Thursday, 12 December 2013

Tutorial 12 December 2013

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Tonight we wrote 5 essay plans and anwered an EMQ - we are speeding up!

EMQ. Ulipristal.
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.
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
Critically analyse “Enhanced Recovery” in Obstetrics and Gynaecology.
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.
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.
1. What is the Court of Protection and what does it do?      6 marks
2. Describe the types of cases you will use and the key points you will make.  14 marks.

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.
12 hours.
18 hours.
32 hours.
72 hours.
120 hours.
Emergency contraception.
Termination of pregnancy.
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.

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