Premenstrual syndrome — DRCOG MCQ
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Correct answer: D — Use a symptom diary and consider lifestyle measures or SSRI
Use a symptom diary and consider lifestyle measures or SSRI is the best answer because the vignette is testing Premenstrual syndrome and the recommended approach is consistent with RCOG Green-top Guideline 48. The other options are less suitable because they either delay time-critical assessment, treat a different presentation, or omit the key safety step. Specifically, Book a non-urgent community midwife appointment; Start combined hormonal contraception; Offer reassurance without further assessment; Start topical oestrogen treatment would be suboptimal in this scenario. In DRCOG-style primary care questions, the safest answer is usually the step that matches the acuity and gestation rather than symptomatic treatment alone.
Reference: RCOG Green-top Guideline 48