A 28-year-old female presents with a six month history of heavy menstrual flow for which she has used at least 12 sanitary towels daily.
She has had generally heavy periods but has found that her condition has deteriorated in the last six months.
Which of the following therapies would be your next step in managing this patient?
A 56-year-old lady presents to your clinic seeking advice on managing her menopausal symptoms. She reports her last period occurred 12 months ago and is experiencing bothersome hot flashes and vaginal dryness. She has no significant medical or surgical history and is interested in trying hormone replacement therapy (HRT) after a thorough discussion of the risks and benefits.
After counseling, there are no contraindications to hormonal treatment, and she is eager to start a suitable regimen.
What is the most appropriate HRT prescription for this patient?
You see a 30-year-old woman in surgery.
She has had three miscarriages in the last 18 months and has been told she has antiphospholipid syndrome. She says she was told that she would need treatment early in any future pregnancy and she has now had a positive pregnancy test.
What is the treatment for antiphospholipid syndrome in pregnancy?
A 55-year-old female attends the GP surgery to discuss treatment for the menopause.
Her last period was 14 months ago. She has been experiencing low mood, which has been attributed to the menopause, but there are no symptoms of overt depression. She has a past history of breast cancer, treated three years ago. She is currently taking Tamoxifen. She has no allergies. She would like treatment for her symptoms.
What is the most suitable course of action for her symptoms?
A 17-year-old female presents for contraceptive counseling. She has a history of cystic fibrosis with frequent hospitalizations, and her current FEV1 is 45%. She doesn’t smoke, has a normal blood pressure, a BMI of 18 kg/m2, and no personal or family history of VTE. What would be the most effective contraceptive option for this patient?
A 32-year-old woman has come to see you to discuss the results of her smear test.
Unfortunately, the sample was inadequate and needs to be repeated.
How soon after the initial smear should she have the repeat smear taken?
A couple is struggling with infertility. The male partner is 32-years-old and the female partner is 33-years-old. They have no children and she has never been pregnant before. They have been having regular unprotected sexual intercourse.
The male partner is in good health with no significant medical history or testicular problems. He doesn’t smoke or drink alcohol and has a body mass index of 23.5 kg/m2. The female partner has regular periods every four weeks and bleeds for four to five days with each period. She has no significant menstrual issues or vaginal bleeding or discharge. Her periods have always been light and regular. She has no other significant medical history and is a non-smoker, non-alcohol drinker, with a body mass index of 24.1 kg/m2. Neither of them take any regular medications.
They have returned to seek further advice after initial investigations were conducted.
It is noted that she had blood tests for FSH, LH, prolactin, TFTs and a day 21 progesterone, all of which were normal. High vaginal swabs were normal. She also underwent an open access hysterosalpingogram which was normal. His semen analysis was normal.
What is the most appropriate management advice to provide at this stage?
A 30-year-old woman presents to you for contraceptive advice. She is 30 days postpartum and has not engaged in sexual activity since giving birth. She had an uncomplicated vaginal delivery following a routine antenatal period. She has no significant medical history, is a non-smoker, and has no notable family history. On examination, her blood pressure is 106/80, and her body mass index is 23. She is currently breastfeeding her baby. Which of the following contraceptive options should she not start using right away?
A 30-year-old female presents with oligomenorrhoea.
On examination she is obese but otherwise normal.
Investigations reveal a prolactin of 1500 mU/L (high), a LH of 1.1, FSH 1.2 and oestradiol 1200 pmol/L (high).
Which one of the following is the most likely diagnosis?
A 16-year-old primigravida reports experiencing constipation and arthralgia during her 28th week of pregnancy. Several biochemical tests are conducted, but which one holds clinical significance?