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8
|
Basic “blurbs” to write and practise.
Setting the scene for breaking bad news, dealing with the information in a GP
referral letter, general pre-pregnancy counselling, recessive inheritance,
x-linked inheritance etc.
|
|
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.
|
|
11
|
Viva. Labour ward
scenario 1.
|
8. Basic
“blurbs”.
There
are a lot of chunks of text that come up time and again when chatting to
patients. It is good to get these practised so that you can deliver them
quickly and efficiently and not miss important points. An absolute basic is the
GP referral letter. Likewise basic pre-pregnancy counselling, which gets and
extra mark or two in any appropriate station.
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.
Roleplay. Magnesium sulphate 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.
11.
Roleplay. Labour Ward Scenario 1.
Candidate's
Instructions.
You are the senior trainee and are starting your shift on the
labour ward. Explain to the examiner how you will prioritise the patients, allocate
staff and the reasons for your decisions.
|
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.
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