|
21. |
Discussion. Balanced translocation. |
|
22. |
Role-play. Teach general pre-pregnancy
counselling |
|
23. |
Role-play. Sterilisation request |
|
24. |
EMQ. Hepatitis D. Delta |
|
25 |
EMQ. Modafinil |
21. Discussion. Balanced translocation..
We did not get round to
this last week and I have been asked to discuss it tonight. You will need the
document I emailed as it has the diagram we will refer to.
22. Role-play. Teach
pre-pregnancy counselling.
Candidate’s instructions.
You are an SpR5 and a teaching afternoon is planned for the midwives from
the antenatal clinic and junior medical staff. Your consultant recently met a
patient who had booked at the clinic. It had been a busy day and the only
prepregnancy counselling she received was a booklet which she was told to read.
The patient has limited reading skills and the consultant felt that a session
on the importance of face-to-face prepregnancy counselling was timely. You have
been asked to conduct a teaching session. Maggie Murray, one of the midwives,
has volunteered to be a role-player so that you can illustrate appropriate
technique.
Your tasks are to explain the importance of prepregnancy counselling and
demonstrate appropriate technique, using Maggie both as a midwife attending the
teaching session and a patient booking in.
23. Role-play. Sterilisation request.
You are a 5th.
year SpR. You are about to see Mrs. Mary Fecund in the gynaecology clinic.
There is a referral letter from the GP.
Read the letter and then
conduct the consultation with Mrs. Fecund as you would do in the clinic in your
hospital.
Perfect Health Centre,
Paradise Lane, Slagheap. SLH
678.
Your ref: BRI 07/54843.
Re. Mary Fecund,
The Shoe, High Street, Slagheap.
Dear Doctor,
Please see Mrs Fecund who
has too many children. She wishes to be sure she has no more and has asked to
be sterilised – one of her friends was sterilised recently which has put her in
the mood to have it done.
Dr. John Williams.
24. Hepatitis D. Hepatitis Delta.
EMQ.
Abbreviations:
HBsAg: hepatitis B surface antigen
HBsAb: antibody to hepatitis B surface antigen
HBV: hepatitis B virus
HCsAg: hepatitis C surface antigen
HDV: hepatitis D virus; hepatitis delta
virus
HEsAg: hepatitis E surface antigen
Question
1.
Which, if any,
of the following statements are true in relation to HDV? This is not a true EMQ
as there may be >1 correct answer.
Option list.
|
A |
HDV is a large DNA virus |
|
B |
HDV is a defective virus |
|
C |
HDV gains entry to human
cells via the HDV receptor |
|
D |
HDV gains entry to human
cells by donning a disguise and using the HBV receptor |
|
E |
HDV only flourishes when
HBsAb is present |
|
F |
HDV only flourishes when
HbsAg is present |
|
G |
Coinfection is when HDV
and another viral infection are present at the same time |
|
H |
Superinfection is when
HDV is present in abnormally high numbers |
|
I |
HDV infection is the least
serious of the viral hepatitides in relation to pregnancy |
|
J |
HDV treatment was
revolutionised by analysis of the benefits of drinking bleach as suggested by
Donald Trump |
|
K |
the WHO has recommended
that those who follow medical advice from Donald trump should be categorised
as ‘having the DTs’. |
|
L |
HDV needs the presence
of HBsAg to be a significant pathogen |
|
M |
HDV needs the presence
of HCsAg to be a significant pathogen |
|
N |
HDV needs the presence of
HEsAg to be a significant pathogen |
|
O |
pegylated interferon
alpha is highly effective as treatment |
|
P |
mother-to-child
transmission is mainly via the placenta |
|
Q |
WHO recommends tenofovir
prophylaxis from 28 weeks in pregnancy in HDV infected women |
|
R |
the infected neonate should
be given HDV vaccine |
25. Modafinil. EMQ. Question.
Question 1. What kind of drug is modafinil?
|
antibiotic |
|
|
B. |
anti-epileptic drug |
|
C. |
anti-viral drug |
|
D. |
brain stimulant |
|
E. |
oral anticoagulant |
|
F. |
tumour necrosis factor antagonist |
Question
2. Which
of the following are true in relation to pregnancy?
|
A. |
it makes
pregnancy more likely for women using hormone contraception |
|
B. |
it is a cause
of hyperprolactinaemia, making pregnancy less likely |
|
C. |
it is believed
to be teratogenic and is contraindicated |
|
D. |
none of the
above |
Question
3.
Which, if any, of the following should be
done before starting treatment with modafinil?
|
A. |
BP measurement |
|
B. |
ECG |
|
C. |
EEG |
|
D. |
cardiac MRI |
|
E. |
liver function
tests |
|
F. |
psychiatric
assessment |
|
G. |
renal function
tests |
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