68
|
Rachel Owen. Perinatal
mental health.
|
69
|
Role-play. Fragile
X syndrome
|
70
|
EMQ. Hand,
foot and mouth disease
|
71
|
EMQ. Measles
and pregnancy.
|
69. Role-play.
Fragile X
syndrome. Father has FXTAS.
Candidate’s instructions.
You are a 4th. year SpR and about to see Louise
Hagerman who is planning her first pregnancy.
GP referral letter.
Jacquemont Medical Centre,
Upper Ridge,
Jacquemont,
Surrey.
Re: Louise Hagerman, Age 25.
58 Main Street,
Jacquemont.
Please see Mrs Hagerman who is planning her first
pregnancy. Her father was recently diagnosed with Fragile-X tremor ataxia
syndrome. I am not well-acquainted with this condition, but understand that the
genetics are complex.
Mrs Hagerman’s health is good, she does not smoke and
recently had a normal cervical smear test.
70. EMQ.
Hand, foot and mouth disease
Abbreviations.
FMD: Foot & mouth
disease.
FMDV: Foot & mouth
disease virus.
HFMD: Hand, foot & mouth
disease.
Which,
if any, of the following statements are true in relation to hand, foot and mouth
disease?
Option list.
A
|
it is the human
form of foot and mouth disease in sheep and cattle
|
B
|
it is most common
in farm workers
|
C
|
it is most
often due to a virus from the Aphthovirus
genus
|
D
|
it is most
often due to the Coxsackie A16 virus
|
E
|
it is most
often due to an enterovirus
|
F
|
the most severe
disease is associated with the Enterovirus A71
|
G
|
usually causes a
mild and self-limiting illness lasting about a week
|
H
|
none of the
above
|
Scenario 2.
Which,
if any, of the following is the main reservoir for HFMD?
Option list.
A
|
cattle
|
B
|
cloven-hoofed
animals
|
C
|
devils
|
D
|
fish
|
E
|
humans
|
F
|
rodents
|
G
|
sheep
|
H
|
none of the above
|
Which, if any, of the following statements are true
about how HFMD is spread?
Option
list.
A
|
by osmosis
|
B
|
contact with fluid from the blisters
|
C
|
coughing and sneezing
|
D
|
faeco-oral transmission
|
E
|
mainly by contamination of food
|
F
|
mainly be contamination of water
|
G
|
none of the above
|
Scenario
4.
Which, if any, of the following statements are true
about when HFMD is spread?
Option
list.
A
|
during the acute phase: about 1 week
|
B
|
through contact with infected animals, particularly cows, pigs
and sheep
|
C
|
Tuesday afternoons
|
D
|
up to 8 weeks after the acute phase due to the persistence of
the virus in faeces
|
E
|
vertically
|
F
|
none of the above
|
Scenario 5.
In which,
if any, of the following groups do most infections occur?
Option list.
A
|
adolescents
|
B
|
adults > 75
years of age
|
C
|
children < 1
year of age
|
D
|
children < 5
years of age
|
E
|
children <
10 years of age
|
F
|
agricultural
workers
|
G
|
none of the
above
|
Answer. E. Children < 10 years. NICECKS says: “outbreaks
occur frequently among groups of children
Which, if any, of the following statements are true about HFMD?
Option
list.
A
|
it is most common in the autumn
|
B
|
it is most common in the winter
|
C
|
it is most common in the spring
|
D
|
it is most common in the summer
|
E
|
there is little variation in incidence by season
|
F
|
none of the above
|
Scenario
6.
What is the incubation period of HFMD?
Option
list.
A
|
1 - 7 days
|
B
|
3 - 7 days
|
C
|
5 - 7 days
|
D
|
10 - 14 days
|
E
|
14 - 21 days
|
F
|
none of the above
|
Which,
if any, of the following statements are true about when an infected child is no
longer contagious?
Option list.
A
|
once the skin
blisters are healed
|
B
|
once the fever
has resolved
|
C
|
once the oral
lesions are no longer painful
|
D
|
once the skin
blisters are no longer filled with fluid
|
E
|
7 days after
the onset of the 1st. symptoms
|
F
|
none of the
above
|
Scenario
8.
How is HFMD usually diagnosed?
Option
list.
A
|
clinically
|
B
|
detection of IgM in serum
|
C
|
detection of the virus in faeces
|
D
|
detection of the virus in vesicular fluid
|
E
|
none of the above
|
Scenario
9.
Which, if any, of the following statements are true in relation to
the risk to the pregnant woman who contracts HFMD?
Option
list.
A
|
it is associated with an ↑ risk of death from pneumonia
|
B
|
it is associated with an ↑ risk of death from pancreatitis
|
C
|
it is associated with an ↑ risk of death from myocarditis
|
D
|
it is associated with an ↑ risk of neurological complications
|
E
|
it is not known to carry ↑ risk compared to the non-pregnant
|
F
|
none of the above
|
Scenario
10.
Which, if any, of the following statements are true in relation to
the embryo / fetus?
Option
list.
A
|
the risk of miscarriage is ↑
|
B
|
the risk of neural tube defect is ↑
|
C
|
the risk of congenital heart defect is ↑
|
D
|
the risk of microphthalmia is ↑
|
E
|
the risk of microcephaly is ↑
|
F
|
none of the above
|
Scenario
11.
Which, if any, of the following statements are true in relation to
the neonate?
Option
list.
A
|
neonatal HFMD may be severe with late pregnancy infection
|
B
|
neonatal HFMD may be severe with maternal immunocompromise
|
C
|
the risk of biliary atresia is ↑
|
D
|
the risk of encephalitis is ↑
|
E
|
the risk of meningitis is ↑
|
F
|
the risk of pancreatitis is ↑
|
G
|
none of the above
|
71. EMQ.
Measles and pregnancy.
Scenario 1.
Which, if any, of the following statements are true in relation to the
measles virus?
Option list.
A
|
it
belongs to the arthropod virus family
|
B
|
it
belongs to the pox virus family
|
C
|
it
belongs to the paramyxovirus family
|
D
|
it
belongs to the rhinovirus family
|
E
|
it
is a DNA virus
|
F.
|
it
is one of the most infectious viruses spread by respiratory droplets
|
Which, if any, of the
following statements is true in relation to the incubation period?
Option list.
A
|
the
incubation period is about 5 days
|
B
|
the
incubation period is about 7 days
|
C
|
the
incubation period is about 10 days
|
D
|
the
incubation period is about 14 days
|
E
|
the
incubation period is about 21 days
|
Scenario 3.
What is the
duration of infectiousness in cases of measles?
Option list.
A
|
from
onset of the rash until it clears
|
B
|
from
onset of the rash until 7 days later
|
C
|
from
4 days before until 4 days after the onset of the rash
|
D
|
from
7 days before until 7 days after the onset of the rash
|
E
|
from
7 days before until 7 days after the onset of the rash
|
F
|
from
the 1st. symptoms until 4 days after the onset of the rash
|
G
|
from
the 1st. symptoms until 7 days after the onset of the rash
|
H
|
from
the 1st. symptoms until 10 days after the onset of the rash
|
Scenario 4.
Which, if any, of
the following are recognised features of measles.
A
|
Cowpat
spots
|
B
|
Coplick
spots
|
C
|
Kowlick
spots
|
D
|
Koplick
spots
|
E
|
Koplik
spots
|
Scenario 5.
What are the spots referred to in the previous question?
Scenario 6.
Which, if any, of
the following are features of measles rash.
A
|
It
starts in the head and spreads peripherally
|
B
|
It
starts in the limbs and spreads centrally
|
C
|
It
is typically pink and blanches on pressure
|
D
|
It
is typically red and does not blanch on pressure
|
E
|
It
is maculo-papular
|
Scenario 7.
Which, if any, of the following are recognised complications of measles?
Option list.
A
|
convulsions
|
B
|
death
|
C
|
diarrhoea
|
D
|
encephalitis
|
E
|
otitis
media
|
F
|
pneumonia
|
G
|
sub-acute
combined degeneration of the cord
|
H
|
sub-acute
sclerosing pan-encephalitis
|
Scenario 8.
Which, if any, of
the following are true of measles infection in pregnancy.
A
|
there
is an ↑ risk of miscarriage
|
B
|
there
is an ↑ risk of neural tube defect
|
C
|
there
is an ↑ risk of pre-eclampsia
|
D
|
there
is an ↑ risk of optic atrophy in the neonate
|
E
|
there
is an ↑ risk of premature delivery
|
F
|
there
is an ↑ risk of severe intrauterine growth retardation
|
G
|
there
is an ↑ risk of severe measles complications in the mother
|
H
|
there
is an ↑ risk of stillbirth
|
Scenario 9.
Which, if any, of the following statements are true in relation to the
pregnant woman who has not been immunised against measles and has been in contact
with a case?
Option list.
A
|
offer
the MMR vaccine
|
B
|
assess
the risk and consider offering HNIG
|
C
|
assess
the risk and consider offering acyclovir
|
D
|
assess
the risk and consider offering acyclovir + HNIG
|
E
|
none
of the above
|
The questions are quite good.How can we access the answers. thks
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