Tutorial 30th September 2013

Tutorial.
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https://soundcloud.com/drtmcf/30-september-2013
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I was a bit slow starting the recording, so the first bit of the laboratory discussion was missed.
I have written an answer for the station, so send your answer and I'll send mine.

The station was as follows:

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.

Then we had a viva about forceps. 

And finally a roleplay.

Topic. Abnormal cervical smear.

Candidate's Instructions.

This is a role-play station.

You are the SpR in the colposcopy clinic.

The patient is attending after a smear showed severe dyskaryosis.

Your tasks are to take a history and explain the investigations you propose.