Monday, 4 November 2013

Tutorial 4 November 2013

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This was the last tutorial in this cycle.
We start the next cycle on Monday 18th. November
Tonight we had 2 roleplays and 2 vivas.

Roleplay 1.

Candidate's Instructions.

You are a SpR and delivered this patient, Mrs Janice Idlewit, of her first baby using the ventouse six weeks ago.
She has been referred back to the clinic and there is no one else to see her.
The GP letter says: “Please see Mrs. Idlewit. Unfortunately some incompetent left a swab behind when she had her recent delivery and repair of episiotomy. She saw me a couple of weeks later complaining of discharge. I must say that when I examined her the stench nearly knocked me over and quite put me off my food for days. I removed what looked like a clot or swab and took swabs for bacteriology. I sent the removed object to the laboratory and they confirmed that it was a surgical swab. The swabs I took did not identify a pathogen. I had prescribed antibiotics and I am pleased to say that she is now well. I have told her that somebody has been incompetent and should be shot. She is hopping mad”.

Viva 1.

Candidate’s instructions.

You have been asked to see a woman whose baby was stillborn.
You will discuss the key issues with the examiner.

Examiner’s instructions.
1.         What training should a doctor have before being allowed to obtain consent?
2.         What are the benefits of PM?
3.         What are the issues that stop mothers agreeing to PM?
4.         What steps should you take before seeing the mother?
5.         What arrangements should you make about seeing the mother?
6.         What types of PM can be agreed?
7.         What limits are there on the mother changing her mind about consent?
8.         What options are there in relation to individual organs that may be specifically examined?
9.         What are the options for disposal of the remains.

Roleplay 2.

Candidate's Instructions.

This patient has attended for follow-up after recent laparoscopy for pelvic pain. The operation findings were entirely normal.
A friend has recently been diagnosed with breast cancer. She wants to know about how to reduce her risk of this disease.

Viva 2.
Examiner's questions

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

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