Survey shows that 94% of women give birth in NHS hospitals each year. This reflects the significant role the NHS plays in providing maternity care and highlights the high level of trust that patients place in these services.
Quote of the day: “In the heart of medicine lies compassion, where every patient is a new chapter of learning and empathy.”