A 75 year-old woman visits her doctor complaining of a 1.5cm ulcerated lesion on her left labium majus. She has been experiencing vulval itching and soreness for the past three years, despite using topical steroid treatment. What is the probable diagnosis?
A 28-year-old nulliparous woman presents to the labour suite at 40+6 weeks gestation. She has expressed her desire for a vaginal delivery throughout her pregnancy. On cervical examination, the cervix is found to be in an intermediate position with a firm consistency. Cervical effacement is estimated to be around 30%, and the cervical dilatation is less than 1cm. The fetal head is palpable at the level of the ischial spines, and her bishop score is 3/10. The midwife has already performed a membrane sweep. What is the next step in management?
A 19-year-old woman goes to a family planning clinic to talk about contraception options. She has been experiencing migraine with aura for the past year and a half. According to the UK Medical Eligibility Criteria, which contraceptive method is considered safe to use without caution or contraindication in this situation?
You assess a 27-year-old woman who presents with vaginal bleeding and lower abdominal pain. She had an IUD inserted as emergency contraception two weeks ago after having unprotected intercourse 6 days prior. The pain is described as severe dysmenorrhoea and is more pronounced in the right iliac fossa. She has been experiencing continuous bleeding for the past 6 days, whereas her normal menstrual cycle lasts 28 days with 4 days of bleeding. She has no issues with eating or drinking. On examination, her temperature is 36.5ºC, and her blood pressure is 104/68 mmHg. There is mild tenderness in the right iliac fossa with no guarding. Urine dip shows no abnormalities, and urine hCG is negative. What is the most probable diagnosis?
A 20-year-old female presents to the emergency department with left-sided pelvic pain and vaginal bleeding. She reports her last menstrual period was 8 weeks ago and has had a positive urinary pregnancy test. The patient is stable hemodynamically, and bloods have been taken for full blood count, renal and liver function, and C-reactive protein. What is the most suitable diagnostic test to determine the underlying cause of her symptoms?
A 35-year-old woman and her partner visit their GP with concerns about their inability to conceive. Despite having regular unprotected intercourse for 12 months, they have not been successful in getting pregnant. The husband’s semen analysis came back normal. The GP decides to order a serum progesterone test to assess ovulation.
At what point should the blood test be conducted?
A 28-year-old female patient, 14 weeks pregnant, comes in for a routine scan and agrees to have her baby screened for chromosomal disorders using the ‘combined test’. The scan and blood test are performed, and a few days later, she is informed that the results indicate a higher likelihood of her baby having Down’s syndrome. She is asked to come to the hospital to discuss the results and what to do next.
What specific combination of results from the combined test would have indicated an increased risk of Down’s syndrome for this patient?
As a foundation doctor in general practice, you have a patient who is a sexually active sixteen-year-old seeking advice about her contraceptive patch. She typically changes the patch on Saturday mornings but forgot to do so this week. What guidance should you provide?
A 28-year-old woman visits her doctor to discuss her fertility and the possibility of conceiving. She is worried about the risk of spina bifida after a friend had a baby with the condition. The patient has no notable medical history and no family history of birth defects. What is the recommended dosage of the supplement used to prevent neural tube defects during the first 12 weeks of pregnancy?
A 35-year-old woman experiences hypertension during the third trimester of her initial pregnancy. Upon conducting a 24-hour urine collection, it is revealed that she has 0.5g protein. Which of the following complications is the least commonly associated with this condition?