Monday, 9 January 2012

Tutorial 9 January 2012


Tonight's materials were as follows:
EMQ.
This question is about cystic fibrosis.
For each scenario choose the option that gives the best answer.
Each option can be used once, more than once or not at all.
And, to make you behave in a model fashion, there is no option list, so you have to decide the correct answer.
Scenario 1.
A woman is 8 weeks pregnant and known to be a carrier of cystic fibrosis.
Her husband is Caucasian.
What is the risk of the child having cystic fibrosis?
Scenario 2.
A healthy woman attends for pre-pregnancy counselling.
Her brother has cystic fibrosis. Her husband is Caucasian.
He has been screened for cystic fibrosis. The test was negative.
What is the risk of them having a child with cystic fibrosis?
Scenario 3.
A healthy woman is a known carrier of cystic fibrosis.
She attends for pre-pregnancy counselling. Her husband has cystic fibrosis.
What is the risk of them having a child with CF?
Scenario 4.
A healthy woman attends for pre-pregnancy counselling. Her sister has had a child with cystic fibrosis.
What is her risk of being a carrier?
Scenario 5.
A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.
What is the risk that she is a carrier?
Scenario 6 .
A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.
The partner’s risk of being a carrier is 1 in X.
What is the risk that she will have a child with CF?
Scenario 7.
A healthy Caucasian woman is 10 weeks pregnant.
Her husband is a known carrier of cystic fibrosis.
Which test would you arrange?
Scenario 8.
A woman attends for pre-pregnancy counselling. She has read about diagnosing CF using cffDNA from maternal blood. Is it possible to test for CF in this way?
Scenario 9.
A woman and her husband are known carriers of cystic fibrosis.
What is the risk of them having an affected child.
Scenario 10.
A woman and her husband are known carriers of cystic fibrosis.
What can they do to reduce the risk of having an affected child?
Scenario 11.
A woman and her husband are known carriers of cystic fibrosis.
Can CVS exclude an affected pregnancy?
 The essays were:

1. Obesity in pregnancy.
Outline the impact of obesity in pregnancy.

2. A 35-year-old woman presents to A&E at 8 weeks’ gestation with left calf pain and leg swelling. Deep vein thrombosis is suspected.
1.  Critically evaluate the immediate management.                  8 marks                
2.  Critically evaluate the management of the remainder of the pregnancy and delivery.                                                                                       8 marks
3.  Critically evaluate the advice you will give postnatally          4 marks

3. A woman of 48 is referred with erratic vaginal bleeding for six months. She has had an intra-uterine contraceptive in place for five years. She has occasional hot flushes.
1. Justify the things you will focus on in taking her history.  6 marks
2. Justify the investigations you will perform.                      6 marks
3. Justify the advice you will give.                                      8 marks

4. You have been asked to review your departmental policy for the use of anti-D.
1. Justify how you will go about the process.                         8 marks.
2. Outline the key issues to be included in the document.    12 marks.

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