Thursday 6 September 2018

Tutorial 6th. September 2018





6 September 2018

45
Role-play. Complaints
46
Role-play. Androgen insensitivity syndrome
47
Role-play. Shoulder dystocia
48
Viva. Enhanced recovery
49
Viva. Diathermy

45. Complaints.
Candidate’s instructions.
You are a 5th. year SpR. The consultant responsible for risk management has asked you to teach a new O&G trainee about complaints.

46. Androgen insensitivity syndrome.
Candidate's Instructions.
This is a role-play station. The patient is Anastasia Johnstone. She is 17 years old. She attended the gynaecology clinic 1 month ago with primary amenorrhoea.
Clinical examination showed an apparently normal young woman with normal breast development but absent pubic and axillary hair. The external genitalia appeared normal. Vaginal examination was not attempted.
She has come today for the results of the ultrasound scan and blood results. The scan has shown absence of the uterus. There are no ovaries in the pelvis. There are bilateral groin masses that could be gonads. The blood tests are reported as: Karyotype. 46XY.
Your tasks are to explain the results and their implications and to answer her questions.

47. Shoulder dystocia.
Candidate’s instructions.
You are the on-call SpR for the labour ward. It is an unusually quiet afternoon, with only one patient in labour and she is a healthy para 1 with a previous normal delivery.
There is a new FY1 in the department. She was on call yesterday when there was a difficult delivery due to shoulder dystocia. The baby needed to be resuscitated and the mother sustained a 4th. degree tear. The FY1 felt completely useless and would like an introduction to shoulder dystocia so that she can be of some practical use the next time she is involved with a case.
The examiner will not react, respond to questions or offer advice.

48. Enhanced recovery.
Candidate's instructions.
You are a newly-appointed consultant. The Clinical Director has asked you to develop a programme for enhanced recovery for inpatient gynaecological surgery.
As a first step, she has asked you to deliver a talk to a unit meeting (all staff can attend) to outline the key features of enhanced recovery. She suspects that little is known by most of the staff about the subject and hopes that your talk will encourage their enthusiastic participation. The examiner will ask you 9 questions pertinent to your talk.

49. Diathermy.
Candidate’s instructions.
This is a structured viva station about diathermy and its uses and complications.
The examiner will ask you 8 questions.
When you have completed an answer you are not allowed to return.



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