Tutorial 16 June 2011

Podcast.
Website.
Tonight we managed 3 essay plans and an EMQ. The sound quality is not as good as it was on Monday. I have no idea why as I used the same equipment. However, I am gradually learning a bit about podcasting and the equipment involved and I hope things will improve.
Send your answers and I'll send mine, but remember to do them under exam conditions.
The essays were:

Question 1

With regard to anti-phospholipid syndrome:

1.  outline how the diagnosis is made.     4 marks.

2.  outline the clinical manifestations of anti-phospholipid syndrome. 

                                                                         6 marks.

3.  outline the management.                    10 marks.

Question 2

A woman of 38 is referred to the gynaecology clinic as the tail of her IUCD could not be seen when she recently had a routine cervical smear.

1.  Outline the history you will take.                      6 marks.

2.  Justify the investigations you will arrange.      4 marks.

3.  Justify your management.                                 10 marks.

Question 3

With regard to vulval cancer.

1. Describe the FIGO staging.                6 marks.

2. Critically evaluate screening.            4 marks.

2. Outline the management.                10 marks.

And the EMQ was:

For each of the following scenarios, choose the most appropriate management option from  the option list. Each option can be used once, more than once or not at all.

Option list.

A.        COC taken sequentially

B.        COC taken continuously

C.        NSAID

D.        danazol 100 mg. b.d.

E.         GnRH analogue

F.         Depot Provera

G.       continuous combined HRT

H.        trans-vaginal scan

I.          hysteroscopy

J.          diagnostic laparoscopy with ± tubal patency tests as appropriate

K.        laparoscopy and ablation

L.         laparoscopic ovarian drilling

M.      hysterectomy

N.       hysterectomy + BSO + addback HRT

O.       advise marriage and continuous child-bearing.

P.        refer to an endometriosis specialist.

Q.       none of the above.

Scenario 1.

A 15-year old girl is seen by you in the gynaecology clinic. She has severe dysmenorrhoea. She has tried NSAIDs without benefit.

Scenario 2.

 A 15-year old girl is seen by you in the gynaecology clinic. She has severe dysmenorrhoea. She has tried NSAIDs and the COC without benefit.

Scenario 3.

A 46-year old woman with known endometriosis is referred to the gynaecology clinic with worsening pelvic pain and intermenstrual bleeding.

Scenario 4.

 A 35-year-old woman with known endometriosis is referred to the gynaecology clinic with tenesmus, dyspareunia and tenderness and nodularity of the recto-vaginal septum.

Scenario 5.

A 40-year-old woman attends the gynaecology clinic complaining of disabling dysmenorrhoea despite two laparoscopic procedures to ablate endometriosis involving the pelvis and ovaries. Her family is complete. She is not keen on medical treatment as previous treatments have been ineffective and caused side-effects.

Scenario 6.

A 38-year-old woman with known endometriosis is referred to the gynaecology clinic with dysmenorrhoea, mastalgia and heavy periods. She has been sterilised.

Scenario 7.

A 35-year-old lady complains of pelvic pain and deep dyspareunia. The pain is not cyclical. She has just started a new job and does not want to lose time from work. Her BMI is 35 and she smokes 20 cigarettes daily.