Diagnosis- Obs and Gynae

Question 1

Answer 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

Answer 5

c?

recheck

Question 6

Answer 6

Question 7

Answer 7

Question 8

Answer 8

Question 9

•A 26-year-old G2P0 attends her 28-week antenatal appointment. The pregnancy has been well to date, and she feels well in herself. However, she has noticed that her face and hands appear more “puffy” than usual. On examination, her blood pressure is 149/94 mmHg. Her blood pressure has been normal before this. Urine dip shows protein ++.

Answer 9

Pre-eclampsia

•Visual disturbance, severe headache, papilloedema, HELLP

Question 10

• A 26-year-old G2P0 attends her 28-week antenatal appointment. The pregnancy has been well to date, and she feels well in herself. However, she has noticed that her face and hands appear more “puffy” than usual. On examination, her blood pressure is 149/94 mmHg. Her blood pressure has been normal before this. Urine dip shows protein ++.
• Most appropriate management:

1. IV labetalol
2. IV bisoprolol
3. PO nifedipine
4. PO labetalol
5. PO ramipril

Answer 10

1.PO labetalol

Question 11

• A 26-year-old G2P0 attends her 28-week antenatal appointment. The pregnancy has been well to date, and she feels well in herself. However, she has noticed that her face and hands appear more “puffy” than usual. On examination, her blood pressure is 149/94 mmHg. Her blood pressure has been normal before this. Urine dip shows protein ++. The patient is a known asthmatic.
• Most appropriate management:

1. IV labetalol
2. IV bisoprolol
3. PO nifedipine
4. PO labetalol
5. PO ramipril

Answer 11

3. PO nifedipine

Question 12

• A 30-year-old woman attends her GP practice with polydipsia and polyuria. She is currently 25 weeks pregnant and this is her first pregnancy. She has a body mass index (BMI) of 32 kg/m². Her GP decides to perform an oral glucose tolerance test upon suspecting gestational diabetes.
• Which result supports this diagnosis?

1. 2 hour glucose = 7.6 mmol/L
2. 2 hour glucose = 7.2 mmol/L
3. Fasting glucose = 4.9 mmol/L
4. Fasting glucose = 5.5 mmol/L
5. Fasting glucose = 5.9 mmol/L

Answer 12

5. Fasting glucose = 5.9 mmol/L

Question 13

A 24-year-old primigravida of twin pregnancy at 33 weeks gestation presents to the Maternity Assessment Unit with a two-day history of worsening itching of her palms and soles. The patient denies abdominal pain, history of gallstones or change in the colour of her stools/urine. There is no history of fever or vomiting.

On examination, there is no evidence of any rash and abdominal examination is unremarkable. Liver function tests reveal raised ALT, AST and bile salts. Serology for hepatitis B and C are negative.

What is the most likely diagnosis?

1. Obstetric cholestasis
2. Atopic eruption of pregnancy
3. Polymorphic eruption of pregnancy
4. Gastroenteritis
5. Acute cholecystitis

Answer 13

1.Obstetric cholestasis – no rash

2. Atopic eruption of pregnancy – rash
3. Polymorphic eruption of pregnancy – rash
4. Gastroenteritis
5. Acute cholecystitis

Question 14

What is this called in pregnant women?

Answer 14

Atopic eruption of pregnancy

Question 15

What is this called in pregnant women?

Answer 15

Polymorphic eruption of pregnancy

Question 16

A 25-year-old nulligravida woman attends her GP appointment, presenting with very heavy bleeding during her periods. She reports having to change her pads every 2 hours in the first 2 days of her cycle.

What are the differentials?

Answer 16

• •No identifiable cause: dysfunctional uterine bleeding
• •Gynae:

a. Fibroids
b. Endometriosis/adenomyosis
c. PID (infection)
d. PCOS
e. Endometrial hyperplasia/cancer

• •Pharmacology: contraceptives (particularly copper coil), anticoagulant medications
• •Endocrine: hyper/hypothyroidism

Question 17

A 28-year-old nulligravida woman attends her gynae appointment after being referred by her GP. She has been suffering from really painful periods and often has to take days off work.

What are your differentials?

Answer 17

Endometriosis

Question 18

A 16-year-old girl attends her GP saying that she’s been missing lots of periods. She’s not sexually active and has been recently started on Isotretinoin (Accutane) for her acne.

What are your differentials?

Answer 18

Polycystic Ovarian Syndrome – PCOS:

Question 19

A 38-year-old woman presents to A&E feeling with a constant, dull ache in her pelvis and feeling generally really unwell. She’s had the pain on and off for the past 8 months, and reports having unprotected sex within the last year. She mentions she’s had an unusual discharge from her vagina which she hasn’t had before.

She has a temperature of 38.7, but her other observations are within the normal range.

What are your differentials?

Answer 19

Pelvic Inflammatory Disease

Question 20

A 64-year-old woman presents with vaginal bleeding. She went through menopause 10 years ago and hasn’t experienced any spotting since. She denies any pain or itching but is having to change a sanitary liner twice a day.

What are your differentials?

Answer 20

Endometrial hyperplasia

Endometrial Cancer