Website.
Contact us.
There was no tutorial tonight as only one girl turned up.
Thursday, 20 March 2014
Thursday, 13 March 2014
Tutorial 13 March 2014
Website.
Contact us.
Contact us.
6.
|
Critique GP letter.
|
7.
|
Roleplay. Primigravida. 8 weeks. Some bleeding. Scan
= IUP. CRL = 12 mm. No fetal heart
activity. Counsel.
|
8.
|
Roleplay. Woman attends for pre-pregnancy counselling
as she plans her 1st. pregnancy. Her sister recently had a baby
with Down’s syndrome.
|
GP letter.
The Medical Centre,
Green Lane,
Broadforth-on-Sea.
Your ref: BRI 07/54843.
Re. Jennifer Houseside,
45 The Maltings,
Broadforth-on-Sea.
Dear John,
It was wonderful to see you and Mary again on Saturday
and so kind of you to invite us. The meal was up to Mary’s high standards and
the company convivial. We may be getting older, but Mary’s fragrant beauty does
not diminish.
Please see this woman who complains of unacceptably heavy
periods. She is huge, malodorous and is more like a whale than a human being.
One can see how the family name originated! I do not envy you the task if you
feel that you have to examine her.
She is as stupid as she is fat. I doubt that she has more
than one brain cell. If she has, they are not inter-connected. She talks
incessantly and brings complete sense of the old adage “empty vessels make most
sound”. Despite the vacuum in her cranium she is awash with idiotic ideas most
of which she gets from her monumentally stupid mother. She is too thick for
logical reasoning to have any impact on her ridiculous views – you might as
well attempt a philosophical discussion with your dog.
The father is a dirty, unpleasant sort and I would not be
surprised if incest had contributed to their low IQs. If the human race has
advanced though evolution and natural selection, what on earth were their
ancestors like?
They are social parasites. None of the family has ever
worked and they live off Social Security payments. I have had the misfortune to
have to do the occasional home visit to various members of the family. They
live in disgusting squalor. If they were pigs their living conditions would
give the species a bad name. Theirs are houses in which you wipe your feet on
the mat as you leave and not as you enter and pray that you never have to visit
again. I am sure the Court of Human Rights would regard a second visit as a
cruel and unnatural punishment. They always ask you to sit, but I would not
wish to ruin my clothes. Their hospitality also extends to offering cups of
tea. Perish the thought! I would rather take my chance with neat hemlock.
Despite living on Social Security payments, they have the
latest widescreen TVs and associated DVD equipment. The husband looks to me as
though he indulges in low-level crime, probably shoplifting. He is a shifty
character whom you would not trust and I strongly advise you to make sure that
all valuables are locked up and out of sight when he or any of her family is
around. One brother is in prison for theft to feed a heroin habit, which
typifies the contribution this family makes to the greater good. Her sister is
said to be a prostitute and I would think it true. Certainly she has a lot of
children and I doubt that any of them have the same father or that she would be
able to enlighten them as to who their fathers might be. She (the sister) is a
regular visitor to the Sexually Transmitted Diseases clinic where she displays
a surprising range of conditions needing treatment. She is a one-woman update
course for the staff ensuring they are abreast of all aspects of STDs. I was
going to say she was a one-woman refresher course, but there is nothing
refreshing about her. The sister is as fat and ugly as my patient, making one
marvel at the mentality of her clients. I cannot imagine how anyone would want
to come within smelling distance of her, far less have sexual relations and pay
for the privilege. Some exotic form of masochism, I guess.
I wish you well in your dealings with her and apologise
for sending such an unpleasant lump to your clinic. This is a family that makes
you wish the Abortion Act could be made retrospective!
Please do your best not to send her back to see me.
Yours sincerely,
Tuesday, 11 March 2014
Tutorial 10 March 2014
Website.
Contact us.
10 March 2014
Labour Ward
Scenario 1.
Contact us.
10 March 2014
10 March 2014
1. How to prepare. Picking a course.
2. Roleplay: how to introduce oneself.
3. Labour ward scenario 1.
4. Labour ward scenario 2.
5. Roleplay: Woman attends for pre-pregnancy
counselling as she plans her 1st. pregnancy. She is healthy. Her brother has cystic fibrosis
Sunday 13.00 hours.
You are given 15 minutes to prepare and you then have a viva with an examiner. Your instructions are to prioritise the patients and allocate staff to go to see them.
1
|
Mrs JH
|
Primigravida. T+8. In labour. 6 cms.
|
2
|
Mrs AH
|
Primigravida at T. In labour. 5 cms.
|
3
|
Mrs. BH
|
Para 2. 30 days post delivery. 2ry. PPH
> 1,000 ml. Hb. 9.3.
|
4
|
Mrs SB
|
Primigravida. 32/52 gestation. Admitted 30 minutes ago.
Abdominal pain + 200 ml. bleeding. Nephrostomy tube in situ - not draining
since this morning. Low placenta on 20 week scan.
|
5
|
Mrs KW
|
Para 1. In labour. Cx. 5 cm. Ceph at
spines.
|
6
|
Mrs KT
|
Para 0+1. 38 weeks. SROM. Ceph
2 cm. above spines. Clear liquor.
|
7
|
Mrs TB
|
Para 1. T+4. Clinically big
baby. Cx fully dilated for 1 hour. Type 1 decelerations.
|
8
|
Mrs RJ
|
Primigravida. Epidural. RIF
pain. Cx fully dilated for 1 hour. Shallow late decelerations. OT position.
Distressed ++. BP /105. ++ protein. Urine output 50 ml in past 4 hours.
|
9
|
Mrs KC
|
Transfer from ICU. 13 days after delivery of 32 week
twins. Laparotomy on day 7 for pelvic pain and fever. Infected endometriotic
cyst removed. IV antibiotics changed to oral.
|
Gynaecology ward.
8 major post operative cases who have been seen on the
morning ward round and are stable. Husband of patient who has had Wertheim's hysterectomy asking to see a doctor for a report
on the operation.
1
|
Mrs JB
|
10 week incomplete miscarriage. Hb. 10.8. Moderate fresh
bleeding.
|
2
|
Ms AS
|
19 years old. Nulliparous. Just admitted with left iliac
fossa pain. Scan shows unilocular 5 cm. ovarian cyst.
|
Medical staff:
Consultant at home. Registrar - you.
Senior House Officer with 12 months experience.
Registrar in Anaesthesia.
Consultant Anaesthetist on call at home.
Midwifery staff:
Senior Sister. Trained to take theatre cases. Able to
site IV infusions and suture episiotomies and tears.
3 staff midwives.
1 trained to take theatre cases. Two able to site IV infusions.
1 Community
midwife looking after Mrs. KW.
2 Pupil Midwives.
Scenario 2.
Monday. 0900 hours. You have just come on duty.
1
|
Mrs
A
|
Para
0+0
|
25
yrs
|
41
weeks. In labour 12 hours. Cx 8 cm. No progress for 4 hours. "Dips"
reported on CTG
|
2
|
Mrs
B
|
Para
1+2
|
31
yrs
|
28
weeks. Just admitted. "Show" + contractions
|
3
|
Mrs
C
|
Para
5+3
|
40
yrs
|
In
labour 8 hours. Cx 6 cm. dilated
|
4
|
Mrs
D
|
Para
1+3
|
27
yrs
|
37
weeks. Diabetes. Admitted ½ hour previously. Previous Caesarean section.
|
5
|
Mrs
E
|
Para
1+2
|
32
yrs
|
40
weeks. Previous 9 lb. baby. In the second stage for 1 ½ hours.
|
6
|
Miss
F
|
Para
0+0
|
15
yrs
|
34
weeks. Concealed pregnancy. In labour. Just admitted. Breech presentation
|
7
|
Mrs
G
|
Para
1+2
|
26
weeks. Admitted with severe abdominal pain
|
|
8
|
Mrs
H
|
Para
2+1
|
39
weeks. In early labour.
|
|
9
|
Mrs
I
|
Para
1+0
|
Delivered
two hours previously by Caesarean section for severe pre-eclampsia. Diastolic
BP / 110. Urine output 50 ml. since delivery
|
|
10
|
Mrs
J
|
Para
1+0
|
Normal
delivery + PPH >1,500 ml. one hour ago
|
Medical
staff:
Consultant: in his Rooms.
You: Registrar.
Foundation
Year 2 six months’ experience.
Registrar
in anaesthetics.
Midwifery
staff:
Senior
Sister.
Two
staff midwives.
One
community midwife.
Two
student midwives.
Subscribe to:
Posts (Atom)