Website
Contact
1. You are the SpR in the antenatal clinic. The consultant is absent due to illness and no other consultant is available. A midwife asks you to see a woman whose scan has shown anencephaly.
1. What steps will you take before seeing the woman? 6 marks
2. Justify the approach you will use during the interview. 10 marks
3. What will you do when the interview is over? 4 marks
2. In relation to diagnostic laparoscopy, critically evaluate:
1. the issues to be discussed in obtaining informed consent 4 marks.
2. the factors that increase the incidence of entry-related injury 4 marks.
3. how entry-related injuries may be minimised 12 marks.
3.Critically evaluate HPV vaccine and its uses.
4. A woman attends the antenatal clinic at 10 weeks. Her son developed chickenpox two days ago. Her sister is 38 weeks pregnant. Critically evaluate the management.
Lead-in.
The following scenarios relate to vulval conditions.
Choose the most likely vulval condition from the option list.
Each option can be used once, more than once or not at all.
Scenario 1.
A 22 year-old woman attends the colposcopy clinic after 2 smears showing minor atypia. The cervical appearances are of aceto-white with punctation.
Scenario 2.
A 60-year old woman has an erythematous rash of the vulva extending to the inner thighs. A similar rash is noted under the breasts. She is not known to have diabetes.
Scenario 3.
A woman attends the gynaecology clinic with a vulval rash. It has a “lacy” appearance.
Scenario 4.
A 35-year old woman attends is noted to have a vulval fistula. She has a history of episodic diarrhoea.
Scenario 5.
A 25-year old woman attends the gynaecology clinic with a history of intense vulval itching and soreness. The appearances are of diffuse erythema with excoriation. Diabetes, candidiasis and other local infections have been eliminated by the GP.
Scenario 6.
A 35-year old woman attends the gynaecology clinic with vulvitis. She also has a scalp rash. Clinical examination shows scaly, pink patches with signs of excoriation. Skin samples grow Malassezia ovalis.
Scenario 7.
A 40-year old woman has evidence of chronic vulval ulceration. She has recently been seen by a dermatologist for mouth ulceration and has been started on thalidomide.
Scenario 8.
An African woman of 35 years attends the gynaecology clinic. She has a ten-year history of chronic vulval ulceration. Examination shows multiple, tender vulval and pubic subcutaneous nodules, some of which have ulcerated.
Scenario 9.
A Caucasian woman of 29 years attends the gynaecology clinic with a chronic vulval rash. Examination shows erythematous areas with clearly defined margins and white scaly patches.
Scenario 10.
A 30-year old woman attends the gynaecology clinic with vulval itching. Examination shows erythema of the labia minora and perineum. Full-thickness biopsy shows abnormal cell maturation throughout the epithelium with increased mitotic activity.
Option list.
A. | Acne. |
B. | Behçet’s syndrome. |
C. | Candidiasis. |
D. | CIN 3 |
E. | CIN1 |
F. | Crohn’s disease. |
G. | Dermatitis. |
H. | Eczema. |
I. | Genital warts. |
J. | Hidradenitis suppurativa. |
K. | Leprosy. |
L. | Lichen planus |
M. | Lichen sclerosis |
N. | Lymphogranuloma venereum |
O. | Normal skin. |
P. | Psoriasis. |
Q. | Seborrhoeic dermatitis. |
R. | Type 1 diabetes mellitus |
S. | Type 2 diabetes mellitus |
T. | Ulcerative colitis. |
U. | VIN III. |
No comments:
Post a Comment