20 September
2018
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8
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EMQ. Coroner
1-3
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9
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Role-play. Woman
attends for pre-pregnancy counselling as she plans her 1st. pregnancy. Her
sister recently had a baby with Down’s syndrome.
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10
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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, how to ask if
role-player has questions, dealing with information such as a relative with a
serious problem, etc. Make a list.
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11
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Viva. C
section scar pregnancy.
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12
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EMQ. Uterine
transplant.
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8. Coroner.
The Coroner. Question 1.
Lead-in.
The following scenarios relate to the role of the Coroner.
Pick one option from the option list.
Each option can be used once, more than once or not at
all.
Option list.
A.
an independent
judicial officer
B.
a barrister acting for
the Local Police Authority
C.
the regional
representative of the Home Office
D.
the regional
representative of the Queen.
E.
an employee of the
High Court.
F.
the Local Authority
G.
the Local Police
Authority
H.
the Home Office
I.
the High Court
J.
the Queen
Scenario 1.
What is the best description of
the status of the Coroner?
Scenario 2.
Who appoints the Coroner?
Scenario 3.
Who pays for the Coroner and
the coronial service?
The Coroner. Question 2.
Lead-in.
The following scenarios relate to the role of the
Coroner.
Pick one option from the option list.
Each option can be used once, more than once or not at
all.
Option list.
A.
must have had
experience as a detective in the police force with rank of Inspector or above
B.
must be a barrister,
lawyer or doctor with at least 5 years’ experience
C.
must be a legally
qualified individual with at least 5 years’ experience
D.
must be a trained
bereavement counsellor
E.
must be able to play
the bagpipes
F.
Monday - Friday; 09.00 - 17.00 hours, including bank
holidays
G.
Monday - Friday; 09.00
- 17.00 hours, excluding bank holidays
H.
All the time
I.
to arrest people
suspected of unlawful killing
J.
to manage traffic in
the vicinity of the Coroner’s court
K.
to make enquiries on
behalf of the Coroner
L.
to make enquiries on
behalf of the Coroner and provide administrative support
M.
to play bagpipes at
coronial funerals
Scenario 1.
What qualifications must the
Coroner have?
Scenario 2.
What are the hours of
availability of the Coroner?
Scenario 3.
What is the role of the
Coroner’s Officers?
The Coroner. Question 3.
Lead-in.
The following scenarios relate to the role of the
Coroner.
Pick one option from the option list.
Each option can be used once, more than once or not at
all.
Option list.
A.
the death must be
reported to the Coroner
B.
the death does not
need to be reported to the Coroner
C.
the Coroner must order
the return of the body for an inquest
D.
the Coroner must order
a post-mortem examination
E.
the Coroner must hold
an inquest
F.
the Coroner should
arrange for the death to be investigated by the Home Office
G.
the death must be
reported to the authorities of the country in which it took place in order that
a certificate of death can be issued
H.
a certificate of live
birth
I.
a certificate of
stillbirth
J.
a certificate of
miscarriage
K.
yes
L.
no
M.
none of the above
Scenario 1.
A resident of Manchester dies suddenly while visiting the
town of his birth in Scotland. His family decides that he will be buried there.
His body is held at the premises of a local funeral director. What actions
should be taken with regard to the Manchester coroner?
Scenario 2.
A resident of London dies suddenly while visiting
Manchester, where he was born. His family decides that he will be buried in
Manchester. His body is held at the premises of a Manchester funeral director.
What actions should be taken with regard to the Manchester coroner?
Scenario 3.
A resident of Manchester dies
on holiday in his native Greece. The family decide that he will be buried in
Greece. What steps must be taken to obtain a valid death certificate?
Scenario 4.
A man of 65 dies of terminal
lung cancer. The GP visited daily until going on holiday three weeks before the
death. He has now returned and says that he will sign a death certificate, but
needs to visit the funeral director to see the body first. Will this be a valid death certificate?
Scenario 5.
A man of 65 dies of terminal
lung cancer. The GP, who visited daily up to the day of his death and attended
to confirm the death, is on holiday. He says that he will sign a death
certificate and put it in the post, so that it will arrive in the morning. Will
this be a valid death certificate?
Scenario 6.
A man of 65 dies of terminal
lung cancer. The GP, who visited daily up to the day before his death, has been
on holiday since. However, he says that he will sign a death certificate and
put it in the post, so that it will arrive in the morning. Will this be a valid
death certificate?
Scenario 7.
A 65-year-old man dies suddenly
12 hours after admission to the local coronary care unit with chest pain,
despite the apparently satisfactory insertion of a coronary artery stent after
a diagnosis of coronary artery thrombosis. What action should be taken with
regard to the Coroner?
Scenario 8.
A 16-year-old girl is admitted
at 36 weeks’ gestation in her first
pregnancy with placental abruption. She is given the best possible care but
develops DIC and hypovolaemic shock and dies after 48 hours. What action should
be taken with regard to the coroner?
Scenario 9.
A 28-year-old woman is admitted
with placental abruption at 36 weeks. She has bruising on the abdominal wall
and the admitting midwife suspects that she has been the victim of domestic
violence, though the woman denies it. Despite best possible care she dies as a
consequence of bleeding. What action should be taken with regard to the
coroner?
Scenario 10.
A 30-year-old woman delivers
normally at home attended by her husband, but has a PPH. The husband practises
herbal medicine. He applies various potions but her condition deteriorates. She
is admitted to hospital by emergency ambulance some hours later in a shocked
condition. She is given the best possible care and is admitted to the ICU. She
dies 7 days later of multi-organ failure and ARDS attributed to hypovolaemic
shock. What action should be taken with regard to the coroner?
Scenario 11.
A woman is admitted at 23 weeks
in premature labour. There is evidence of fetal heart activity throughout the
labour, with the last record being 5 minutes before the baby delivers. The baby
shows no evidence of life at birth. The mother requests a death certificate so
that she can register the birth and arrange a funeral. What form of certificate
should be issued?
Scenario 12.
A woman is admitted at 26
weeks’ gestation in premature labour. The presentation is footling breech. At 8
cm. cervical dilatation the trunk is delivered and the cord prolapses. There is
good evidence of fetal life with fetal movements and pulsation of the cord. The
head is trapped and it takes 5 minutes to deliver it. The baby is pulseless,
apnoeic and without visible movement at birth. Intubation and CPR are carried
out for 20 minutes when the baby is declared dead. What action should be taken
with regard to the coroner?
Scenario 13.
A 65-year-old man dies 2 hours
after admission to hospital with an apparent stroke. The coroner requests
access to the notes. What access should be provided?
Option list.
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A
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provide access to the records by
the Coroner in person
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B
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provide unrestricted access to
the medical records by the coroner’s officers
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C
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provide a copy of the hospital
records to the coroner or her officers
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D
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provide a medical report, but no
access to the medical records
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E
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provide a copy of the letter to
the GP about the recent admission
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F
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none of the above
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9. Pre-pregnancy
counselling: Down’s syndrome.
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.
How to prepare. Basic ‘blurbs’ to write and practise.
11. C.
section scar pregnancy.
The examiner will ask 17 questions about C
section scar pregnancy ( CSSP).
12. EMQ.
Uterine transplant.
Uterine transplant.
Abbreviations.
ET: embryo
transfer.
UT: uterine
transplant
Scenario 1.
When was the 1st.
human uterine transplant performed?
Option list.
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A
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2000
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B
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2015
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C
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2010
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D
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2011
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E
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2012
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F
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2013
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G
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2014
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H
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2015
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I
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2016
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J
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2017
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Scenario 2.
When was the 1st.
livebirth after human uterine transplant?
Option list.
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A
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2000
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B
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2015
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C
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2010
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D
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2011
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E
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2012
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F
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2013
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G
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2014
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H
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2015
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I
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2016
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J
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2017
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Scenario 3.
How many live
births had occurred worldwide after UT up to the end of 2017?
Option list
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A
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< 5
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B
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5 - 10
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C
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11 - 20
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D
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21 - 50
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E
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51 - 100
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F
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> 100
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Scenario 4.
For which of
the following conditions is UT a possible treatment?
Option list.
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A
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Androgen Insensitivity
syndrome. AIS.
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B
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Congenital Adrenal
hyperplasia. CAH.
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C
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Kallmann’s syndrome. KS.
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D
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Mayer-Rokitansky-Küster-Hauser
syndrome. MRKH.
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E
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McCune-Albright
syndrome. MCAS.
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F
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Swyer’s syndrome. SS.
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G
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Turner’s syndrome. TS.
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Scenario 5.
Which, if any,
of the following are commonly used for donor selection?
Option list.
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A
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absence of adenomyosis
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B
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absence of fibroids
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C
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age < 65 years
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D
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good general health
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E
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negative cervical smear
and no high-risk HPV
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F
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no cancer in past 5
years
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G
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parous
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H
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vaginal length > 7
cm.
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Scenario 6.
What is the
rate of graft survival at 1 year, failure being the need for hysterectomy?
Option list.
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A
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< 10%
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B
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11 – 20%
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C
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21 – 30%
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D
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31 – 40%
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E
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41 – 50%
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F
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51 – 60%
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G
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> 60%
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H
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the figure is unknown
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Scenario 7.
Which of the
following statements is correct?
Option list.
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A
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donor surgery is more
extensive than recipient surgery
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B
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donor surgery is less
extensive than recipient surgery
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C
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donor surgery is as
extensive as recipient surgery
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Scenario 8.
What are the
risks to the donor in addition to the usual ones of bleeding, infection, haematoma and thrombosis? There is
no option list.
Scenario 9.
Which
condition has been the reason for recipients needing uterine transplant and
which complication is more likely in addition to the usual ones of
bleeding, infection, haematoma and
thrombosis? There is no option list.
Scenario 10.
When is IVF
and cryopreservation of eggs done?
Option list.
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A
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before uterine
transplantation
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B
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at the time of uterine
transplantation
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C
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12 months after uterine
transplantation to ensure graft rejection does not occur
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D
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when the recipient
chooses
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E
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none of the above
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Scenario 11.
Which
maintenance therapy was used immediately before embryo transfer in the first
case resulting in livebirth?
Option list.
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A
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azathioprine +
corticosteroids + tacrolimus
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B
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azathioprine +
ciclosporin + corticosteroids + mycophenolate mofetil
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C
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azathioprine +
corticosteroids + mycophenolate mofetil + tacrolimus
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D
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azathioprine +
corticosteroids + tacrolimus
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E
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ciclosporin +
corticosteroids + mycophenolate mofetil + tacrolimus
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F
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ciclosporin +
mycophenolate mofetil + tacrolimus
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G
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corticosteroids +
mycophenolate mofetil + tacrolimus
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H
|
corticosteroids +
tacrolimus
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