Tutorial 12th. March 2018

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12 March 2018

11	Role-play. Break bad news. Primigravida. 8 weeks. Some bleeding. Scan = IUP. CRL = 12 mm. No fetal heart activity. Counsel.
12	Viva. Obstetric surveillance systems
13	Roleplay. Hydatidiform mole.
14	Viva. Hydatidiform mole genetics.

11. Breaking bad news.

Candidate's Instructions.

This is a role-play station. The role-player will act as the patient. An examiner will be present.

You are the SpR in the ante-natal clinic. The Consultant who was in clinic has been asked to assist her Consultant colleague in the labour ward theatre. She is unlikely to return for some time as the case is one of massive PPH and hysterectomy may be necessary.

One of the midwives asks you to see a patient who has just had a scan in the EPU.

She is primigravid and the gestation is 8 weeks. She has had some bleeding.

An ultrasound scan = IUP. CRL = 12 mm. No fetal heart activity. No adnexal masses.

12.  Structured discussion. Obstetric surveillance systems.

Candidate's Instructions.

The examiner will ask you 2 questions about surveillance systems used in obstetrics.

The first question has 4 marks; the second 16 marks.

The examiner will ask if you wish to move to the second question when you appear to have completed the first to ensure that you have time for the remaining answers. But it is for you to decide when you move on.

13. Hydatidiform mole.

Candidate's Instructions.

You are the SpR in the gynae clinic. The consultant has said that it will be a good experience for you to see the next patient.

She was recently an inpatient for evacuation of retained products after an apparent miscarriage at 8 weeks. The histology report showed a complete mole.

The GP was contacted and asked to see her. An appointment was sent to her to attend today.

Your task is to take a history and explain the implications of the diagnosis.

14. Viva. Hydatidiform mole genetics.

Candidate's Instructions.

This is a viva. Tell the examiner what you know about the genetics of hydatidiform mole & placental site trophoblastic tumour. The examiner will just listen and not guide you in any way.