Women's Health and Paediatrics
What this domain tests
Contraception, menopause, antenatal shared care, and the paediatric presentations that are frequent but time-critical.
Core rules
- Contraception safety. Use the UK Medical Eligibility Criteria. Combined hormonal contraception is category 4 (do not use) in migraine with aura, and in smokers aged 35 or over smoking 15 or more a day. Consider transdermal or progestogen-only methods when venous thromboembolism risk matters.
- Emergency contraception. Levonorgestrel 1.5 mg is licensed to 72 hours, ulipristal to 120 hours, and a copper intrauterine device to five days and is the most effective. Offer a pregnancy test if the period is late.
- Menopause. Oestrogen alone if the uterus is absent; combined oestrogen and progestogen if present, to protect the endometrium. Transdermal oestrogen is preferred where there is venous thromboembolism or migraine risk. Review annually.
- Antenatal shared care. Know the pre-eclampsia warning signs - headache, visual disturbance, epigastric pain, sudden swelling - and the reduced fetal movements pathway.
- Fever in the under-3-month-old is an emergency, as is any febrile child who is pale, mottled, difficult to rouse or has a non-blanching rash.
- Bronchiolitis is supportive care with safety netting; antibiotics and bronchodilators do not help.
Worked example
A 37-year-old smoker of 20 a day with migraine with aura asks for the pill. Both aura and smoking make combined hormonal contraception category 4. You discuss a progestogen-only pill, the contraceptive implant or a copper intrauterine device, and record the risk discussion.
Traps
- Prescribing a combined pill to a smoker over 35 with aura.
- Missing the non-blanching rash or the lethargic febrile child.
- Giving a bronchodilator for bronchiolitis.
- Failing to ask about migraine when assessing contraception.