26 May 2016.
7
|
EMQ. Cystic
fibrosis.
|
8
|
EMQ. Mode of inheritance
|
9
|
EMQ. Cervical cancer staging
|
10
|
SBA. Cancer incidence & mortality
|
7. EMQ. Cystic fibrosis.
This question is about cystic
fibrosis.
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?
8. EMQ. Mode of
inheritance.
Lead-in.
The following questions relate to the mode of inheritance
– some not quite to “mode”, but I am sure you will indulge me!
For each question, write what you think is the mode of
inheritance or appropriate answer. There is no option list.
Comment.
You are expected to know a lot
of basic genetics and it is hard to remember the details. A list to go over in
the days before the exam makes sense. Use this one and add anything else you
can think of – and let me know of your additions so I can add them to this
list. Don’t add a load of rare syndromes – you will just end up confused. But
add anything that you know has featured in the exam.
List of questions.
1. achondrogenesis.
2. achondroplasia.
3. acute fatty liver of pregnancy (AFLP).
4. adreno-genital syndrome
5. adult
polycystic kidney disease.
6. androgen insensitivity syndrome.
7. albinism.
8. Angelman syndrome.
9. Apert syndrome.
10. Becker muscular dystrophy.
11. Beckwith-Wiedemann syndrome.
12. BRCA 1.
13. BRCA2.
14. Cavanan syndrome.
15. Charcot-Marie-Tooth disease.
16. chondrodystrophy.
17. Christmas disease.
18. congenital adrenal hyperplasia.
19. Cowden
syndrome.
20. cri-du-chat syndrome.
21. cystic fibrosis.
22. Dandy-Walker syndrome.
23. developmental dysplasia of the hip.
24. Down’s syndrome.
25. Duchenne muscular dystrophy
26. Dwarfism. See isolated growth hormone deficiency.
27. Edward’s syndrome.
28. exomphalos.
29. Ehlers-Danlos syndrome
30. Fanconi anaemia
31. Fitz-Hugh-Curtis syndrome.
32. Fragile X syndrome.
33. galactosaemia.
34. gastroschisis.
35. glucose-6-phosphatase deficiency. G6PD.
36. glucose-6-phosphate dehydrogenase deficiency. G6PDD.
37. haemochromatosis.
38. haemosiderosis.
39. haemophilia A:
40. haemophilia B.
41. Hunter syndrome.
42. Huntington’s
disease.
43. ichthyosis.
44. isolated
growth hormone deficiency.
45. juvenile
polycystic kidney disease.
46. Kallmann’s
syndrome.
47. Klinefelter’s
syndrome.
48. Lesch Nyhan syndrome.
49. Lynch syndrome (HNPCC).
50. Malignant hyperthermia.
51. Maple syrup urine disease.
52. Marfan’s syndrome.
53. Martin-Bell syndrome.
54. Mayer-Rokitansky-Kuster-Hauser syndrome.
55. McCune-Albright
syndrome.
56. Meckel-Gruber syndrome.
57. Medium-chain acyl-CoA dehydrogenase deficiency.
58. mucopolysaccharidosis type I.
59. Myotonic
dystrophy.
60. neurofibromatosis.
61. Niemann-Pick
disease.
62. Noonan syndrome.
63. ocular albinism.
64. osteogenesis imperfecta.
65. osteoporosis.
66. Patau’s
syndrome.
67. Perrault syndrome.
68. phenyketonuria.
69. polydactyly.
70. porphyria.
71. Potter’s syndrome.
72. Prader-Willi syndrome.
73. Prune-belly syndrome.
74. pyruvate kinase deficiency.
75. sickle cell disease.
76. spherocytosis.
77. Syndrome
X.
78. Tay-Sach’s disease.
79. Thalassaemia.
80. Thrombophilia.
81. Triple X syndrome.
82. Turner’s syndrome.
83. Swyer’s syndrome.
84. Uniparental disomy.
85. VACTERL.
86. vitamin D resistant rickets
87. von Willebrand’s disease.
88. A
mother has spina bifida. What is the risk of a child being affected?
89. A
mother has had a child with spina bifida, what is the risk of the next child
being affected?
90. A mother has had two children with spina bifida. What is
the risk of the next child being affected?
91. A mother has grand-mal epilepsy. What is the risk of her
child having epilepsy?
92. A mother and her partner both have grand-mal epilepsy. What
is the risk of their child having epilepsy?
93. A mother has insulin-dependent diabetes mellitus. What is
the risk of a child being affected?
94. A
mother has congenital heart disease. What is the risk of a child being
affected?
95. A mother takes lithium for bi-polar disorder throughout her
pregnancy. What is the risk of the child having congenital heart disease?
96. A mother has a nuchal translucency scan at 11 weeks. The
result is 6 mm. What is the risk of the fetus having congenital heart disease?
9. EMQ.
Cervical cancer staging.
EMQ Paper 1 ,
Question 6 . Ca Cx staging.
Lead-in.
The following scenarios relate to cervical cancer
staging.
For each, select the most appropriate staging.
Pick one option from the option list.
Each option can be used once, more than once or not at
all.
Scenario 1.
A woman of 25 has a cone
biopsy. The histology report shows squamous cell carcinoma penetrating to a
depth of 2 mm and 6 mm in width. The resection margins are tumour-free. There
is no evidence of spread outside the uterus. She is nulliparous and wishes to retain
her fertility.
Scenario 2.
A woman of 25 has a cone biopsy. The histology report
shows squamous cell carcinoma penetrating to a depth of 5 mm and 6 mm in width.
The resection margins are tumour-free. There is no evidence of spread outside
the uterus. She is nulliparous and wishes to retain her fertility.
Scenario 3.
A woman of 25 has a cone
biopsy. The histology report shows squamous cell carcinoma penetrating to a
depth of 5 mm and 6 mm in width. The resection margins are not tumour-free. There
is no evidence of spread outside the uterus. She is nulliparous and wishes to retain
her fertility.
Scenario 4.
A woman of 25 has a cone
biopsy. The histology report shows squamous cell carcinoma penetrating to a
depth of 6 mm and 3 cm in width. The resection margins are tumour-free. There
is no evidence of extension outside the uterus. She is nulliparous and wishes
to retain her fertility.
Scenario 5.
A woman of 25 has a cone
biopsy. The histology report shows squamous cell carcinoma penetrating to a
depth of 6 mm and 5 cm in width. The resection margins are tumour-free. She is
nulliparous and wishes to retain her fertility.
Scenario 6.
A woman of 38 has a cone
biopsy. The histology report shows squamous cell carcinoma penetrating to a
depth of 4 mm and 6mm in width. The resection margins are tumour-free. An MR
scan shows involvement of the lymphatic nodes in the left of the pelvis.
Scenario 7.
A woman of 45 has carcinoma of
the cervix. It extends into the parametrium, but not to the pelvic side-wall.
It involves the upper 1/3 of the vagina. There is MR evidence of para-aortic
node involvement.
Scenario 8.
A woman of 55 has carcinoma of
the cervix. It extends to the pelvic side-wall. It involves the upper 1/3 of
the vagina. She has a secondary on the end of her nose.
Scenario 9.
A woman of 55 has carcinoma of
the cervix. It involves the bladder mucosa.
Scenario 10.
A woman of 35 has a proven
cancer of the cervix with extension into the right parametrium, but not to the
pelvic side-wall. Left hydroureter and left non-functioning kidney are noted on
IVP and there is no other explanation for the findings. Cystoscopy shows
bullous oedema of the bladder mucosa.
Scenario 11.
A woman of 25 has a cone
biopsy. It shows malignant melanoma. The lesion invades to a depth of 3 mm and
is 5 mm in width. The margins of the biopsy are clear. There is evidence of
lymphatic vessel involvement. There is no evidence of spread outside the
uterus.
Option list.
Micro-invasive cervical cancer.
Stage Ia1
Stage Ia2
Stage Ia3
Stage Ib1
Stage Ib2
Stage Ib3
Stage IIa
Stage IIb
Stage IIc
Stage IIIa
Stage IIIb
Stage IIIc
Stage IVa
Stage IVb
Stage IVc
Stage Va
Stage Vb
Stage Vc
None of the above.
This question illustrates the problems surrounding
staging. If you are not a cancer specialist, it is not something that you think
about very often, if ever. So you have to put it into your list of things to
revise in the days before the exam. If you haven’t started this list, do so
now.
10. SBA.
Cancer incidence & mortality.
Abbreviations.
NHL: non-Hodgkin Lymphoma
Question 1.
Lead-in
Which is
the most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Breast
|
|
C.
|
Cervix
|
|
D.
|
Endometrium
|
|
E.
|
Lung
|
Question 2.
Lead-in
Which is
the 2nd. most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Breast
|
|
C.
|
Cervix
|
|
D.
|
Endometrium
|
|
E.
|
Lung
|
Question 3.
Lead-in
Which is
the 3rd. most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Breast
|
|
C.
|
Cervix
|
|
D.
|
Endometrium
|
|
E.
|
Lung
|
Question 4.
Lead-in
Which is
the 4th. most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Breast
|
|
C.
|
Cervix
|
|
D.
|
Endometrium
|
|
E.
|
Lung
|
Question 5.
Lead-in
Which is
the 5th. most common female cancer?
Option List
|
A.
|
Cervix
|
|
B.
|
Malignant melanoma
|
|
C.
|
Non-Hodgkin’s lymphoma
|
|
D.
|
Ovary
|
|
E.
|
Vulva
|
Question 6.
Lead-in
Which is
the 6th. most common female cancer?
Option List
|
A.
|
Cervix
|
|
B.
|
Non-Hodgkin’s lymphoma
|
|
C.
|
Ovary
|
|
D.
|
Skin
|
|
E.
|
Vulva
|
Question 7.
Lead-in
Where does
cervical cancer feature in the list of the most common female cancers?
Option List
|
A.
|
10th.
|
|
B.
|
12th.
|
|
C.
|
16th.
|
|
D.
|
20th.
|
|
E.
|
24th.
|
Question 8.
Lead-in
Where does
vulval cancer feature in the list of the most common female cancers?
Option List
|
A.
|
10th.
|
|
B.
|
12th.
|
|
C.
|
16th.
|
|
D.
|
20th.
|
|
E.
|
24th.
|
Question 9.
Lead-in
Which is
the most common cancer causing female death in the UK?
Option List
|
A.
|
Breast
|
|
B.
|
Bowel
|
|
C.
|
Lung
|
|
D.
|
Ovary
|
|
E.
|
Pancreas
|
Question 10.
Lead-in
Which is
the 2nd. most common cancer causing female death in the UK?
Option List
|
A.
|
Breast
|
|
B.
|
Bowel
|
|
C.
|
Lung
|
|
D.
|
Ovary
|
|
E.
|
Pancreas
|
Question 11.
Lead-in
Which is
the 3rd. most common cancer causing female death in the UK?
Option List
|
A.
|
Breast
|
|
B.
|
Bowel
|
|
C.
|
Lung
|
|
D.
|
Ovary
|
|
E.
|
Pancreas
|
Question 12.
Lead-in
Which is
the 4th. most common cancer causing female death in the UK?
Option List
|
A.
|
Brain
|
|
B.
|
Oesophagus
|
|
C.
|
Ovary
|
|
D.
|
Pancreas
|
|
E.
|
Uterus
|
Question 13.
Lead-in
Which is
the 5th. most common cancer causing female death in the UK?
Option List
|
A.
|
Brain
|
|
B.
|
Oesophagus
|
|
C.
|
Ovary
|
|
D.
|
Pancreas
|
|
E.
|
Uterus
|
Question 14.
Which is
the 6th. most common cancer causing female death in the UK?
Option List
|
A.
|
Brain
|
|
B.
|
Oesophagus
|
|
C.
|
Ovary
|
|
D.
|
Pancreas
|
|
E.
|
Uterus
|
Question 15.
Lead-in
The
incidence of cervical cancer has fallen from the late 1970s until now. What is
the approximate figure for the fall?
Option List
|
A.
|
10%
|
|
B.
|
25%
|
|
C.
|
50%
|
|
D.
|
60%
|
|
E.
|
75%
|
Question 16.
Lead-in
The
incidence of cervical cancer fell in the past decade. What is the approximate
figure for the fall?
Option List
|
A.
|
5%
|
|
B.
|
10%
|
|
C.
|
15%
|
|
D.
|
20%
|
|
E.
|
25%
|
Question 17.
Lead-in
What proportion of cervical
cancer is diagnosed in women < 45 years?
Option List
|
A.
|
20%
|
|
B.
|
30%
|
|
C.
|
40%
|
|
D.
|
50%
|
|
E.
|
60%
|
Question 18.
Lead-in
When was
routine HPV vaccination of girls introduced in the UK?
Option List
|
A.
|
2000
|
|
B.
|
2002
|
|
C.
|
2004
|
|
D.
|
2006
|
|
E.
|
2008
|
Question 19.
Lead-in
From what
year might we expect to see a reduction in cervical cancer incidence as a
result of the HPV vaccination programme?
Option List
|
A.
|
2020
|
|
B.
|
2025
|
|
C.
|
2030
|
|
D.
|
2040
|
|
E.
|
2050
|
Question 20.
Lead-in
When was
routine HPV vaccination of boys introduced in the UK?
Option List
|
A.
|
2010
|
|
B.
|
2011
|
|
C.
|
2012
|
|
D.
|
2014
|
|
E.
|
None of the above
|
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years of trying we were at a point where we were willing to try anything. And I'm glad we came to DR ODUCK AYAMUD, Because his predictions put us at ease, and I
honestly believe him, and his gods really helped us as well, I am thankful for all he has done. If you are in this kind of problem i will advice you to contact him
with this email: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN USE ANY OF THE EMAILS TO CONTACT HIM for you to have your own baby in the
family....YOU CAN ALSO CALL / ADD HIM UP ON WHATSAPP USING THIS MOBILE NUMBER:+2347059232579
ReplyDeleteMy life is back!!! After 8 years of marriage, my husband left me and left me with our three kids. I felt like my life was about to end, and was falling apart. I
contacted you and after I explained you my problem. In just 24hours, my husband came back to us and show me and my kids much love and apologize for all the pain he
have bring to the family. We solved our issues, and we are even happier than before DR ODUCK AYAMUD you are the best spell caster i really appreciate the love spell
you casted for me to get the man back to my life i will keep sharing more testimonies to people about your good work Thank you once again DR ODUCK AYAMUD at:
oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN USE ANY OF THE EMAILS TO CONTACT HIM incase you are in any problem you can contact this man for help
he is always there in his temple to help you solve your problem Contact Email is: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN USE ANY OF THE
EMAILS TO CONTACT HIM. CONTACT HIM TODAY VIA THIS EMAIL ADDRESS: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN USE ANY OF THE EMAILS TO CONTACT HIM
AS HIS POWERS ARE SO STRONG AND VERY EFFECTIVE AND HAS NO BAD EFFECT INSTEAD IT HAVE A VERY GOOD RESULT AFTER CASTING THE SPELL.... YOU CAN ALSO CALL / ADD HIM UP ON
WHATSAPP USING THIS MOBILE NUMBER:+2347059232579
ReplyDeleteMy Name is KPELELIO.I will love to share my testimony to all the people in the forum cos i never thought i will have my girlfriend back and she means so much to
me..The girl i want to get marry to left me 4 weeks to our wedding for another man..,When i called her she never picked my calls,She deleted me on her facebook and she
changed her facebook status from married to Single...when i went to her to her place of work she told her boss she never want to see me..I lost my job as a result of
this cos i cant get myself anymore,my life was upside down and everything did not go smooth with my life...I tried all i could do to have her back to all did not work
out until i met a Man when i Travel to Africa to execute some business have been developing some years back..I told him my problem and all have passed through in
getting her back and how i lost my job...he told me he gonna help me...i don't believe that in the first place.but he swore he will help me out and he told me the
reason why my girlfriend left me and also told me some hidden secrets.i was amazed when i heard that from him..he said he will cast a spell for me and i will see the
results in the next couple of days..then i travel back to US the following day and i called him when i got home and he said he's busy casting those spells and he has
bought all the materials needed for the spells,he said am gonna see positive results in the next 2 days that is Thursday...My girlfriend called me at exactly 12:35pm
on Thursday and apologies for all she had done ..she said,she never knew what she's doing and her sudden behavior was not intentional and she promised not to do that
again.it was like am dreaming when i heard that from her and when we ended the call,i called the man and told him my wife called and he said i haven't seen anything
yet... he said i will also get my job back in 3 days time..and when its Sunday,they called me at my place of work that i should resume working on Monday and they gonna
compensate me for the time limit have spent at home without working..My life is back into shape,i have my girlfriend back and we are happily married now with kids and
i have my job back too.This man is really powerful..if we have up to 20 people like him in the world,the world would have been a better place..he has also helped many
of my friends to solve many problems and they are all happy now..Am posting this to the forum for anybody that is interested in meeting the man for help.you can mail
him to oduckayamud49@yahoo.com I cant give out his number cos he told me he don't want to be disturbed by many people across the world..he said his email is okay and
he' will replied to any emails asap..hope he helped u out too..good luck: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN USE ANY OF THE EMAILS TO
CONTACT HIM. ONCE AGAIN HIS EMAIL ADDRESS IS: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN USE ANY OF THE EMAILS TO CONTACT HIM ......YOU CAN ALSO
CALL / ADD HIM UP ON WHATSAPP USING THIS MOBILE NUMBER: +2347059232579
I have always wanted to be able to not live paycheck to paycheck or have any debt. I worked in accounting for about 20 years and was barely able to make ends meet. It
ReplyDeleteseemed like any time I moved up in the company and received a RISE/PROMOTION, my living expenses would go up significantly and I was never able to get ahead... Then
one day my best friend told me the truth about what he did when his wife left him. He had a love spell cast on her and she stopped the divorce proceedings and they got
back together. When he told me this I asked who he used and he gave me the email address which is: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN
USE ANY OF THE EMAILS TO CONTACT HIM and I immediately contacted him for help. I saw that they offered different kinds of money spells to help win the lottery. I was
immediately intrigued. I have always felt like I was going to win the lottery someday. I had the jackpot lottery spell cast and awaited my win. I was told to play the
lottery each week and I did what I was told. I played the lottery each week anyways, so it did not change anything. Within about two weeks it happened. I won
$1000,000.00!! I could not believe it! It was more than enough money to retire right away, but I invested it well and it has allowed me to go down to part time work
and will help me retire much earlier. I am eternally grateful for finding their email address: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN USE
ANY OF THE EMAILS TO CONTACT HIM .... DR ODUCK AYAMUD IS VERY POWERFUL AND RELIABLE CONTACT HIM NOW: oduckayamud49@yahoo.com OR oduckayamud49@gmail.com .... YOU CAN
USE ANY OF THE EMAILS TO CONTACT HIM.....YOU CAN ALSO CALL / ADD HIM UP ON WHATSAPP USING THIS MOBILE NUMBER:+2347059232579
My name is Charlotte Oliver. Out of respect for you and your spells I must make this testimony know to all. I've been to other spell casters without seeing any result, all they want was after my money. I just wished I came to you earlier, i got the best from you. My ex husband was gone for a year and I went everywhere and other spell casters for help but no result until my friend introduce me to Dr Isikolo. After the Love Spell was done, I finally got a calls from him in less than 48 hours. His spells worked wonders and my husband is back with full of love. It was like a miracle! He suddenly came back with flowers saying that i should for give him, i was truly flabbergasted and shocked when my husband kneel down begging for forgiveness and for me to accept him back. I'm really short of words and joyful, you are a God sent to me and my entire family.. And now i am a joyful woman once again. Thank you so much Dr Isikolo. To everyone who is looking for a real spell caster contact Dr.Isikolo at isikolosolutionhome@gmail.com You can also Whatsapp him on +2348133261196
ReplyDeleteThis is certainly a shocking and a genuine Testimony..I visited a forum here on the Internet on the 23th of April 2018 , And i saw a marvelous testimony of this powerful and great spell caster called Dr Oseiboh on the forum..I never believed it, because i never heard nor learn anything about spell nor magic before.. Not a soul would have been able to influence me about black magical spells, not until Dr Oseiboh did it for me and restored my marriage of 6 years back to me and brought my spouse back to me just as i read on the Internet..i was truly astonished and shocked when my husband knelt down begging for forgiveness and for me to accept him back.. I am really short of expressions, and i don't know how much to convey my appreciation to you Dr Oseiboh you are a God sent to me and my entire family.. And now i am a joyful woman once again thanks for your good work and for restoring happiness to my home..LOVE SPELL,LOTTERY,PREGNANCY SPELL, DIVORCE SPELL,ANY FOUNDATION COURSES,REVENGE SPELL,STOP COURT CASE AND WIN ANY COURT PROBLEM,DEATH SPELL,BUSINESS SPELL AND MANY MORE YOU MAY NEED. Email him now for your own help. via email droseiboh12@gmail.com add him on whatsapp line or call +2347017565415.
ReplyDeleteWhy does everyone hang their hopes on medical science. They do not own the work cure! You are amazing and strong and your belief system is held hostage by science. People can say I'm fighting cancer and will beat it and sometimes do with all kinds of things including the powerful mind and everyone applauds. But say herpes can be cured and your laughed at. I was cured by Lucky and I'm not special. I was lucky enough to have been introduced to Dr Lucky Herbal Clinic guided medications. when I was diagnosed with Hsv1&2 I applied the power of my mind and those medications and defeated this weak virus. Herpes is a weak virus and mostly causes emotional pain. Take back your life and power and defeat the weak chicken virus. Almost 10 years no outbreaks and herpes has caused zero problems in my life. Yes I'm cured. Contact Dr Lucky Now! Email: drluckyherbalclinic2@gmail.com, or contact via whatsapp +22378760009
ReplyDeleteI'm so excited my broken Marriage has been restored. My ex husband is back after he left me and our 2kids for another woman. I was so happy to meet Dr. OKu how he helps many people to bring their Lover back so i contact him to help me too. husbandThat was how Dr. Oku helped me to bring my back.. A big thank you to Dr. Oku because I never thought my ex Husband will be back to me so quickly with your spell. You are the best and world greatest. If you are here and you need your Ex Lover back or your husband moved to another woman, do not cry anymore, contact this powerful spell caster now. Here’s his contact:Email him at: okutemple@gmail.com You can also Call/WhatsApp:+2348163425519
ReplyDeleteYou can also reach him out on his Facebook page https://www.facebook.com/Dr-Oku-temple-114147387163908/