23
|
EMQ.
Pertussis.
|
24
|
Role-play.
PMB.
Explain investigation etc. in one-stop clinic
|
25
|
Viva. Obstetric surveillance systems
|
26
|
Role-play.
Mechanisms of
normal labour & delivery.
|
27
|
Structured
discussion. Cochrane Collaboration
|
23. EMQ.
Pertussis.
Question 1.
Lead-in.
Why is pertussis of current concern in
obstetrics?
Option
List
A
|
Research has linked pertussis
in the 1st. trimester with an ↑ risk of congenital heart disease
|
B
|
A mini-epidemic since 2011 has caused ↑ deaths of mothers & of babies
< 3 months
|
C
|
A mini-epidemic since 2011 has caused ↑ deaths of babies < 3 months
|
D
|
The infecting organism has become increasingly drug-resistant
|
E
|
The infecting organism has become increasingly virulent
|
Question 2.
Lead-in
Which organism causes whooping
cough?
Option
List
A
|
Bordella
pertussis
|
B
|
Bacteroides pertussis
|
C
|
Rotavirus whoopoe
|
D
|
Respiratory syncytiovirus pertussis
|
E
|
None of the above
|
Question 3.
Lead-in
Which, if any, of the following
statements is true about the organism what causes whooping cough? This is not a
true SBA as I have condensed several questions into one to save space, there
are more than 5 options and there may be more than one correct answer.
Option
List
A
|
the organism is aerobic
|
B
|
the organism is anaerobic
|
C
|
the organism is capsulated
|
D
|
the organism is flagellate
|
E
|
the
organism is an obligate intra-cellular parasite
|
F
|
the organism is a Gram -ve diplococcus
|
G
|
the organism is a Gram +ve diplococcus
|
H
|
the organism requires special transport
media
|
I
|
no one is going to ask me any of this stuff
|
Lead-in
Which of the following statements is true?
Option List
A
|
Pertussis is no longer a significant threat
to infants
|
B
|
Pertussis
remains a significant threat to infants
|
C
|
The risk
of death from pertussis is eliminated by timely antibiotic therapy
|
D
|
the risk
of death from pertussis is eliminated by timely antiviral therapy
|
E
|
None of
the above
|
Question 5.
Lead-in
Which of the following statements
is true?
Option
List
A
|
Pertussis
is not a notifiable disease
|
B
|
Pertussis is a notifiable disease
|
C
|
Pertussis is not a notifiable
disease, but cases should be reported to the local bacteriologist
|
D
|
Pertussis is not a notifiable
disease, but cases should be subject to audit
|
Question 6.
Lead-in
What is the main mode of spread
of the organism that causes pertussis?
Option
List
A
|
contact with contaminated
surfaces
|
B
|
contaminated food
|
C
|
contaminated water
|
D
|
respiratory droplets
|
E
|
none of the above
|
Question 7.
Lead-in
What is the main reservoir of the
organism that causes pertussis?
Option
List
A
|
budgerigars
|
B
|
cats
|
C
|
dogs
|
D
|
humans
|
E
|
pigeons
|
F
|
pigs
|
G
|
none of the above
|
Question 8.
Lead-in
What is the epidemiology of
pertussis?
Option
List
A
|
the
condition is endemic
|
B
|
the condition is endemic with
mini-epidemics every 3-5 years
|
C
|
the condition is endemic with mini-epidemics
most years in the winter months
|
D
|
the condition is epidemic, with
outbreaks at roughly three-year intervals
|
E
|
the condition is epidemic, with
outbreaks at unpredictable intervals
|
Question 9.
Lead-in
What is the incubation period for
pertussis?
Option
List
A
|
3-6 days
|
B
|
7-10 days
|
C
|
11-14 days
|
D
|
15-18 days
|
E
|
none of the above.
|
Question 10.
Lead-in
What is the duration of
infectivity of someone with pertussis?
Option
List
A
|
2 days from exposure → 5 days
after onset of paroxysms of coughing
|
B
|
3 days from exposure → 10 days
after onset of paroxysms of coughing
|
C
|
4 days from exposure → 14 days
after onset of paroxysms of coughing
|
D
|
6 days from exposure → 21 days
after onset of paroxysms of coughing
|
E
|
none of the above
|
Question 11.
Lead-in
What % of non-immune, close
contacts of pertussis will develop the disease?
Option
List
A
|
50%
|
B
|
60%
|
C
|
70%
|
D
|
80%
|
E
|
90%
|
Question 12.
Lead-in
What practical issues are current
for obstetrician in relation to pertussis?
Option
List
A
|
The
DOH advises that all pregnant women be immunised to ↓maternal death rates.
|
B
|
The DOH advises that all pregnant
women be immunised to ↓ deaths in babies < 3 months.
|
C
|
The DOH advises that all babies be
immunised at birth.
|
D
|
The DOH advised that “Boostrix- IPV” should replace
“Repevax” from July 2014.
|
E
|
The DOH advises that immunisation of
pregnant women be continued until 2019
|
Question 13.
Lead-in
Which, if any, of the following statements
is true in relation to average annual number of deaths due to pertussis in the
years before routing child immunisation was introduced?
Option
List
A
|
the number was 10,000
|
B
|
the number was 5,000
|
C
|
the number was 4,000
|
D
|
the number was 3,500
|
E
|
the number was <1,000
|
Question 14.
Lead-in
Which, if any, of the following
statements are true in relation to pertussis vaccine.
Option
List
A
|
“Boostrix- IPV” is a vaccine for pertussis only
|
B
|
“Repevax” is a vaccine for pertussis
only
|
C
|
“Boostrix- IPV” &
“Repevax” are live, attenuated vaccines
|
D
|
“Boostrix- IPV” &
“Repevax” act against diphtheria, tetanus and polio as well as pertussis
|
E
|
“Boostrix- IPV” &
“Repevax” are acellular
|
Question 15.
Lead-in
Which, if
any, of the following statements are true in relation to the JCVI’s advice of
the best time to administer pertussis vaccine in pregnancy?
Option List
A
|
20 - 24
weeks
|
B
|
25- 28 weeks
|
C
|
28 - 32 weeks
|
D
|
28 - 34 weeks
|
E
|
none of the above
|
Question 16.
Lead-in
A woman
has suspected pertussis in early pregnancy. Should she still be offered
vaccination?
Option List
A
|
Yes
|
B
|
No
|
C
|
I don’t know
|
D
|
I don’t know
|
E
|
I hate this subject now
|
Question 17.
Lead-in
A woman
has proven pertussis in early pregnancy. Should she still be offered
vaccination?
Option List
A
|
Yes
|
B
|
No
|
C
|
I don’t know
|
D
|
I don’t know
|
E
|
I hate this subject now
|
Question 18.
Lead-in
A pregnant
woman misses out on vaccination as part of the TIPP. Should vaccination still
be offered in the puerperium?
Option List
A
|
Yes
|
B
|
No
|
C
|
I don’t know
|
D
|
I don’t know
|
E
|
I hate this subject now
|
24. Role-play.
PMB
Candidate’s Instructions.
This is a follow-on from the station we did in the
previous tutorial. You are an SpR in the “one-stop” PMB clinic. You saw Mary
Smith, age 55 years, who had had a single, unprovoked episode of postmenopausal
bleeding. You have taken her history, which is unremarkable apart from the
bleeding, which was unprovoked and not associated with other symptoms. Her
health is good apart from Type II diabetes which is well-controlled on diet.
She has no other history of significant illness or surgery. She has never taken
HRT and is not on any medicines. She does not take anticoagulants or aspirin.
Your tasks are to take a family history to explain the
reason for advising further investigation and the investigations you recommend
be done today. You will also explain how the results of these investigations
will affect the situation and the possibilities for further management.
25. Viva.
Obstetric surveillance systems
This is a
structured discussion station.
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.
26. Role-play.
Mechanisms of normal labour &
delivery
Candidate's Instructions.
Explain
the mechanisms of normal labour & delivery to the role-player, who is a
medical student and keen to learn how to do a normal delivery. Your consultant
has said that she needs a clear understanding of the mechanisms before considering
conducting a delivery.
27. Structured
discussion. Cochrane Collaboration.
Candidate’s instructions.
This is a viva about the Cochrane Collaboration.
The examiner will ask 8 questions and give one instruction.
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