Thursday, 24 November 2011

Tutorial 24 November 2011

Website.
Tutorial.
Tomorrow is the big day with the degree presentation ceremony at the RCOG.
Our congratulations to those who passed. http://www.drcog-mrcog.info/Pass%20list%20Nov%202011.htm.
Particular congratulations to Lucy for her Gold Medal.
 If you managed to listen to the recent OSCE tutorials, you will have appreciated the very high standards that Lucy and some of the others, particularly Clare, had attained.
Tonight we started off with by trying to clear up confusion about what I am hoping people will get from the tutorials.
The main thing is to develop techniques for essay-writing and answering the EMQs.
You need lots of practice under exam conditions.
I do not offer an essay-marking service with comments on how to improve.
You will need to sign up for one of the commercial services if you want that.
I simply don't have time.
Anyway, it is better if you learn to do the criticism yourself, which is what our system should teach you.
Listen to the podcast for further advice.
I am keen that you have a good format for the various bits necessary for a good role-play.
So, we did another role-play this evening.

Candidate’s instructions.

You are the SpR in the gynaecology clinic. You have been asked to see Jenny Williams, who has come for pre-pregnancy counselling.


Letter from the General Practitioner.


5 High Street,

Deersworthy,

Kent.

DO9 1JY.



Re Mrs. J. Williams,

Manor Place,

Deersworthy.

 

Dear Dr.,

Please see this woman who is planning pregnancy. I understand that her sister has had a baby with Down’s syndrome.

Regards,

Dr. Jolly.

Listen in to hear the point I was trying to make.
Then we had an EMQ with no option list!
This was to highlight good EMQ technique, which is to read the task, then the scenario and decide what the answer should be before you see the option list.
The EMQ was:

Lead-in.

The following scenarios relate to early pregnancy.

For each, select the diagnosis you most want to exclude.

Pick one option from the option list.

Each option can be used once, more than once or not at all.

Scenario 1.

A 35-year-old primigravida is seen in the EPU with vaginal bleeding and severe left iliac fossa pain. The pregnancy occurred after four cycles of IVF and embryo transfer was performed six weeks ago. Her β-hCG is >1,000 iu/l. An ultrasound scan showed an intra-uterine pregnancy of an appropriate size for the gestation. Normal fetal heart activity was noted. No adnexal masses were seen.

Scenario 2.

A 25-year-old woman with known PCOS is seen in the early pregnancy unit after an episode of slight vaginal bleeding. Her LMP was 10 weeks ago. An ultrasound scan shows an intra-uterine pregnancy with CRL of 6 mm. No fetal heart activity is seen.

Scenario 3.

A GP phones for advice. She is conducting her morning surgery. A nulliparous woman has returned from France where she has enjoyed the local food, particularly unpasteurised soft cheese and pork meats. She has presented with diarrhoea and mild abdominal pain. A β-hCG is 25 iu/l. She is concerned about listeriosis and toxoplasmosis, about which she has read.

Scenario 4.

A 30-year-old parous woman attends the EPU with vaginal bleeding and lower abdominal pain. An ultrasound scan shows a 30 mm. intra-uterine sac but no evidence of fetal heart activity.

Scenario 5.

 A 45-year-old para 6 is admitted to the A&E department with 6 weeks’ amenorrhoea. A β-hCG is positive. She complains of retrosternal pain and has a history of heartburn and acid reflux. Her BMI is 30. She smokes 40 cigarettes daily and has COAD.

Finally, we wrote a plan for another essay.
Critically evaluate screening for gynaecological cancer.
Send me your answers and I'll send mine.

1 comment:

  1. my response: 1- HSS 2- missed mis carriage 3-? 4-PUV 5- cardic problem.

    ReplyDelete