Tutorial 1st. October 2020

 

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84	Viva. Tentorium cerebelli
85	Roleplay. Pre-pregnancy counselling. Phenylketonuria
86	Viva. Obstetric surveillance systems
87	Roleplay. Teach junior colleague re postnatal depression

 

84. Viva. Tentorium cerebelli.

Candidate’s instructions.

This is an old-fashioned viva, which is harder than the new ‘structured discussion’. Do the origami and make the model. Tell the examiner what you know about the mechanics of tentorial tears. The examiner will just listen and not guide you in any way.

 

85. Role-play. Phenylketonuria.

Candidate’s instructions.

You are the SpR in the pre-pregnancy clinic. Your consultant is off on sick leave and you are the most senior doctor in the clinic.

You are about to see Jane White who is planning her first pregnancy. Your task is to take a history and discuss the optimum management now and during pregnancy.

The GP letter reads:

Prime Health Practice,

Primetown,

Sussex.

0298766543.

Practice Manager:

Mrs Wilhelmina Bland.

 

Dear Doctor,

Please see Jane White, 35 years of age and planning her first pregnancy. Her health is good – she seems only to attend the Practice for routine checks such as cervical smears – the most recent of which was taken last year and was normal. From talking to her and examining her records, it is clear that she is very healthy and has always had good physical and mental health. Her social circumstances are good. The one thing of concern is that she told me she was on a diet in childhood supervised by the local paediatric team. She can’t recall what it was about and she stopped the diet at about the age of 14. Both of her parents are dead – her mother fifteen years ago at the age of 40 and her father two years ago in a RTA, so cannot shed light on what the diet was for. Fortunately, when I checked through her notes, I came across correspondence indicating that the problem was phenylketonuria. I have told her that I am no expert in phenylketonuria and the implications for pregnancy, so have eschewed the temptation to provide any advice.

I look forward to receiving your expert report.

Dr. John Worthy.

 

86. Viva. Obstetric surveillance systems.

Candidate's Instructions.

This is a viva station.

The examiner will ask you 2 questions about surveillance systems used in obstetrics.

The first question is less important than the second, so don’t spend too much time on it.

The examiner will ask if you wish to move to the second question when you appear to have completed the first, but it is for you to decide when you move on.

 

87. Role-play. Teach junior colleague re postnatal depression.

Candidate's Instructions.

This is a role-play station. You are an SpR5 and in charge of running the labour ward.

There are only two women in labour, both are healthy and without complication. This is the second pregnancy for both and they had uncomplicated 1^st. pregnancies and normal deliveries. They are being looked after by the midwives who are happy that all is well and good progress is being made.

One of the midwives has mentioned that one lady had postnatal depression and asked if anything different should be done for her.

The consultant has suggested that you give a tutorial to your new colleague and any midwives who are interested.