Thursday 7 June 2012

Tutorial 7 June 2012


Tonight we had an EMQ and 3 essays.
 
EMQ: Turner’s  syndrome.

This is supposed to be an EMQ, but some of the questions are MCQs with “True” and “False” answers, so I have put these in the answer list. But it includes everything I think you might be asked about Turner’s.

Option list
1 in   500
1 in 1,000
1 in 1,500
1 in 2,000
1 in 2,500
1 in 3,000
1 in 10,000
1 in 50,000

0%
0.1%
1 %
2%
5%
10%
15%
20%
25%
30%
40%
50%
60%
70%
80%
90%
> 90%

Most common
2nd. most common
True
False
Answer not on this option list.

Questions.
1.      TS is due to 45XO.                                                
2.      What is the incidence of TS?                                  
3.      The incidence of TS rises with maternal age?           .
4.      Most cases of TS are due to loss of a paternal chromosome. 
5.      How common in monosomy X in TS?                     
6.      How common is monosomy Y in TS?                     
7.      What % of miscarriages are due to TS?                  
8.      What % of TS pregnancies miscarry?                     
9.      ↑ NT is a feature of TS                                           
10.    ↑ NT is a feature of congenital heart disease           
11.    Low birth weight is a feature of TS.                         .
12.    If TS is suspected, but the neonate’s karyotype from blood testing is normal, the diagnosis is Noonan’s syndrome.                               .
13.    Neonates are at normal risk of developmental dysplasia of the hip. 
14.    Immune hydrops is more common in TS.                
15.    Cystic hygroma is more common in TS.                 
16.    What is the approximate risk of malignancy if there is XY mosaicism in TS?
17.    How common is webbing of the neck in TS?                       
18.    How common is an occipital hairline in TS?             
19.    How common is congenital heart disease in TS?     
20.    Dissecting aortic aneurysm is more common in TS.
21.    How common is lymphoedema in TS?                    
22.    How common is kidney disease in TS?                   
23.    Short stature in TS has been linked to the TS gene. 
24.    What % of adolescents with TS have scoliosis.       .
25.    Inverted nipples are more common in TS.               
26.    1ry. amenorrhoea occurs in all cases.                     
27.    Adrenarche occurs at a normal time.                       
28.    Cubitus valgus is more common in TS.                   
29.    Cleft palate if a feature of TS.                                
30.    Micrognathia is a feature of TS.                             
31.    Abnormalities of teeth and nails are more common in TS.    
32.    Otitis media is more common in TS.                                   
33.    Intelligence is usually lower in TS, especially verbal skills.   
34.    Women with TS have higher mortality rates than other women..
35.    Oestrogen should be started on diagnosis to promote bone growth.  .
36.    Oestrogen-only HRT is appropriate for bone protection.      
37.    Women with TS have an risk of hypertension.      
38.    Women with TS have an risk of coeliac disease.  
39.    Women with TS have an increased risk of Crohn’s disease and ulcerative colitis. 
40.    Women with TS have an ↑ risk of diabetes              
41.    Women with TS have an ↑ risk of hyperthyroidism.  
42.    Women with TS have an ↑ risk of deafness. .
43.    Women with TS have an ↑ risk of osteoporosis.
44.    Women with TS have similar rates of red-green colour blindness as men.  
45.    Women with TS have a normal incidence of ptosis. 
46.    Women with TS cannot have children.
47.    The “short stature homeobox” (SHOX) gene has been implicated in TS

A 25-year-old primigravida attends the antenatal clinic at 36 weeks. She has read a magazine article about delayed cord clamping. DCC.
1. Outline the factors that make DCC unwise.                                         6 marks.
2. Justify the advice you will give about the risks & benefits of DCC.  8 marks.
3. Outline the arrangements necessary for DCC.                                    6 marks.          

In relation to coeliac disease and pregnancy.
1.            What is coeliac disease?                                                                                                            2 marks
2.            What are the clinical features in the non-pregnant?                                       4 marks.
3.            How is coeliac disease diagnosed?                                                               4 marks.
4.            What are the implications of coeliac disease for the pregnant woman?    6 marks.
5.            Evaluate the management options in relation to pregnancy.                     4 marks              

You have been asked to give a lecture on the Mental Capacity Act 2005 to the junior staff of the department of O&G using illustrative examples.
Describe the types of cases you will use and the key points you will make.

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