Monday 14 December 2015

Tutorial 14th. December 2015


14th. December 2015.

23
EMQ. Cystic fibrosis.
24
EMQ. Parvovirus & pregnancy
25
EMQ. Drugs in O&G 1
26
EMQ. Drugs in O&G 2
27
Communication skills.

23.         EMQ. Cystic fibrosis.
I know that we covered this in the previous tutorial. But there was no podcast due to malfunction of the software I use to record the tutorials. That is now sorted out. There are sure to be questions about CF and I think it is sometimes easier to understand after listening to a discussion than by wading through written explanations. And it is such an important topic that repetition will do no harm.

For each scenario choose the option that gives the best answer.
Each option can be used once, more than once or not at all.
And, to make you behave in a model fashion, there is no option list, so you have to decide the correct answer.
Scenario 1.
A woman is 8 weeks pregnant and known to be a carrier of cystic fibrosis.
Her husband is Caucasian.
What is the risk of the child having cystic fibrosis?
Scenario 2.
A healthy woman attends for pre-pregnancy counselling.
Her brother has cystic fibrosis. Her husband is Caucasian.
He has been screened for cystic fibrosis. The test was negative.
What is the risk of them having a child with cystic fibrosis?
Scenario 3.
A healthy woman is a known carrier of cystic fibrosis.
She attends for pre-pregnancy counselling. Her husband has cystic fibrosis.
What is the risk of them having a child with CF?
Scenario 4.
A healthy woman attends for pre-pregnancy counselling. Her sister has had a child with cystic fibrosis.
What is her risk of being a carrier?
Scenario 5.
A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.
What is the risk that she is a carrier?
Scenario 6 .
A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.
The partner’s risk of being a carrier is 1 in X.
What is the risk that she will have a child with CF?
Scenario 7.
A healthy Caucasian woman is 10 weeks pregnant.
Her husband is a known carrier of cystic fibrosis.
Which test would you arrange?
Scenario 8.
A woman attends for pre-pregnancy counselling. She has read about diagnosing CF using cffDNA from maternal blood. Is it possible to test for CF in this way?
Scenario 9.
A woman and her husband are known carriers of cystic fibrosis.
What is the risk of them having an affected child.
Scenario 10.
A woman and her husband are known carriers of cystic fibrosis.
What can they do to reduce the risk of having an affected child?
Scenario 11.
A woman and her husband are known carriers of cystic fibrosis.
Can CVS exclude an affected pregnancy?
Scenario 12.
A woman with cystic fibrosis is planning pregnancy. Her husband is a  known carriers of cystic fibrosis. What is the risk of having an affected child?
Scenario 13.
A woman with cystic fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been advised not to breastfeed because her breast milk will be protein-deficient due to malabsorption.
Is this advice correct?
Scenario 14.
A woman with cystic fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been advised not to breastfeed because her breast milk will contain abnormally low levels of sodium.
Is this advice correct?

24          EMQ. Parvovirus & pregnancy
Lead-in.
The following scenarios relate to parvovirus infection
Pick one option from the option list.
Each option can be used once, more than once or not at all.
Abbreviations.
PvB19:          parvovirus B19
PvIgG:           parvovirus B19 IgG
PvIgM:          parvovirus B19 IgM
Option list.
There is none: make up your own answers!
Scenario 1.
What type of virus is parvovirus?
Scenario 2.
Is the title B19 something to do with the American B19 bomber, its potentially devastating bomb load and the comparably devastating consequences of the parvovirus on human erythroid cell precursors?
Scenario 3.
PVB19 in the UK occurs in mini-epidemics at 3 – 4 year intervals, usually during the summer months.
Scenario 4.
Which animal acts as the main reservoir for infection?
Scenario 5.
What percentage of UK adults are immune to parvovirus infection?
Scenario 6.
What names are given to acute infection in the human?
Scenario 7.
What is the incubation period for parvovirus infection?
Scenario 8
What is the duration of infectivity for parvovirus infection?
Scenario 9.
What are the usual symptoms of parvovirus infection in the adult?
Scenario 10.
What is the incidence of parvovirus infection in pregnancy?
Scenario 11.
How is recent infection diagnosed?
Scenario 12.
How long does PvIgM persist and why is this important?
Scenario 13.
What is the rate of vertical transmission of parvovirus infection?
Scenario 14.
Are women with parvovirus infection who are asymptomatic less likely to pass the virus to their fetuses?
Scenario 15.
To what degree is parvovirus infection teratogenic?
Scenario 16.
What proportion of pregnancies infected with parvovirus are lost?
Scenario 17.
What is the timescale for the onset of hydrops?
Scenario 18.
Laboratories are advised to retain bloods obtained at booking for at least 2 years for possible future reference. True or false?
Scenario 19.
What ultrasound features would trigger consideration of cordocentesis?
Scenario 20.
Must suspected parvovirus infection be notified to the authorities?  Yes or No.
Scenario 21.
Possible parvovirus infection does not need to be investigated after 20 week’s gestation.  True or false?
Scenario 22
If serum is sent to the laboratory from a woman with a rash in pregnancy for screening for rubella, the laboratory should automatically test for parvovirus infection too.  True or false?

25.         EMQ. Drugs in O&G. 1.
Abbreviations.
ACE:              angiotensin-converting enzyme
ACEI:            angiotensin-converting enzyme inhibitor
ARA:             angiotensin II receptor antagonist
HG:               hyperemesis gravidarum
IUGR:            intra-uterine growth retardation
LDA:              low-dose aspirin
MAOI:          monoamine oxidase inhibitor
Option list.
a)         False.
b)        True.
c)         5
d)        10
e)         15
f)          18
g)         20
h)        24
i)           contraindicated in the months before pregnancy
j)           contraindicated in the 1st. trimester
k)         contraindicated in the 2nd. trimester
l)           contraindicated in the 3rd. trimester
m)      contraindicated in all trimesters
n)        not contraindicated in pregnancy
o)        contraindicated in breastfeeding
p)        not contraindicated in breastfeeding
q)        an acute, severe illness like rheumatoid arthritis
r)          an acute, severe illness with encephalopathy and acute fatty liver
s)         an acute, severe illness with gastro-intestinal tract bleeding.
Scenario 1.
When are ACE inhibitors contraindicated in pregnancy?
Scenario 2.
When are ARAs contraindicated in pregnancy?
Scenario 3.
Can St. John’s Wort (SJW) be used in pregnancy?
Scenario 4.
Methyl dopa is an acceptable option for the treatment of gestational hypertension. True / False.
Scenario 5.
Spironolactone is contraindicated in pregnancy. True/False
Scenario 6.
Furosemide is an acceptable option in the management of gestational hypertension. True / False.
Scenario 7.
When are thiazide diuretics contraindicated in pregnancy?
Scenario 8.
Salbutamol is contraindicated for the management of premature labour. True / False.
Scenario 9.
Ergometrine is an integral part of active management of the 3rd. stage.  True / False.
Scenario 10.
When is aspirin contraindicated in pregnancy & the puerperium?
Scenario 11.
When are NSAID’s contraindicated in pregnancy and why?
Scenario 12.
Pethidine:       adverse neonatal effects are most likely if the drug is administered in the six hours before birth.
Scenario 13.
Pethidine:       what is the half-life in the mature neonate?
Scenario 14.
Pethidine:       is contraindicated in those taking MOAIs or who have taken them in the previous 2 months. 
Scenario 15.
Pethidine:       is relatively contra-indicated when there is significant blood loss.
Scenario 16.
Pethidine:       has greater analgesic effect in labour than Diamorphine.
Scenario 17.
What is Reye’s syndrome?
Scenario 18.
What is “torsades de pointes” and when is it of importance in the management of HG?

26.         EMQ. Drugs in O&G. 2.
Option list.
I have not given one to make you think! And, in the exam, you should be deciding your answer before you check the option list.
Scenario 1.
What is the generic name for Prostin?
Scenario 2.
What kind of drug is Prostin?
Scenario 3.
What is the generic name for Misoprostol?
Scenario 4.
What kind of drug is Misoprostol?
Scenario 5.
What is the generic name for Gemeprost?
Scenario 6.
What kind of drug is Gemeprost?
Scenario 7
What is the generic name for Mifepristone?
Scenario 8
What king of drug is Mifepristone?
Scenario 9
What are the constituents of a 1 ml. ampoule of Syntometrine?
Scenario 10
What is the generic name for Carbetocin?
Scenario 11
What kind of drug is Carbetocin?
Scenario 12
What is the generic name for Hemabate?
Scenario 13
What kind of drug is Hemabate?
Scenario 14
What is the generic name for Atosiban?
Scenario 15
What kind of drug is atosiban?
Scenario 16
What if the generic name for Cervagem?
Scenario 17
What kind of drug is Cervagem?
Scenarion 18
What is the cost of 1mg. of Prostin E2 gel and what are its storage requirements?
Scenarion 19
What is the cost of a 1mg. Gemeprost pessary and what are its storage requirements?
Scenarion 20
What is the cost of 200 mcg. of misoprostol and what are its storage requirements?

27.         EMQ. Lead-in.
Communication skills.


1 comment:

  1. As a sign of gratitude for how my son was saved from cystic fibrosis , i decided to reach out to those still suffering from this.
    My son suffered cystic fibrosis in the year 2013 and it was really tough and heartbreaking for me because he was my all and the symptoms were terrible, he always have shortness of breath , and he always complain of burning in the chest . we tried various therapies prescribed by our neurologist but none could cure him. I searched for a cure and i saw a testimony by someone who was cured and so many other with similar body problem, and he left the contact of the doctor who had the cure to cystic fibrosis. I never imagined cystic fibrosis has a natural cure not until i contacted him and he assured me my son will be fine. I got the herbal medication he recommended and my son used it and in one months time he was fully okay even up till this moment he is so full of life.cystic fibrosis has a cure and it is a herbal cure contact the doctor for more info on drwilliams098675@gmail.com on how to get the medication. Thanks for reading my testimony.

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