Monday 19 March 2012

Tutorial 19th. March 2012

Tutorial.
Website.
Contact.

We started with a list of laboratory reports the consultant's secretary has asked you to look at.
This station is about administrative management, not clinical management.
You need to be aware of the possible clinical issues to decide the appropriate management and the degree of urgency.
The second was a "breaking bad news" role-play.

 
Laboratory results.

Your consultant is on annual leave.
Her secretary has asked you to look through the following results and decide what action should be taken in relation to each.

+ve MSSU at booking. No symptoms.

GTT at 34 weeks. Peak level 11.5.

FBC with ­ MCV at booking.

Thrombocytopenia at booking. 50,000.

Hydatidiform mole after evacuation of suspected miscarriage.

Histology after ERPC for incomplete miscarriage: no trophoblastic tissue.

Endometrial cancer: hysteroscopy: thickened endometrium. Histology: Anaplastic malignancy.

Endometrial cancer: MR scan: reaching serosa and upper endocervical canal.

Consultant does lap drainage of normal looking ovarian cyst. Malignant cells. Nulliparous. Wants children.

HVS: trichomonas.

Clue cells on smear. 12/52 pregnant.

Antenatal discharge: endocervical swab: chlamydia

Actinomyces on smear.

Herpes in pregnancy

Severe dyskaryosis on cervical smear at booking.

Primary infertility: FSH & LH ­ at 25 on day 3 of cycle.

Primary infertility. FSH 3, LH 12 on day 3 of cycle.

Treated with cabergoline for ­ prolactin and pituitary adenoma.
+ve beta HCG.

3 cm. ovarian cyst. ­ Ca 125.

“Miscarriage” ERPC. Histology report: Decidual reaction. No trophoblastic tissue seen.

Roleplay.

Break bad news. Primigravida. 8 weeks. Some bleeding. Scan = IUP. CRL = 12 mm. No fetal heart activity. Counsel.

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