Website: www.drcog-mrcog.info.
Tonight we discussed an EMQ, which I wrote a couple of hours before.
If you find any errors or bits that are not clear, please let me know.
If you find any errors or bits that are not clear, please let me know.
Botulinum toxin has been the subject of a couple of Green-top guidelines, so is a possible essay topic. Mug it up, there is not much to it and it would be an easy essay to answer.
EMQ Paper 1, Question 7. Ulipristal.
Lead-in.
The following scenarios relate to ulipristal. For each, select the most appropriate answer from the option list.
Each option can be used once, more than once or not at all.
Scenario 1.
What type of drug is ulipristal?
Scenario 2.
How is ulipristal broken down / excreted?
Scenario 3.
What is the half life of ulipristal?
Scenario 4.
Which drug may prolong the half life of ulipristal?
Scenario 5.
What is the main use of ulipristal?
Scenario 6.
What is the dose of ulipristal?
Scenario 7.
What time-scale applies to the licensed use of ulipristal?
Scenario 8.
What contraceptive advice is given to those using ulipristal?
Scenario 9.
What advice is given to women who are breast-feeding?
Scenario 10.
Can treatment with ulipristal be repeated within 1 month?
Option list.
GnRH analogue.
Selective serotonin reuptake inhibitor.
19-nortestosterone-derived progestogen.
21-hydroxyprogesterone-derived progestogen.
mifepristone derivative.
Selective oestrogen receptor modulator.
Selective progesterone receptor modulator.
Urinary excretion.
Evaporation.
Evaporation.
Metabolised by renal cytochrome P450 enzyme system.
Metabolised by hepatic cytochrome P450 enzyme system.
30 mg. with dose repeated if vomiting occurs within 3 hours.
100 mg. with dose repeated if vomiting occurs within 3 hours.
150 mg. with dose repeated if vomiting occurs within 3 hours.
phenobarbitone
valium
erythromycin
12 hours.
18 hours.
32 hours.
72 hours.
120 hours.
Depot-contraception.
Depression.
Emergency contraception.
Menorrhagia.
Termination of pregnancy.
Yes.
No.
Maybe.
Continue.
Discontinue for 36 hours.
Discontinue for 72 hours.
May interfere with contraception containing progestagen.
May interfere with contraception containing oestrogen.
No action if LARC being used.
Changed my mind - I'm going to become a dermatologist.
Changed my mind - I'm going to become a dermatologist.
I deliberately made it a huge list to discourage you from looking there to find an answer before you have made up your mind about what the answer should be.
Then we discussed plans for some essays.
The subjects for the tutorials are not prepared.
The aim is to simulate the exam and you don't get forewarning of the essay topics from the RCOG.
The idea of writing plans or complete essays is to develop technique.
The tutorials are meant to be discussions about what should go into an answer.
And how to add value and meet the requirement to "justify" or "critically evaluate".
It is also good for me to come to the discussions without preparation.
It reminds me of stuff that I need to revise.
But, remember. Nobody knows everything and all of us have errors stored in our heads.
If we agree on something that you know is wrong, let me know.
I wrote the questions shortly before the tutorial, so the markings may need to be adjusted.
The subjects for the tutorials are not prepared.
The aim is to simulate the exam and you don't get forewarning of the essay topics from the RCOG.
The idea of writing plans or complete essays is to develop technique.
The tutorials are meant to be discussions about what should go into an answer.
And how to add value and meet the requirement to "justify" or "critically evaluate".
It is also good for me to come to the discussions without preparation.
It reminds me of stuff that I need to revise.
But, remember. Nobody knows everything and all of us have errors stored in our heads.
If we agree on something that you know is wrong, let me know.
I wrote the questions shortly before the tutorial, so the markings may need to be adjusted.
A 16-year-old virgin is referred with dysmenorrhoea. You are the SpR and see her in the gynaecology clinic. She is accompanied by her mother.
a. justify the history you will take. 6 marks
b. justify the investigations you will arrange. 4 marks
c. critically evaluate your management. 8 marks.
A nulliparous 24-year-old woman presents with hirsutism. You are the SpR and see her in the gynaecology clinic.
a. justify the history you will take. 6 marks
b. justify the investigations you will arrange. 6 marks
c. justify the management you will suggest. 8 marks
A 15-year-old girl attends the A&E department on a Sunday afternoon requesting emergency contraception. She is unaccompanied. You are the SpR on call for gynaecology. The A&E consultant has asked you to deal with the problem.
a. on your way to A&E, you make a list of the crucial issues to address in the consultation. Justify your inclusions in the list. 6 marks
b. justify the investigations you will undertake. 4 marks
c. critically evaluate your management. 10 marks
With regard to botulinum toxin therapy:
a. describe the mode of action and contra-indications. 4 marks
b. critically evaluate it use in uro-gynaecology. 8 marks
c. critically evaluate its use in general gynaecology. 8 marks
We discussed all but the last.
Send me your answers and I'll send my thoughts.
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