DRCOG Online Revision – Free Trial Paper

1. A 23 year old attends her GP with secondary amenorrhoea for 6 months. She is nulliparous with a BMI of 36 and her periods have always been irregular with 55-60 day cycles on average. A urinary pregnancy test is negative but she reports alopecia, worsening acne and recently a deepening of her voice. Her GP arranges some blood tests and the results are shown below with normal ranges shown in brackets:

 

FSH – 10.5                         (1.0-11.0 IU/L)

LH – 8.5                               (0.5-14.5 IU/L)

Testosterone – 7.8         (0.8-3.1 nmol/L)

Prolactin – 401                 (90-520 mu/L)

TSH – 2.1                              (0.5-7.0 mu/L)

Free T4 – 20                       (11-23 pmol/L)

 

What is the next most appropriate investigation?

2. A 38 year old woman presents to her GP with increasingly heavy periods for the past six months. She reports that her menstrual cycles are approximately 30 days in length with prolonged heavy bleeding for 10-14 days where she has to use dual protection of tampons and sanitary towels. What is the next most appropriate investigation?

3. A 26 year old primigravida attends her GP at 30 weeks of gestation as she is planning to travel abroad for a family event in Australia. She has been fit and well during this pregnancy, remaining under midewifery led antenatal care. She requests a letter from her GP to give to the airline to allow her to travel. Which of the following statements regarding air travel in pregnancy is incorrect?