A 28-year-old pregnant woman is seeking advice from you. Her younger sister has recently been diagnosed with Chickenpox and she is concerned about her own health as she is currently 16 weeks pregnant. The patient lives with her sister and spends a significant amount of time with her every day. At present, she is feeling well and has not shown any signs of infection or rashes. What would be the best course of action for this patient?
A 29-year-old woman has given birth to her first child.
The child was breech and she underwent external cephalic version. She is adamant that she and her partner want one child only and that he will be seeking a vasectomy. The child’s blood group is A rhesus positive, the mother’s blood group is 0 rhesus negative.
What is the most suitable recommendation regarding anti-D injection?
A 35-year-old Afro-Caribbean woman presents having suffered her fourth miscarriage. She has a history of venous thrombosis.
She is positive for the lupus anticoagulant.
What is the probable diagnosis?
The practice nurse has asked you to see a patient who has had a routine cervical smear test which shows atypical endometrial cells. She is 55 years old and has only had two periods in the last year.
She wants to know what course of action needs to be followed.
What is the correct course of action with a finding of atypical endometrial cells in a woman aged 55?
A 25-year-old woman who is 36 weeks pregnant with her first child seeks your advice on whether to breastfeed. She is facing pressure to return to work soon but is aware of the benefits of breastfeeding for both her and her baby’s health.
Which of the following conditions is known to have a lower incidence in breastfed infants?
A 28-year-old nulliparous woman presents to you for advice on when to book her cervical smear test. She reports having a 4-day menstrual cycle every 28 days and using condoms for contraception. Is there a specific time during her cycle that would be best for her to schedule the smear test? What is the optimal timing for a cervical smear?
You are seeing a 65-year-old lady with oestrogen-receptor-positive breast cancer.
She has been prescribed exemestane 25 mg daily by her oncologist and has been taking this for four months.
Which of the following is the most common side effect that this patient may experience?
A 19-year-old sexually active female who is on the combined oral contraceptive pill presents with breakthrough bleeding between her periods.
She has been on the same pill for almost three years and noticed breakthrough bleeding for the first time two months ago. She denies post-coital bleeding. On further questioning she has not missed any pills and has had no recent illnesses or medical problems.
What is the most probable reason for her breakthrough bleeding?
A 47-year-old woman presents with a complaint of a lump in her left breast.
On questioning, she says she first noticed this lump eight weeks ago. There is no change in size in relation to the menstrual cycle. There is no family history of breast cancer.
On examination, the lump measures 3 × 4 cm and it is firm, but not tender and not mobile. The other breast is normal.
What is the most likely diagnosis?
During a routine contraception review, you ask a 27-year-woman whether she has any troublesome vaginal discharge or any unscheduled bleeding. She says that she has no unscheduled bleeding and that she has always had a very slight, clear, intermittent vaginal discharge. She has no other symptoms and is in a stable relationship.
What is the most probable reason for this?