Thursday, 30 August 2018

Tutorial 30th. August 2018


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30 August 2018

36
Viva. Waiting list prioritisation
37
Role-play. Caesarean section on maternal request
38
Role-play. Premenstrual syndrome
39
Viva. Maternity Dashboard
40
Viva. Cochrane Collaboration

36. Waiting list prioritisation.
Candidate’s instructions.
Your consultant is away. The waiting-list manager comes to see you. The following patients have been listed by junior staff. 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.



37. Caesarean section on maternal request.
Candidate’s instructions.
You are a SpR5 in the antenatal clinic. Your consultant is feeling unwell and has gone to lie down.
The midwife has just seen a primigravid woman who has requested Caesarean section. She is healthy, with no significant medical history and the pregnancy has been normal.
The gestation is 36 weeks, the head is engaged and the baby seems to be of an average size.
The midwife has done all the routine investigations and has asked you to see her to discuss the request for Caesarean section.
It is your task to discuss her request as you would in a normal clinic.

38. Premenstrual syndrome.
Candidate's Instructions.
This is a roleplay station.
Your task is to take a history and advise about initial investigations and management.

GP Letter.
The Medical Centre,
Haversham Way,
Lasttown.
XS89 9JH.
Re Jenny Smith,
55 Town Street, Lasttown.
Dear Doctor,
Please see this woman who complains of pre-menstrual syndrome. I don’t really believe in this condition so have not attempted to treat it.
Regards, Dr. N.O.G. Ood.

39. Candidate’s instructions.
This is a viva station about the RCOG’s Maternity Dashboard.
The examiner will ask you 14 questions.
When you have finished a question, you will not be allowed to return to it as later questions may indicate the answer. If you return, no marks will be awarded, even for correct answers.

40. Viva. Cochrane Collaboration..
Candidate’s instructions.
This is a viva about the Cochrane Collaboration.
The examiner will ask 8 questions and give one instruction.



 Forest plot used for Cochrane logo
 
I tried to copy the plot, but the software would not allow it.
You will need to download it from the 'Materials for the tutorials' folder on Dropbox.

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