Monday 28 November 2011

Tutorial 28 November 2011

Website.
Tutorial.
The tutorials only stay on the internet for a few weeks. I have 12 hours available to me and would need to pay hundreds of pounds more to buy extra time. This I do not propose to do. The next tutorial to get the chop is that from 1st. November. It was the one on urodynamics by Ahmed Yassin. If you have not listened to it, I would advise that you download it as it is very good and you don't want to miss it. There are some charts to go with it. If you don't have them you can send an e-mail.

Tonight we had some EMQs about the coroner. These took me all day to write and were a real pain.
However, there are EMQs on this subject in the exam data base, so you need to know the basics. I am writing a MCQ for paper 13 that should cover it in conjunction with the EMQs.
The questions are below.
Send me your answers and I'll send my versions and reasoning.

The Coroner. Question 1.

Lead-in.
The following scenarios relate to the role of the Coroner.
Pick one option from the option list.
Each option can be used once, more than once or not at all.

Abbreviations.

Suggested reading.
I try will put all you need to know into the answer to MCQ13, question 5.

Option list.
A.        an independent judicial officer
B.        a barrister acting for the Local Police Authority
C.        the regional representative of the Home Office
D.        the regional representative of the Queen.
E.         an employee of the High Court.
F.         the Local Authority
G.       the Local Police Authority
H.        the Home Office
I.          the High Court
J.          the Queen
Scenario 1.
What is the best description of the status of the Coroner?
Scenario 2.
Who appoints the Coroner?
Scenario 3.
Who pays for the Coroner?
 
The Coroner. Question 2.

Lead-in.
The following scenarios relate to the role of the Coroner.
Pick one option from the option list.
Each option can be used once, more than once or not at all.

Suggested reading.
I try will put all you need to know into the answer to MCQ13, question 5.

Option list.
A.        must have had experience as a detective in the police force with  rank of Inspector or above
B.        must be a barrister, lawyer or doctor with at least 5 years’ experience
C.        must be a legally qualified individual with at least 5 years’ experience
D.        must be a trained bereavement counsellor
E.         must be able to play the bagpipes
F.         Monday -  Friday; 09.00 - 17.00 hours, including bank holidays
G.       Monday - Friday; 09.00 - 17.00 hours excluding bank holiday
H.        All the time
I.          to arrest people suspected of unlawful killing
J.          to manage traffic in the vicinity of the Coroner’s court
K.        to make enquiries on behalf of the Coroner
L.         to make enquiries on behalf of the Coroner and provide administrative support
Scenario 1.
What qualifications must the Coroner have?
Scenario 2.
What are the hours of availability of the Coroner?
Scenario 3.
What is the role of the Coroner’s Officers?
 
The Coroner. Question 3.

Lead-in.
The following scenarios relate to the role of the Coroner.
Pick one option from the option list.
Each option can be used once, more than once or not at all.

Option list.
A.        the death must be reported to the Coroner
B.        the death does not need to be reported to the Coroner
C.        the Coroner must order the return of the body for an inquest
D.        the Coroner must order a post-mortem examination
E.         the Coroner must hold an inquest
F.         the Coroner should arrange for the death to be investigated by the Home Office
G.       the death must be reported to the authorities of the country in which it took place in order that a certificate of death can be issued
H.        a certificate of live birth
I.          a certificate of stillbirth
J.          a certificate of miscarriage
K.        yes
L.         no
M.      none of the above

Scenario 1.
A resident of Manchester dies suddenly while visiting the town of his birth in Scotland. His family decides that he will be buried in the town of his birth. His body is held at the premises of a local funeral director to arrange the funeral and burial. What actions should be taken with regard to the Manchester coroner?
Scenario 2.
A resident of London dies suddenly while visiting Manchester, where he was born. His family decides that he will be buried in Manchester. His body is held at the premises of a Manchester funeral director who will arrange the funeral and burial. What actions should be taken with regard to the Manchester coroner?
Scenario 3.
A resident of Manchester dies on holiday in his native Greece. The family decide that he will be buried in Greece. What steps must be taken to obtain a valid death certificate?
Scenario 4.
A man of 65 dies of terminal lung cancer. The GP who had visited daily up to three weeks before the death has been on holiday for three weeks. He has now returned and says that he will sign a death certificate, but needs to visit the funeral director to see the body first.  Will this be a valid death certificate?
Scenario 5.
A man of 65 dies of terminal lung cancer. The GP who has visited daily up to the day of his death and attended to confirm the death is on holiday. However, he says that he will sign a death certificate and put it in the post, so that it will arrive in the morning. Will this be a valid death certificate?
Scenario 6.
A man of 65 dies of terminal lung cancer. The GP who has visited daily up to the day before his death has been on holiday since. However, he says that he will sign a death certificate and put it in the post, so that it will arrive in the morning. Will this be a valid death certificate?


Scenario 7.
A 65-year-old man dies suddenly 12 hours after admission to the local coronary care unit with chest pain, despite apparently satisfactory insertion of a coronary artery stent after a diagnosis of coronary artery thrombosis. What action should be taken with regard to the Coroner?
Scenario 8.
A 16-year-old girl is admitted at 36 weeks’  gestation in her first pregnancy with placental abruption. She is given the best possible care but develops DIC and hypovolaemic shock and dies. What action should be taken with regard to the coroner?
Scenario 9.
A 28-year-old woman is admitted with placental abruption at 36 weeks. She has bruising on the abdominal wall and the admitting midwife suspects that she has been the victim of domestic violence, though the woman denies it. Despite best possible care she dies as a consequence of bleeding. What action should be taken with regard to the coroner?
Scenario 10.
A 30-year-old woman delivers normally at home attended by her husband, but has a PPH. The husband practises herbal medicine. He applies various potions but her condition deteriorates. She is admitted to hospital by emergency ambulance. She is given best possible care and is admitted to the ICU. She dies 7 days later of multi-organ failure and ARDS attributed to hypovolaemic shock. What action should be taken with regard to the coroner?
Scenario 11.
A woman is admitted at 23 weeks in premature labour. There is evidence of fetal heart activity throughout the labour, with the last record being 5 minutes before the baby delivers. The baby shows no evidence of life at birth. The mother requests a death certificate so that she can register the birth and arrange a funeral. What form of certificate should be issued?
Scenario 12.
A woman is admitted at 26 weeks’ gestation in premature labour. The presentation is footling breech. At 8 cm. cervical dilatation the trunk is delivered and the cord prolapses. There is good evidence of fetal life with fetal movements and pulsation of the cord. The head is trapped and it takes 5 minutes to deliver it. The baby is pulseless, apnoeic and without visible movement at birth. Intubation and CPR are carried out for 20 when the baby is declared dead. What action should be taken with regard to the coroner?

Then we had two essays to plan.
 
Question1.
A woman books at 8 weeks’ gestation in her first pregnancy. She is concerned because she works in a nursery where there has been an outbreak of cytomegalovirus infection. Critically evaluate the management.
 Question 2.
You have been asked to perform an audit. Outline the key issues involved in preparing and performing an audit.
Send me your answers, written under exam conditions and I'll send my version. You will only get good at essay-writing by practising under exam conditions. Don't waste your time and mine by spending more than 22 minutes or by preparing by getting your  books out. You won't get any more time in the exam and you can't take your books with you.
I have deliberately not included a template to make the essays harder.