18
|
EMQ.
Pertussis.
|
19
|
Role-play.
ERPC
after miscarriage. ? mental health issue.
|
20
|
|
21
|
Roleplay.
Hydatidiform
mole.
|
Role-players.
Beatrice Lamb.
Candidates.
Shradha Chakhaiyar India
Purnima Dalal Wales
Namrata Kumar India
Sohini Munchi India
Nandita Sanyal India.
18. 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 to ↑
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
Which of the following best
describes the DOH’s advice about 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
|
19. Role-play. ERPC after miscarriage. ? mental health issue.
Candidate’s instructions.
You
are the on-call SpR. The Sister on the gynaecology ward has asked you to see
Margaret Barber who had surgical evacuation of retained products under general
anaesthesia yesterday evening after incomplete miscarriage. She is physically
well, but the Sister is concerned as she appears distressed and depressed. She
and some of the nurses have tried to find out what is going on, but she is
withdrawn and uncommunicative. They are concerned that she has some kind of
mental health problem.
Your
task is to deal with the patient as in real life.
20. Structured discussion. The uses of MgSO4 in O&G..
Candidate’s instructions.
This is a station about the uses of MgSO4 in
O&G.
The examiner will not ask questions, prompt or otherwise
assist. It is up to you to give as full an account of the uses as you can
muster.
21. Roleplay. Hydatidiform mole.
Candidate's Instructions.
You are the SpR in the gynae clinic. The consultant has
said that it will be a good experience for you to see the next patient. She was
recently an inpatient for evacuation of retained products after an apparent
miscarriage at 8 weeks. The histology report showed a complete mole.
The GP was contacted and asked to see her. An appointment
was sent to her to attend today.
Your task is to take a history and explain the
implications of the diagnosis.
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