Thursday 20 June 2013

Tutorial 20 June 2013


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EMQ
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.
GnRH analogue.
Selective serotonin reuptake inhibitor.
19-nortestosterone derived progestagen.
21-hydroxyprogesterone-derived progestagen.
mifepristone derivative.
Selective oestrogen receptor modulator.
Selective progesterone receptor modulator.
Urinary excretion.
Metabolised by renal cytochrome P450 enzyme system.
Metabolised by hepatic cytochrome P450 enzyme system.
30 mg. with dose repeated if vomiting occurs within 3 hours.
100 mg. with dose repeated if vomiting occurs within 3 hours.
150 mg. with dose repeated if vomiting occurs within 3 hours.
phenobarbitone
valium
erythromycin
12 hours.
18 hours.
32 hours.
72 hours.
120 hours.
Depot-contraception.
Depression.
Emergency contraception.
Menorrhagia.
Termination of pregnancy.
Yes.
No.
Maybe.
Continue.
Discontinue for 36 hours.
Discontinue for 72 hours.
May interfere with contraception containing progestagen.
May interfere with contraception containing oestrogen.
No action if LARC being used.



18
With regard to Systemic Lupus Erythematosis (SLE):
1.  outline the clinical manifestations of SLE.             4 marks.
2.  outline the implications of SLE for pregnancy .    4 marks.
3.  critically evaluate how the diagnosis is made.      4 marks.
4.  critically evaluate the management in the woman wishing to be pregnant.       8 marks.
4a.critically evaluate the management of a woman booking at 8 weeks.              8 marks.
19
A nulliparous woman of 30 years attends for pre-pregnancy counselling. Her father is a carrier of the Fragile X premutation. Her paternal uncle has Fragile X syndrome. Critically evaluate the management.
20
In relation to diagnostic laparoscopy, critically evaluate:
1. the issues to be discussed in obtaining informed consent      4 marks.
2. the factors that increase the incidence of entry-related injury 4 marks.
3. how entry-related injuries may be minimised                      12 marks
21
A six year old girl is referred to the gynaecology clinic with a 2 month history of vaginal discharge.
1. Justify the history you will take.            5 marks
2. Justify the investigations you will do.     5 marks
3. Critically evaluate the management.     10 marks

3 comments:

  1. Can I send in my answers in this comment box for reviewing?

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