Tutorial 6 December 2012

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Tonight we had an EMQ on Ulipristal and 3 essays.
Do your answer to the EMQ but not the essays.
Then start the podcast.
I left the recording running while the group were writing their essay plans, so you will be able to do yours in the same time. They had slightly more than 5 minutes, which is the maximum you should be aiming for in the exam.

EMQ. Ulipristal.

Lead-in.

The following scenarios relate to ulipristal. For each, select the most appropriate from the option list.

Each option can be used once, more than once or not at all.

Scenario 1.

What type of drug is ulipristal?

Scenario 2.

How is ulipristal broken down / excreted?

Scenario 3.

What is the half-life of ulipristal?

Scenario 4.

Which drug may prolong the half-life of ulipristal?

Scenario 5.

What is the main use of ulipristal?

Scenario 6.

What is the dose of ulipristal?

Scenario 7.

What time-scale applies to the licensed use of ulipristal?

Scenario 8.

What contraceptive advice is given to those using ulipristal?

Scenario 9.

What advice is given to women who are breast-feeding?

Scenario 10.

Can treatment with ulipristal be repeated within 1 month?

 

Option list.

1.       GnRH analogue.

2.       Selective serotonin reuptake inhibitor.

3.       19-nortestosterone derived progestagen.

4.       21-hydroxyprogesterone-derived progestagen.

5.       mifepristone derivative.

6.       Selective oestrogen receptor modulator.

7.       Selective progesterone receptor modulator.

8.       Urinary excretion.

9.       Metabolised by renal cytochrome P450 enzyme system.

10.   Metabolised by hepatic cytochrome P450 enzyme system.

11.   30 mg. with dose repeated if vomiting occurs within 3 hours.

12.   100 mg. with dose repeated if vomiting occurs within 3 hours.

13.   150 mg. with dose repeated if vomiting occurs within 3 hours.

14.   phenobarbitone

15.   valium

16.   erythromycin

17.   12 hours.

18.   18 hours.

19.   32 hours.

20.   72 hours.

21.   120 hours.

22.   Depot-contraception.

23.   Depression.

24.   Emergency contraception.

25.   Menorrhagia.

26.   Termination of pregnancy.

27.   Yes.

28.   No.

29.   Maybe.

30.   Continue.

31.   Discontinue for 36 hours.

32.   Discontinue for 72 hours.

33.   May interfere with contraception containing progestagen.

34.   May interfere with contraception containing oestrogen.

35.   No action if LARC being used.

1. With regard to hyperemesis gravidarum.

1.  Outline how the diagnosis is made.                                                          2 marks

2.  Outline the immediate consequences.                                                     6 marks

3.  Outline the consequences in later pregnancy.                                        6 marks

4.  Justify your management of a woman seen with HG at 10 weeks.     6 marks

2. A 35-year-old woman plans to go to a malarial area of Africa to join her husband who works there. She is 6 weeks pregnant.

Critically evaluate the advice you will give her.

3. A woman of 18 attends the A&E Department requesting emergency contraception.

1.  Outline the history you will take.                                                                                  4 marks.

2.  Justify the investigations you will arrange.                                                               2 marks.

3.  Outline the methods of emergency contraception and their pros and cons. 8 marks                                                                                                                              

3.  Justify your management.                                                                                               8 marks.