MSRA-2677
A 65-year-old woman complains of abdominal bloating and is found to have shifting dullness on examination. What is a risk factor for ovarian cancer?
MSRA Category: Reproductive Medicine
MSRA-2678
A pregnant woman presents at 24 weeks pregnant. What would be the expected symphysis-fundal height?
MSRA-2679
A 35 year old woman who is 30 weeks pregnant presents with malaise, headaches and vomiting. She is admitted to the obstetrics ward after a routine blood pressure measurement was 190/95 mmHg. Examination reveals right upper quadrant abdominal pain and brisk tendon reflexes. The following blood tests are shown:
Hb 85 g/l
WBC 6 * 109/l
Platelets 89 * 109/l
Bilirubin 2.8 µmol/l
ALP 215 u/l
ALT 260 u/l
γGT 72 u/l
LDH 846 u/I
A peripheral blood film is also taken which shows polychromasia and schistocytes. What is the most likely diagnosis?
MSRA-2664
A 25-year-old woman comes to the GP after having unprotected sex 3 days ago and requests emergency contraception. She has a regular menstrual cycle lasting 30 days, and her last period started 14 days ago. She has no significant medical history and is a non-smoker with a BMI of 23 kg/m². What is the most suitable course of action for the GP to suggest?
MSRA-2680
A 35-year-old female patient presents to the GP clinic seeking the combined oral contraceptive pill (COCP). She has a BMI of 25 kg/m2 and a history of migraine without aura. She is a smoker, consuming 20 cigarettes a day, and drinks socially. The patient gave birth to her second child 10 weeks ago and is currently breastfeeding. Her mother had a pulmonary embolism at the age of 60 years. Identify the UKMEC 4 contraindication that would make the COCP unsuitable for her.
MSRA-2665
A 25-year-old woman has given birth to her first child. During delivery, the midwife had to perform McRoberts manoeuvre due to shoulder dystocia, but there were no other complications. After the placenta was delivered, the midwife discovered a perineal tear that involved the external anal sphincter (EAS) but did not extend to the internal anal sphincter (IAS) or rectal mucosa. What is the best course of action for management?
MSRA-2650
A 32-year-old woman presents with intense itching at 36 weeks of pregnancy. The itching began 3 weeks ago and has been causing her sleepless nights. She experiences itching all over her body, particularly in her hands and feet, but has not observed any rashes. Her mother had comparable symptoms during her second pregnancy. Apart from this, she is in good health. What is the best course of action?
MSRA-2651
A 32-year-old woman who is 8 weeks pregnant is curious about the anomaly scan after hearing about a friend’s experience. She wants to know the earliest possible time she can have the scan.
When can the anomaly scan be done at the earliest?
MSRA-2652
Sophie, 16, has come to her doctor’s office to ask for the combined oral contraceptive pill (COCP). As per the guidelines of the Faculty of Sexual and Reproductive Healthcare (FSRH), what is an absolute contraindication for the COCP?
MSRA-2653
You assess a 29-year-old woman who is 24 weeks pregnant. Due to her BMI of 33 kg/m², she underwent a routine oral glucose tolerance test which yielded the following results:
Time (hours) Blood glucose (mmol/l)
0 7.8
2 10.6
Apart from this, there have been no other complications during her pregnancy and her anomaly scan showed no abnormalities. What would be the best course of action?