MSRA Category: Reproductive Medicine

MSRA-2714

A 30-year-old woman visits her GP with a query regarding oral contraception. She gave birth to her fourth child 2 weeks ago and believes that her family is complete. After weighing the options, she has decided to begin taking the combined contraceptive pill. She has no significant medical history and only takes regular vitamin supplements without any allergies. She is not breastfeeding at the moment.
What is the earliest possible time for her to start taking her preferred contraceptive?

MSRA-2715

A 16-year-old girl presents with heavy menstrual bleeding since her first period at age 13. She has a history of frequent nosebleeds in childhood. After a normal physical exam and ultrasound, what is the most crucial next step?

MSRA-2716

A 29-year-old woman arrives at the delivery ward for childbirth. She is 38 weeks pregnant and had an uncomplicated pregnancy. Her first child, who is now 2 years old, had neonatal sepsis due to Group B Streptococcus (GBS). She has no significant medical history. What is the best course of action for managing the risk of GBS?

MSRA-2717

A 29-year-old woman comes to the clinic to discuss contraception. She has recently given birth to a healthy baby girl and is currently breastfeeding. After discussing various options, she has decided to start taking progesterone-only pills. When would be the appropriate time to advise her to begin taking them?

MSRA-2718

A 28-year-old woman presents to the antenatal clinic at 12 weeks gestation for discussion about testing for chromosomal disorders. She has no significant medical history and is concerned about the potential risks to her and her baby. Upon investigation, her b-hCG levels are elevated, PAPP-A levels are decreased, and ultrasound reveals thickened nuchal translucency. The calculated chance of a chromosomal disorder is 1/100. What is the recommended next step in her management?

MSRA-2719

A 35-year-old woman visits her GP with concerns about not having had a period for 6 months. She has also noticed increased sweating at night and occasional hot flashes, but attributes this to the warm weather. She has no desire for children and is only seeking reassurance that there is no underlying issue causing her amenorrhea. She has no significant medical history or family history.

The following blood tests were conducted:
– TSH: 2 mU/L (normal range: 0.5 – 5.5)
– T4: 10 pmol/L (normal range: 9 – 18)
– Prolactin: 15 µg/L (normal range: <25)
– FSH: 75 iu/L (normal range: <40)
– Oestradiol: 45 pmol/L (normal range: >100)

Repeat blood tests 6 weeks later show no changes. What is the most appropriate course of action for this patient?

MSRA-2713

A 75-year-old woman presents with post-menopausal bleeding. She has experienced multiple episodes over the past 6 months. The bleeding is heavy enough to require sanitary pads, but she denies any clots. She reports no bowel or urinary symptoms and has not experienced any weight loss. She went through menopause at 50 years old and took hormone replacement therapy for 2 years to alleviate hot flashes and mood swings. She has one child who was born via spontaneous vaginal delivery 45 years ago. There is no family history of gynaecological issues. What is the most probable diagnosis?

MSRA-2701

A 25-year-old actress visits your clinic seeking advice on contraception. She expresses concern about weight gain as she needs to maintain her figure for her profession. Which contraceptive method has been linked to weight gain?

MSRA-2702

A 28-year-old pregnant woman comes to the clinic complaining of severe vomiting. She is currently 10 weeks pregnant and this is her first pregnancy. According to RCOG guidelines, what are the diagnostic criteria for hyperemesis gravidarum?

MSRA-2703

At her booking appointment, a 29-year-old pregnant woman reports a history of pre-eclampsia in her previous pregnancy. To decrease the risk of intrauterine growth retardation, what medication should be initiated at 12-14 weeks gestation?