Thursday, 9 June 2011

Tutorial 9 June 2011

Podcast.
Website.

Tonight we set out to write 4 essays, but only managed 2. I think I was talking too much!
I would suggest that you write essays, or at least plans, for all 4 and send them to me. I'll then send my versions.
Below the topics are extracts from my table of the essays that have featured in the exam in recent years. These indicate that diabetes is a "hot topic". It has come up every 2 or 3 years since 2000, but not since 2007, so is likely to reappear soon. Add in the recent NICE guidelines and you have a classic "hot topic". Contraception has come even more often, twice a year in 1998 and 1999 and not more than every 2 years since. Alcohol has not featured in the essays but would make a very good subject. The only thing upsetting the arithetic is the reduction of the number of essays.

The topics were:
Question 1.
You are the SpR in the antenatal clinic at 31 weeks. You see a 35-year old woman for review. She has had an abnormal GTT at 30 weeks.
Outline your immediate management.                                                         5 marks.
Outline the management of the remainder of the pregnancy and the delivery.  8 marks.
Outline the subsequent management.                                                         4 marks.
Outline the management of the neonate.                                                     3 marks.

Question 2.
A primigravid woman attends the antenatal booking clinic at 5 weeks’ gestation. She smells strongly of alcohol. She admits to consuming at least ½ bottle of vodka each day.
1.      Critically evaluate the public health advice in the UK about alcohol and pregnancy.
                                                                                                 4 marks.
2.      Critically evaluate screening for alcohol abuse in pregnancy.  4 marks.
3.      Critically evaluate the risks to the fetus and child of the mother who abuses alcohol in pregnancy.                                                                       6 marks.
4.      Justify the management you would arrange for this patient.    6 marks.

Question 3.
Critically evaluate the management of thrombocytopenia in pregnancy.

Question 4.
Critically evaluate the non-contraceptive benefits of hormonal contraception.




Pre-pregnancy counselling. Diabetes. Type 1.
September
2007
Pregnancy. Diabetes. Abnormal GTT at 30 weeks
September
2004
Pregnancy. Diabetes. GTT in early pregnancy. Dubious result.
September
2002
Pregnancy. Diabetes. Outcome to match non-diabetic. How to go about it
March
2000


Contraception. LARC. Long-acting, reversible. Advantages & disadvantages.
March
2009
Contraception. Emergency
March
2007
Contraception. Pill & DVT risk – sister has had DVT
March
2005
Contraception. Pill: breakthrough bleeding
March
2004
Contraception. IUCD. Lost threads. Age 38. Management
September
2003
Contraception. Effect on subsequent fertility
March
1999
Contraception. Emergency. 17. Ist coitus.
September
1999
Contraception. IUCD, Copper. 5 yrs in situ. Occ missed K. Age 47
September
1998
Contraception. Pill. Non-contraceptive advantages
March
1998

Pregnancy. Thrombocytopenia. 28 weeks. Primip
March
2000

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