Thursday 29 March 2018

Tutorial 29th. March 2018


29 March 2018
27
Role-play. Fragile X syndrome.
28
Role-play. PMB
29
Viva. Waiting list prioritisation.
30
Viva. HPV immunisation.

27. Fragile X syndrome.
Candidate’s instructions.
You are about to see Mary White who has been booked in with her first pregnancy by the midwife in the antenatal clinic. The midwife has asked you to see her as Mary has told her that there is a family history of Fragile X syndrome.
Your task is to discuss Fragile X syndrome and the implications for Mary, the pregnancy and her father.

28. PMB.
Candidate’s Instructions.
You are an SpR in the “one-stop” PMB clinic. You are about to see a woman with bleeding some years since her menopause.
A 55 year old woman is referred by her General Practitioner.
Your task is to take an appropriate history and advise her about the investigations you feel are appropriate and why.
Referral letter from the General Practitioner.
Manor Lodge,
High Street,
Bestown.
BE5 S00
Re: Mrs. Mary Smith,   Age 55.
5b High Street,
Bestown.
BE5 SO1
Dear Doctor,
Please see Mrs. Smith who has had bleeding down below. It is a number of years since she reached the menopause.
Yours sincerely,
James Fewords,
General Practitioner.

29. Waiting list prioritisation.
Candidate’s instructions.
Your consultant is away. The waiting-list manager comes to see you. The following patients have been listed and the waiting-list manager wants you to:
              confirm the appropriateness of the proposed treatment,
              decide the degree of urgency,
              confirm the appropriateness of the proposed venue,
              decide any special requirement(s) for each patient.

Name
Age
Clinical Problem
Proposed operation
Venue
Special Needs
Urgency
JK
5
chronic discharge.
? foreign body
EUA
Main theatre


JM
32
1ry. infertility
Laparoscopy + tubal patency tests
Main theatre


GN
77
Vulval cancer. Coronary thrombosis x 2. Unstable angina.
Radical vulvectomy agreed at MDT.
Main theatre


RU
55
PMB x1. Weight 20 stones. (127 kg.)
1 kg. = 2.2 lb.
1 stone = 14 lb.
D&C.

DCU.


LD
32
Menorrhagia. Fibroids. Anaemia.
Vaginal hysterectomy.

Main theatre.


DT
22
Does not want children.
Lap. Steril.
DCU


HB
14
Unwanted pregnancy at 10/52.
TOP
DCU. TOP list.
.

JY
44
GSI.
Anterior colporrhaphy.

Main theatre.


JS
23
Vaginal discharge. Cervical ectropion.
Diathermy to cervix.

DCU


DT
55
3 cm. ovarian mass.
Laparoscopy ? proceed to Hyst + BSO.

Main theatre.


EV
32
CIN3.
Cone biopsy.

DCU


UW
34
Endometriosis
Laparoscopic ablation
DCU


HT
88
Cystocoele/ rectocoele/ 2nd. degree uterine prolapse
Manchester Repair.

Main theatre.


KN
58
Haematuria
Cystoscopy
DCU


JW
18
Menorrhagia & copes badly with menstrual hygiene. Has Down’s syndrome. Sexually active.
Hysterectomy
Main theatre


TB
30
Menorrhagia. 2nd. degree uterine descent. Been sterilised. Jehovah’s witness.
Vaginal hysterectomy and repair.
Main theatre.


BM
55
Stage Ib cancer cervix. Been discussed at MDT. For Wertheim’s hysterectomy. Factor V Leiden. VTE on Pill. On warfarin.
Wertheim’s hysterectomy.
Main theatre.


NU
60
Recurrent rectocoele.
Posterior colporrhaphy.
Main theatre.



30. HPV immunisation.
Candidate’s instructions.
This is a viva station about the UK programme for routine HPV immunisation.
The examiner will ask you 18 questions.
When you have finished a question, you will not be allowed to return to it as later questions may indicate earlier answers. If you return, no marks will be awarded, even for correct answers.