MSRA Category: Reproductive Medicine

MSRA-2559

A 25-year-old female patient visits her GP complaining of thick, white vaginal discharge that is causing itchiness and hindering her ability to focus on her studies. She reveals that she has previously attempted to treat these symptoms with over-the-counter remedies, as she has experienced two similar episodes within the past five months. The patient is sexually active and uses both condoms and oral contraceptives. During her visit, a urine dip test is conducted, which yields negative results for pregnancy, protein, leucocytes, and nitrites. What would be the most effective course of action for managing this patient’s recurring symptoms?

MSRA-2575

A 28-year-old female patient visits her GP for a routine check-up after her initial cervical smear. She has no medical history, no family history of gynaecological cancers, and no known allergies to medications. She is currently taking the progesterone-only pill. The results of her smear test indicate:
Positive for HPV
Low-grade dyskaryosis cytology
What is the next course of action for managing this patient?

MSRA-2560

A 55-year-old woman visits the clinic with a complaint of experiencing night sweats and hot flashes for the past year. She had her last menstrual period 20 months ago. The patient is currently undergoing treatment with tamoxifen for breast cancer. She reports no other symptoms but would like to receive medication to alleviate her hot flashes. What is the most suitable prescription for her?

MSRA-2561

A 26-year-old primigravida presents for her first prenatal visit at 12 weeks. She expresses worry about a condition her mother had during pregnancy that caused seizures. The patient has no medical history and her blood pressure measures 125/85 mmHg during the appointment. Urine dipstick results are normal. Her BMI is 38 kg/m². What is the best course of action for management?

MSRA-2562

A 50-year-old woman presents to the GP clinic with complaints of heavy vaginal bleeding. She reports having regular menstrual cycles and denies any intermenstrual or postcoital bleeding. The patient has no significant gynaecological history and is not on any regular medications. She is not in a committed relationship and uses condoms for contraception. Additionally, she has no desire to have children. What is the recommended initial treatment option?

MSRA-2563

A 25-year-old Caucasian female teacher visits the clinic to inquire about preconception care. She intends to conceive and is interested in learning about the supplements she should take. She has never given birth before and is in good health. She is not on any medication and has no known allergies. She does not smoke or consume alcohol.
What supplements do you suggest she take?

MSRA-2564

A 27-year-old woman arrives at the emergency department complaining of sudden abdominal pain and vaginal bleeding. She had her last period 6 weeks ago and is sexually active without using any hormonal contraception. She has no significant medical history. Upon examination, she has a heart rate of 84 bpm and a blood pressure of 128/78 mmHg. There is tenderness in the left iliac fossa. A pregnancy test confirms that she is pregnant, and further investigations reveal a 40 mm left adnexal mass with no heartbeat. The serum b-hCG level is 6200 IU/L. What is the most appropriate course of action for her management?

MSRA-2565

A 36-year-old woman arrives at the emergency department complaining of sudden abdominal pain and vaginal bleeding. She has a medical history of complicated pelvic inflammatory disease that resulted in scarring of her right fallopian tube. Her last menstrual period was six weeks ago. Upon examination, her heart rate is 93 bpm, and her blood pressure is 136/76 mmHg. Palpation of the left iliac fossa causes pain. A urinary pregnancy test confirms her pregnancy, and further investigations reveal a 45 mm left adnexal mass with no heartbeat detected. Her serum b-hCG level is 5200 IU/L. What is the most appropriate course of action for her treatment?

MSRA-2566

A 32-year-old woman who is 34 weeks pregnant has been found to have a urinary tract infection through routine dipstick testing. The cause is identified as group B streptococcus and treated with a brief course of oral antibiotics. What is the appropriate management plan for delivering her baby in a few weeks?

MSRA-2567

A 20-year-old woman who is 8 weeks into her first pregnancy presents with vaginal bleeding and is seen in the early pregnancy assessment unit. The ultrasound scan confirms a viable intrauterine pregnancy, but the high vaginal swab has isolated group B streptococcus (GBS). What is the appropriate management for her?