Monday, 30 December 2013

30 December 2013

Contact us.

Tonight we discussed one EMQ and five SAQ plans.
I hope you have a happy and healthy New Year.
And a successful one if you are sitting the part 2 exam.

EMQ. Antenatal steroids
A 55-year-old woman is referred to the gynaecology clinic. A friend of the same age has recently been found to have osteopenia and has been started on a bisphosphonate drug. She wishes to discuss her risk of osteoporosis and what she can do to reduce it.
1. Discuss how her risk of osteoporosis can be assessed.                        6 marks
2. Critically evaluate the steps that can be taken to reduce her risk.  14 marks
With regard to nuchal translucency.
a. What is nuchal translucency, how is it measured and what are
    the important values?  6 marks
b. When is it measured and why are other times not used?     4 marks
c. Critically evaluate the uses and implications of NT
    measurement.      10 marks.
With regard to pertussis and pregnancy.
1.            What is pertussis caused by, how is it spread, what kind of vaccine is available and can it be used in pregnancy?          4 marks.
2.            What are the important epidemiological facts in relation to pertussis in the UK in 2012 and 2                                         3 marks
3.            What is the current advice in the UK about pertussis in pregnancy and who creates the advice?                                        3 marks.
4.            Critically evaluate the justification for the advice.  10 marks.
A healthy, 25-year-old, nulliparous woman books at 8 weeks. She wishes to know what particular advice is relevant to her as she is married to a farmer.
1. outline the history you will take.                    6 marks
2. outline the investigations you will arrange.  4 marks
3. justify the advice you will give.                      10 marks.
Your consultant is on leave. The Secretary gives you a histology report relating to a 24-year-old woman who had suction evacuation for incomplete miscarriage 10 days before. The histology report is diagnostic of complete hydatidiform mole.
1.  Justify your immediate management.     8 marks
2.  Detail the subsequent management.    12 marks.

Antenatal steroids and the neonate.

The following scenarios relate to antenatal steroid use and the neonate.
Pick one option from the option list.
Each option can be used once, more than once or not at all.
ANS:      antenatal steroids.
FGR:      fetal growth restriction.
GTG:     Green-Top Guideline No 7 from the RCOG. “Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality.”
RDS:      respiratory distress syndrome. Now better known as “surfactant-deficient lung disease of the new-born”.
Option list.
There is no option list.
I want you to come up with your answers.

Scenario 1.
What are the benefits to the neonate of appropriate administration of antenatal steroids?
Scenario 2.
At what gestations should antenatal steroids be offered to women with singleton pregnancies who are at risk of premature labour?
Scenario 3.
At what gestations should antenatal steroids be offered to women with multiple pregnancies who are at risk of premature labour?
Scenario 4.
What advice is contained in the GTG in relation to very early gestations, threatened premature labour and the use of antenatal steroids.
Scenario 5.
What advice is contained in the GTG in relation to antenatal steroids and Caesarean section?
Scenario 6.
What advice is given in the GTG about ANS in relation to the fetus with FGR at risk of premature delivery?
Scenario 7
What advice is given in the GTG in relation to ANS for women with IDDM?
Scenario 8
What advice is in the GTG in relation to adverse effects of ANS on the fetus?
Scenario 9
What advice is in the GTG in relation to short-term maternal adverse effects?
Scenario 10
What contraindications to ANS are cited in the GTG?
Scenario 11
What is the recommended drug regime for ANS administration?
Scenario 12.
What is the time-scale for maximum effect of ANS in reducing RDS?
Scenario 13.
When should repeat courses of ANS be given?

No comments:

Post a comment