A 30-year-old woman has been discharged from hospital with a diagnosis of systemic lupus erythematosus (SLE) with antiphospholipid antibodies. Her antibodies remained positive at 12 weeks and she is now on hydroxychloroquine monotherapy. She has a healthy BMI and blood pressure, does not smoke, and has no personal or family history of venous or arterial thrombosis or breast cancer. She is requesting to restart the combined pill. How would you advise her on this?
Sophie has presented herself to the GP practice as she is interested in starting contraception. She has chosen to use the contraceptive implant as she wants to avoid taking pills for her contraception. After obtaining informed consent, the implant was inserted into her arm. What is the main mechanism of action of this type of contraception?
A 48-year-old patient has requested a consultation to discuss the outcome of her recent cervical screening test. The test showed normal cytology and was negative for high-risk human papillomavirus (hrHPV). In her previous screening test 18 months ago, she had normal cytology but tested positive for hrHPV. What guidance should you provide to the patient based on her latest screening test result?
A 35-year-old woman presents to the emergency department with worsening left-sided abdominal pain. The pain started suddenly 4 hours ago and has been steadily getting worse. She reports that the pain started following intercourse. She is uncertain about the date of her last menstrual period as she currently has the Mirena coil fitted. She denies any vaginal bleeding or discharge. Apart from the pain, she has no other symptoms and her vital signs are stable.
Upon examination, her lower abdomen is tender on palpation but there is no guarding or rigidity. Pelvic exam including bimanual exam is unremarkable. The Mirena coil threads are clearly visualised. An ultrasound reveals free fluid in the pelvic cavity and a urinary pregnancy test is negative.
What is the most likely diagnosis?
A 28-year-old female patient arrives at the emergency department complaining of intense pain in her left lower quadrant. Upon conducting a pregnancy test, it is discovered that she is pregnant. Her medical history reveals that she had an appendectomy at the age of 18 due to a ruptured appendix.
After undergoing a vaginal ultrasound, it is revealed that she has an unruptured tubal pregnancy on the left side. The ultrasound also shows adhesions at the distal end of the right fallopian tube.
What would be the most appropriate course of action for management?
Ms. Johnson, a 26-year-old marketing executive, was diagnosed with a left tubal ectopic pregnancy 3 weeks ago. Despite being treated with methotrexate, her hCG levels did not improve. As a result, surgical intervention was deemed necessary. Ms. Johnson has no notable medical history and is in good health. What type of surgery is the surgeon most likely to perform?
A 28-year-old woman presents to the Emergency Department with sharp, left lower abdominal pain, which has been intermittently present for several days. It does not radiate anywhere. It is not associated with any gastrointestinal upset. Her last menstrual period was 10 weeks ago. She is sexually active although admits to not using contraception all the time. Her past medical history includes multiple chlamydial infections. On examination, the abdomen is tender. An internal examination is also performed; adnexal tenderness is demonstrated. A urine pregnancy test is positive.
What investigation is recommended as the first choice for the likely diagnosis?
A 26-year-old woman is ready to be discharged from the labour ward following an uncomplicated delivery. The medical team discusses contraception options with her before she leaves. The patient had previously been taking microgynon (ethinylestradiol 30 microgram/levonorgestrel 50 micrograms) and wishes to resume this medication.
The patient has no significant medical history, is not taking any other medications, and has no allergies. She is a non-smoker with a BMI of 19 kg/m² and does not plan to breastfeed her baby.
What is the appropriate time frame for the patient to safely restart her medication?
A 20-year-old woman comes to the clinic 72 hours after having unprotected sex and requests emergency contraception. She had her last period 5 days ago and has no significant medical history or regular medications. Her BMI is 23 kg/m2 and her blood pressure is 118/72 mmHg. She decides to take ulipristal (Ella-One) for emergency contraception and also expresses interest in starting a combined oral contraceptive pill (COCP). She asks when she can begin taking it. What advice should be given?
A 75-year-old woman presents to the acute medical unit with abdominal distension and shortness of breath. A chest x-ray reveals a right pleural effusion. Following the removal of an ovarian mass, it is determined to be benign on histology. What is the name of this syndrome?