Fertility and sub fertility

Question 1

According to NICE guidance ‘a woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner.’ What is the first step?

Answer 1

The most appropriate first line investigation in this patient is a day 21 progesterone.
(can tell whether the patient is actually ovulating)

Question 2

A 37 week lady has HELLP syndrome, what are the treatments?

Answer 2

Key elements of management include intravenous magnesium sulfate for seizure prophylaxis, intravenous dexamethasone, control of blood pressure and replacement of blood products as needed. However, the definitive treatment is delivery of the fetus - this is the only cure for the condition.

Question 3

What is Ca19.9 the marker for?

Answer 3

Pancreatic cancer

Question 4

What is CEA the tumour marker for?

Answer 4

Bowel cancer