Tutorial.
Tonight we managed to deal with 1 EMQ and four essays.
The first essay was about essay-writing and prompted by the fact that quite a lot of people still seem confused by what we are trying to do with the essays.
The main idea is to move from being pretty hopeless at essay-writing now to being really good in the exam hall.
This will only come with lots of practice - and practice is no good unless it is done under exam conditions.
There was a bit of a digression into MDU and BMA membership, which was not really necessary.
Antenatal steroids and the neonate.
Lead-in.
The following scenarios relate to antenatal steroid use and the neonate.
Pick one option from the option list.
Each option can be used once, more than once or not at all.
Abbreviations.
ANS: antenatal steroids.
FGR: fetal growth restriction.
GTG: Green-Top Guideline No 7 from the RCOG. “Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality.”
RDS: respiratory distress syndrome. Now better known as “surfactant-deficient lung disease of the new-born”.
Option list.
As before, there is no option list.
I want you to come up with your answers.
I’ll produce one and send it once I have seen your answers.
Scenario 1.
What are the benefits to the neonate of appropriate administration of antenatal steroids?
Scenario 2.
At what gestations should antenatal steroids be offered to women with singleton pregnancies who are at risk of premature labour?
Scenario 3.
At what gestations should antenatal steroids be offered to women with multiple pregnancies who are at risk of premature labour?
Scenario 4.
What advice is contained in the GTG in relation to very early gestations, threatened premature labour and the use of antenatal steroids.
Scenario 5.
What advice is contained in the GTG in relation to antenatal steroids and Caesarean section?
Scenario 6.
What advice is given in the GTG about ANS in relation to the fetus with FGR at risk of premature delivery?
Scenario 7
What advice is given in the GTG in relation to ANS for women with IDDM?
Scenario 8
What advice is in the GTG in relation to adverse effects of ANS on the fetus?
Scenario 9
What advice is in the GTG in relation to short-term maternal adverse effects?
Scenario 10
What contraindications to ANS are cited in the GTG?
Scenario 11
What is the recommended drug regime for ANS administration?
Scenario 12.
What is the time-scale for maximum effect of ANS in reducing RDS?
Scenario 13.
When should repeat courses of ANS be given?
Question1.
You have been asked to give a tutorial on essay-writing for MRCOG part II candidates.
Outline the key aspects of the advice you will wish to convey.
Question2.
With regard to the Clinical Negligence Scheme for Trusts.
1. What it the CNST? 4 marks
2. Describe the impact of the CNST on obstetric practice. 16 marks
Question3.
A 28-year-old woman is referred to the gynaecology clinic with suspected premature ovarian failure. She has “hot flushes”, has not menstruated for 8 months and a FSH level was found to be 40 iu/l.
1. Outline the main causes of premature ovarian failure. 10 marks
2. Critically evaluate the management options. 10 marks
Question4.
A nulliparous woman of 30 years attends for pre-pregnancy counselling. Her father is a carrier of the Fragile X premutation. Her paternal uncle has Fragile X syndrome.
Critically evaluate the management.
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