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Tonight's materials were as follows. The EMQs caused a bit of headache so make sure you do them as there are bound to be some like them in the exam.
In most of the questions, if one partner was affected or a carrier, it was assumed that the other was not affected. I will need to re-write the questions to tighten this up, but assume if for the answers unless the question specifically spells out that both are affected.
Haemophilia A. Question 1.
Lead-in.
The following scenarios relate to haemophilia A, factor VIII deficiency (HA).
For each, select the most appropriate answer from the option list.
Each option can be used once, more than once or not at all.
Scenario 1.
A woman attends for pre-pregnancy counselling. Her brother has haemophilia A. What is her risk of being a carrier?
Scenario 2 .
A woman attends for pre-pregnancy counselling. Her father has haemophilia A. What is her risk of being a carrier?
Scenario 3.
If she is tested and found to be a carrier, what tests will you arrange for her partner?
Scenario 4.
If she is a carrier, what is the risk to her male offspring?
Scenario 5.
If she is a carrier, what is the risk to her female offspring?
Scenario 6.
If she is a carrier and her partner has haemophilia A, what are the risks to their female offspring?
Scenario 7.
If she is a carrier and her partner has haemophilia A, what are the risks to their male offspring?
Haemophilia A. Question 2. Pre-pregnancy counselling.
Lead-in.
The following scenarios relate to haemophilia A and pre-pregnancy counselling.
For each, select the most appropriate risk from the option list.
Pick one option from the option list.
Each option can be used once, more than once or not at all.
Scenario 1.
A nulliparous 20-year-old wishes to know the risk of her being a carrier as her father has mild haemophilia A.
Scenario 2.
A nulliparous 20-year-old wishes to know the risk of her being a carrier as her father has severe haemophilia A.
Scenario 3.
A para 3, 30-year-old wishes to know the risk of her being a carrier as her mother is a carrier.
Scenario 4.
A para 0+4, 25-year-old wishes to know the risk of her being a carrier as her sister has an affected son.
Scenario 5.
A para 6, 40-year-old wishes to know the risk of her being a carrier as her daughter has had an affected baby.
Scenario 6.
A nulliparous woman wishes to know the risk of a son having haemophilia as she is a carrier.
Scenario 7.
A nulliparous woman wishes to know the risk of a son having haemophilia as her husband has haemophilia A.
Scenario 8.
A nulliparous woman wishes to know the risk of a daughter being a carrier as she is a carrier.
Scenario 9.
A nulliparous woman wishes to know the risk of a daughter being a carrier as her husband has haemophilia A.
Scenario 10.
A nulliparous woman wishes to know the risk of a son having haemophilia as her paternal grandfather had haemophilia A.
Scenario 11.
A nulliparous woman wishes to know the risk of a son having haemophilia as her maternal grandfather had haemophilia A.
Scenario 12.
A nulliparous woman wishes to know the risk of a son having haemophilia as her husband’s paternal grandfather had haemophilia A.
Scenario 13.
A nulliparous woman wishes to know the risk of a son having haemophilia as her husband’s maternal grandfather had haemophilia A.
Scenario 14.
A nulliparous woman wishes to know the risk of a son having haemophilia as her mother’s brother has haemophilia A.
Scenario 15.
A nulliparous woman wishes to know her risk of being a carrier as she has read about it in a magazine. There is no family history of haemophilia A.
Option list.
A. | 0 % |
B. | 0.1 % |
C. | 1 % |
D. | 12.5 % |
E. | 13.3% |
F. | 20 % |
G. | 25 % |
H. | 33 % |
I. | 50 % |
J. | 66.6% |
K. | 68 % |
L. | 75 % |
M. | 80 % |
N. | 90 % |
O. | 100 % |
P. | 200 % |
Essays 29 December 2011.
1. A nulliparous woman of 20 years attends the A&E department with abdominal pain and vaginal discharge. The A&E SpR suspects acute pelvic inflammatory disease and has asked you to see her. Justify:
1. the history you will take. 6 marks.
2. the investigations you will arrange. 4 marks.
3. the immediate management. 6 marks.
4. the follow-up arrangements you will discuss. 4 marks.
2. A six year old girl is referred to the gynaecology clinic with a 2 month history of vaginal discharge.
1. Justify the history you will take. 5 marks
2. Justify the investigations you will do. 5 marks
3. Critically evaluate the management. 10 marks
3. A woman is found to have a temperature of 39.0 C. on the second day after a normal delivery.
1. what is the definition of puerperal pyrexia? 2 marks.
2. is puerperal pyrexia a notifiable disease? 2 marks.
3. critically evaluate the investigation. 8 marks.
4. critically evaluate the management. 8 marks.
4. Critically evaluate neonatal screening.
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