Tutorial 3 September 2020

 

3 September  2020

77	Tutorial. Neonatal jaundice
78	Role-play. Premenstrual syndrome
79	EMQ. Maternal mortality definitions

 77. Tutorial. Neonatal jaundice.

 78. Role-play. Premenstrual syndrome.

Candidate's Instructions.

This is a roleplay station.

Your task is to take a history and advise about initial investigations and management.

GP Letter.

The Medical Centre,

Haversham Way,

Lasttown. XS89 9JH.

Re Jenny Smith,

55 Town Street,

Lasttown.

Dear Doctor,

Please see this woman who complains of pre-menstrual syndrome. I don’t really believe in this condition so have not attempted to treat it.

Regards,

Dr. N. O. G. Ood.

 

79. EMQ. Maternal mortality definitions.

Option List.

A.   Death of a woman during pregnancy and up to 6 weeks later, including accidental and incidental causes.

B.   Death of a woman during pregnancy and up to 6 weeks later, excluding accidental and incidental causes.

C.   Death of a woman during pregnancy and up to 52 weeks later, including accidental and incidental causes.

D.   Death of a woman during pregnancy and up to 52 weeks later, excluding accidental and incidental causes.

E.   A pregnancy going to 24 weeks or beyond.

F.    A pregnancy going to 24 weeks or beyond + any pregnancy resulting in a live-birth.

G.  Maternal deaths per 100,000 maternities.

H.  Maternal deaths per 100,000 live births.

I.     Direct + indirect deaths per 100,000 maternities.

J.     Direct + indirect deaths per 100,000 live births.

K.   Direct death.

L.    Indirect death.

M. Early death.

N.  Late death.

O.  Extra-late death.

P.   Fortuitous death.

Q.  Coincidental death.

R.   Accidental death.

S.    Maternal murder.

T.   Not a maternal death.

U.  Yes

V.   No.

W. I have no idea.

X.   None of the above.

Abbreviations.

MD:        maternal death.

MMR:     Maternal Mortality Rate.

MMRat: Maternal Mortality Ratio.

SUDEP:  Sudden Unexplained Death in Epilepsy.       

Question 1.          

What is a Maternal Death (MD)?

Option list.

A	death during pregnancy
B	death during pregnancy or the month after
C	death during pregnancy or the six weeks after
D	death during pregnancy or the three months after
E	death during pregnancy or the year after
F	none of the above

Question 2.          

Which categories are included in the definition of MD? This is not a true EMQ as >1 answer may be correct.

Option list.

A	accidental death
B	coincidental death
C	direct death
D	iatrogenic death
E	incidental death
F	indirect death
G	late death

Question 3.          

Which categories are included in the discussions in the MMRs? This is not a true EMQ as more than one answer may be correct.

Option list.

A	accidental death
B	coincidental death
C	direct death
D	iatrogenic death
E	incidental death
F	indirect death
G	late death

Question 4.          

A woman dies from a ruptured ectopic pregnancy at 10 weeks’ gestation. What kind of death is it?

Question 5.          

A woman dies from a ruptured appendix at 10 weeks’ gestation. What kind of death is it?

Question 6.          

A woman dies from suicide at 10 weeks’ gestation. What kind of death is it?

Question 7.          

A woman with a 10-year-history of coronary artery disease dies of a coronary thrombosis at 36 weeks’ gestation. What kind of death is it?

Question 8.          

A woman has gestational trophoblastic disease, develops choriocarcinomas and dies from it 24 months after the GTD was diagnosed and the uterus evacuated. What kind of death is it?

Question 9.          

A woman develops puerperal psychosis from which she makes a poor recovery. She kills herself when the baby is 18 months old. What kind of death is it?

Question 10.      

A woman develops puerperal psychosis from which she makes a poor recovery. She kills herself when the baby is 6 months old. What kind of death is it?

Question 11.      

What is a “maternity”.

Question 12.      

What is the definition of the Maternal Mortality Rate?

Question 13.      

What is the Maternal Mortality Ratio?

Question 14.      

A woman is diagnosed with breast cancer. She has missed a period and a pregnancy test is +ve. She decides to continue with the pregnancy. The breast cancer does not respond to treatment and she dies from secondary disease at 38 weeks. What kind of death is it?

Question 15.      

A woman who has been the subject of domestic violence is killed at 12 weeks’ gestation by her partner. What kind of death is it?

Question 16.      

A woman is struck by lightning as she runs across a road. As a result she falls under the wheels of a large lorry which runs over abdomen, rupturing her spleen and provoking placental abruption. She dies of haemorrhage, mostly from the abruption. What kind of death is it?

Question 17.      

A woman is abducted by Martians who are keen to study human pregnancy. She dies as a result of the treatment she receives. As this death could only have occurred because she was pregnant, is it a direct death?

Question 18.      

Could a maternal death from malignancy be classified as “Direct”?

Question 19.      

Could a maternal death from malignancy be classified as “Indirect”?

Question 20.      

Could a maternal death from malignancy be classified as “Coincidental”?

Question 21.      

A pregnant woman is walking on the beach at 10 weeks when she is struck by lightning and dies. What kind of death is this?

Question 22.      

A woman is sitting on the beach breastfeeding her 2-year old baby when she is struck by lightning and dies. What kind of death is this?