Website: www.drcog-mrcog.info.
Tonight we discussed 4 topics. As usual, there were a number of things that we were not sure about and will need to look up. A visit to the BSCCP is called for to get guidelines for recommended follow-up after diagnosis / treatment of CIN. And this would be something to add to the ever-growing list of things to revise in the weekend before the exam.
I have now got the relevant paper about European guidelines for follow-up. You can find it here:
http://www.bsccp.org.uk/docs/public/pdf/European%20Guidelines%20mgt%20of%20abnormal%20cytology%20Part%202.pdf.
http://www.bsccp.org.uk/docs/public/pdf/European%20Guidelines%20mgt%20of%20abnormal%20cytology%20Part%202.pdf.
The topics were:
1. Critically evaluate screening for gynaecological cancer.
2. A nulliparous woman with menorrhagia and fibroids is considering uterine artery ablation. She is concerned about the possible adverse effects of UAE on her fertility and any pregnancy that might ensure.
1. Critically evaluate the potential impact of UAE and alternative treatment options for the menorrhagia and fibroids on her fertility. 8 marks
2. Critically evaluate the potential effects of UAE on pregnancy. 12 marks
This topic is covered in MCQ paper 9, question 37.
3. A woman books at 8 weeks’ gestation in her first pregnancy. She is concerned because she works in a nursery where there has been an outbreak of cytomegalovirus infection.
1. Why is CMV important in relation to pregnancy? What is the probability that she is immune? How is CMV transmitted? What is the incubation period of CMV infection? What are the symptoms of CMV infection in the adult? 6 marks
2. Critically evaluate the management in the booking clinic. 8 marks
3. Critically evaluate the management of the remainder of the pregnancy. 6 marks
This topic is covered in MCQ paper 1, question 5.
4. This question is about CIN and hysterectomy for non-malignant conditions. A woman is listed for hysterectomy for menorrhagia and fibroids.
1. Critically evaluate the issues related to CIN that should be considered pre-operatively? 4 marks
2. Critically evaluate the management if she has been on routine recall for smears and the pathology report shows no sign of CIN. 2 marks
3. Critically evaluate the management in the event of the pathology report showing the unexpected presence of CIN3 with apparently complete excision. 6 marks
4. Critically evaluate the management in the event of the pathology report showing the presence of CIN3 with apparently incomplete excision. 8 marks
Write an essay under exam conditions and send it to me and I'll send my version, once I get it written.
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