Tutorial 27th. March 2017

Contact us

Website

27 March 2017

6	Viva. The examiner will ask you 2 questions about the part 3 exam.
7	Homework. Basic “blurbs” to write and practise. Setting the scene for breaking bad news, general pre-pregnancy counselling, dominant, recessive & x-linked inheritance etc.
8	Viva. Labour ward scenario 1.
9	Role-play. Woman attends for pre-pregnancy counselling as she plans her 1st. pregnancy. Her sister recently had a baby with Down’s syndrome.
10	Viva. The uses of MgSO4 in O&G.

6. The examiner will ask 2 questions about the part 3 exam.

The exam committee has highlighted some key aspects that will be expected to be reflected in the exam. This is meant to make you think about them and use them on the big day.

7. Basic “blurbs”.

You need to develop and practise some basics: setting the scene for breaking bad news, general pre-pregnancy counselling, dominant, recessive & x-linked inheritance etc. These are things that come up time and again and it helps a lot of you can deliver them swiftly and smothly.

8. Labour ward scenario 1.

We are told that preparatory stations won’t be used. Quite how they will devise stations about important topics like labour ward management remains to be seen.

Labour Ward.

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. Early 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.

9. Roleplay. Pre-pregnancy counselling.

Candidate’s instructions.

You are the SpR in the gynaecology clinic. You have been asked to see Jenny Williams, who has come for pre-pregnancy counselling.

Letter from the General Practitioner.

5 High Street,

Deersworthy,

Kent.

DO9 1JY.

Re Mrs. J. Williams,

Manor Place,

Deersworthy.

Dear Dr.,

Please see this woman who is planning pregnancy. I understand that her sister has had a baby with Down’s syndrome.

Regards,

Dr. Jolly.

10. Viva. Use of MgSO₄ in O&G

Candidate’s instructions.

This is a viva station about the uses of MgSO₄ in O&G.

The examiner will not ask questions, prompt or otherwise assist. It is up to you to give as full an account of the uses as you can muster.