Question Easy: A 30-year-old woman who is 28 weeks pregnant comes to see you for a routine check-up. She mentions that she has been feeling some movements in her abdomen but is unsure if they are normal fetal movements. What advice can you give her regarding monitoring fetal movements? 🤰
A) There is no need to monitor fetal movements until 36 weeks.
B) Start monitoring fetal movements after 32 weeks and report if they decrease.
C) Fetal movements should be felt by 24 weeks; if absent, seek medical advice.
D) Count at least 10 movements in 2 hours when you feel it’s quieter than usual.
E) Only monitor movements during the day as the fetus sleeps at night.
Question Medium: A 27-year-old woman presents with oligomenorrhea and hirsutism. She has been diagnosed with polycystic ovary syndrome (PCOS). What is the first-line treatment to manage her symptoms? 🏥
A) Clomifene citrate
B) Metformin
C) Oral contraceptive pill
D) Spironolactone
E) Finasteride
Question Hard: A 35-year-old pregnant woman, gravida 3 para 2, attends her 36-week antenatal appointment. She has a history of asthma and is currently experiencing mild symptoms. Her asthma is managed well with inhalers. She has no known drug allergies. What is the most appropriate management plan for her labour? 🚑
A) Continue with usual asthma medications, including inhalers, during labour.
B) Discontinue all asthma medications to prevent neonatal respiratory depression.
C) Opt for a caesarean section to avoid stress-induced asthma exacerbation.
D) Use only steroid inhalers during labour and avoid bronchodilators.
E) Administer oral corticosteroids prophylactically prior to onset of labour.
Explanations & Answers:
Question Easy Answer: D
Question Easy Explanation: NICE guidelines recommend that pregnant women monitor fetal movements from 24 weeks and contact healthcare providers if they notice a reduction. Counting 10 movements in 2 hours is a common strategy to ensure fetal well-being when movements seem less frequent.
Question Medium Answer: C
Question Medium Explanation: The first-line treatment for women with PCOS who are not trying to conceive and wish to regulate their menstrual cycle and reduce hirsutism is the oral contraceptive pill. It helps regulate periods and reduce androgen levels, thus managing symptoms effectively. According to NICE guidelines, lifestyle modification is also crucial, but the oral contraceptive pill remains primary for symptom management.
Question Hard Answer: A
Question Hard Explanation: Women with asthma should continue their usual asthma medications during labour, including their inhalers, as per NHS guidelines. Stopping medication can increase the risk of exacerbations. Management should focus on maintaining asthma control, mirroring usual care to prevent exacerbations.
Medical fact of the day: Did you know that skin changes in pregnancy, like the “mask of pregnancy” or melasma, are due to increased hormonal levels and affect about 50-70% of pregnant women in the UK?
Quote of the day: “The best way to predict the future is to create it. 💪🏽 Keep pushing forward, one patient at a time.”