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EMQ. Hepatitis B and pregnancy.
Lead-in.
Each of the following scenarios relates to hepatitis
B and pregnancy.
Instructions.
For each scenario, select the most appropriate
option from the option list.
Each option can be used once, more than once or
not at all.
Abbreviations.
HBcAg: hepatitis B core antigen
HBeAg: hepatitis B e antigen
HBsAg: hepatitis B surface antigen
HBcAb: antibody to hepatitis B core antigen
HBeAb: antibody to hepatitis B e antigen
HBsAb: antibody to hepatitis B surface antigen
HBIG: hepatitis B immunoglobulin
HBV: hepatitis B virus
Option list.
A. acyclovir
B. divorce
C. HBcAg
+ve
D. HBeAg
+ve
E. HbsAg
+ve
F. HBsAg
+ve; HBsAb –ve; HBcAb -ve
G. HBsAg
+ve; HBsAb –ve on two tests six months apart
H. HBsAG
–ve; HBsAb -ve on two tests six months apart
I.
HBsAg –ve; HBsAb +ve; HBcAb –ve
J.
HBsAg –ve; HBsAb +ve; HBcAb +ve
K. HBsAg
–ve; HBsAb +ve
L. HBsAg
+ve; HBcAg +ve
M. HBV
vaccine.
N. HBIG
O. HBV
vaccine + HBIG
P. immune
as a result of infection
Q. immune
as a result of vaccination
R. not
immune
S. chronic
carrier of HBV infection
T. 10%
U. 30%
V. 50%
W. 60%
X. 70
- 90%
Y. soap
and boiling water
Z. 10%
dilution of bleach in water
AA. 10%
dilution of formaldehyde in alcohol
BB. ultraviolet
irradiation
CC. yes
DD.no
EE. none
of the above
Scenario 1.
An asymptomatic primigravida books at
10 weeks. Her partner had an acute HBV infection 4 months ago. What results on
routine blood testing would indicate that she has an acute infection?
Scenario 2.
An asymptomatic primigravida books at
10 weeks. Her partner had an acute HBV infection 4 months ago. What results on
routine blood testing would indicate that she is immune to the HBV as a result
of natural infection?
Scenario 3.
An asymptomatic primigravida books at
10 weeks. Her partner had an acute HBV infection 4 months ago. What results on
routine blood testing would indicate that she is immune to the HBV as a result
of HBV vaccine?
Scenario 4.
An asymptomatic primigravida books at
10 weeks. Her partner had an acute HBV infection 6 months ago. What results on
routine blood testing would indicate that she is a chronic carrier of HBV
infection?
Scenario 5.
Testing shows that he is positive for HBsAg,
positive for HBcAb but negative for IgM HBcAb. What does this mean in relation
to his HBV status?
Scenario 6.
Testing shows that he is negative for HBsAg,
positive for HBcAb and positive for HBsAb.
What does this mean in relation to his HBV
status?
Scenario 7
A primigravid woman at 8 weeks
gestation is found to be non-immune to the HBV. She has recently married and
her husband is a chronic carrier. What should be done to protect her from
infection?
Scenario 8
A woman is a known carrier of
Hepatitis B. What is the risk of vertical transmission in the first trimester?
Scenario 9
A woman is a known carrier of
Hepatitis B. What is the risk of the neonate who has been infected by vertical
transmission in the third trimester becoming a carrier without treatment?
Scenario 10
How effective is hepatitis B
prophylaxis in preventing chronic carrier status developing in a neonate
infected as a result of vertical transmission?
Scenario 11
Can a woman who is a chronic HBV
carrier breastfeed safely?
Scenario 12.
Hepatitis B infection is the most dangerous of
the viral hepatitis infections in pregnancy.
Scenario 13.
A pregnant woman who is not immune to
HBV has a partner who is a chronic carrier. Can HBV vaccine be administered
safely in pregnancy?
Scenario 14.
A pregnant woman who is not immune
has a partner with acute hepatitis due to HBV. He cuts his hand and bleeds onto
the kitchen table. How should she clean the surface to ensure that she gets rid
of the virus?
Scenario 15.
Is it true that the presence of HBeAg in maternal
blood is a particular risk factor for vertical transmission? Not really a
scenario, but never mind!
22
|
Critically evaluate the statement:
“fortification of flour is overdue in the UK”.
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23
|
With regard to fetal welfare in labour.
1. Critically evaluate the methods available for
monitoring the fetal condition. 4 marks
2.
List the criteria recommended by NICE for continuous electronic fetal
monitoring. 6 marks.
|
24
|
With regard to endometrial cancer.
1. Outline the key features of Type 1 and Type 2
cancers. 4 marks
2. Outline the FIGO histological grading
system. 2
marks
3. Critically evaluate the FIGO staging for
endometrial cancer. 6 marks
4. Detail the FIGO staging system for endometrial
cancer. 8 marks.
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25
|
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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