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Phase 3 Medicine 2026

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In which of the following clinical situations are serial βHCG levels useful for tracking progress?

 
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A 22 year old woman is seeing you at 6 weeks post-partum.  She had a normal vaginal delivery and is currently breast-feeding four times a day without problem.  Which of the following would you advise?
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Theme: Urinary frequency

 

For each patient with frequency of micturition, select the most likely diagnosis.

 

STEM 1:

A 25 year old woman has urinary frequency with severe urgency and suprapubic discomfort for the last two days, just after she last had intercourse.  Over the last 24 hours she has noted severe dysuria, nocturia, strangury and foul smelling urine.  She has a temperature of 37.9°C.  Initial laboratory studies show a white cell count of 12 x 109/L (4.5-11) and urinalysis reveals nitrites, leukocytes and trace of blood. 

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STEM 2:

A 55 year old woman has frequency of micturition with severe urgency and nocturia over the last 12 months.  Occasionally she leaks a few drops of urine as she is getting her underwear down in the toilet.  Her bladder chart shows that she drinks 1.2 L per day and voids volumes of 50-120 ml every 1-2 hours.  Pelvic ultrasound reveals 1.5 cm fibroid on posterior uterine wall.  Urinalysis shows a raised specific gravity but is otherwise normal.

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A 22 year old woman is in spontaneous labour at term with her second child having had a previous normal vaginal delivery.  Which of the following management steps will be most likely to reduce her risk of postpartum haemorrhage?
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A 28 year old couple presents in their second pregnancy, with the woman having been induced at 38 weeks in her first pregnancy for severe pre-eclampsia.  She asks you what is the chance of her having pre-eclampsia in this pregnancy.  Which of the following is the most likely risk of recurrence?

 
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Which of the following is the major cause of perinatal mortality in Australia?
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A 32 year old nulliparous woman is referred to the Antenatal Clinic from her midwife at 38 weeks gestation because of breech presentation. The pregnancy has been otherwise unremarkable.  An ultrasound at 36 weeks shows an estimated weight of 3050g, with the fetus in flexed breech position. The amniotic fluid index is 14 and umbilical artery Doppler is within normal limits.  Which of the following would you recommend to this woman as the next step in management?
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A 26 year old woman complains of a vaginal discharge over the last few months but no pruritis.  Which of the following is the most likely cause of her symptoms?
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A 20 year old woman, who has been taking a low dose oral contraceptive pill for the past 6 months, presents with a two day history of light vaginal bleeding. She recalls taking a pill 12 hours late several days ago but has not missed any other pills. She has never had any previous irregular bleeding on this pill. She is presently 10 days into her pill packet and had a normal withdrawal bleed 2 weeks ago. She is regularly sexually active with her partner of 6 months and had intercourse yesterday. Which of the following is the most appropriate advice?
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