|
31 |
Role-play.
Unknown
syndrome. |
|
32 |
Role-play.
Endometrial
cancer. |
|
33 |
Viva.
Headache. |
|
34 |
SBA.
Pertussis. |
31. Role-play. Unknown syndrome.
Candidate’s instructions.
You are an SpR5 running the antenatal clinic as the
consultant is on leave. You are about to see Constance Merryweather who booked
today at 10 weeks in her first pregnancy. She has been booked by the community
midwife for home delivery as she has a phobia about hospitals and found her
previous admissions very stressful. The hospital midwife has done created a set
of hospital notes in case the booking is switched to the hospital. She has also
done the booking bloods. A scan confirmed a singleton pregnancy with gestation
of 10 weeks. An appointment has been given for her to have the combined 1st.
trimester test.
The GP letter is as follows.
The Health Centre,
Greenville.
Dear Dr,
Please see Mrs. Constance Merryweather. She is a new
patient at our practice and we don’t yet have all her notes. She has an early
pregnancy and has been booked for home confinement by our midwife who has asked
you to see her as she has some kind of platelet disorder. I don’t have any more
details and the name she gave rang no bells. Your advice will be much appreciated.
John Du MB.
Your tasks are to take a
history and advise about management of the pregnancy.
32. Role-play. Endometrial cancer.
Candidate’s instructions.
You are a 5th. year
SpR in the gynae clinic. You are about to see Jane Green. She is 55 years of
age and reached the menopause at the age of 51. She attended the one-stop PMB
clinic two week ago after a single episode of postmenopausal bleeding a couple
of weeks before. An ultrasound scan showed the endometrial thickness to be 8
mm. and hysteroscopy showed thickened endometrium, from which a Pipelle biopsy
was taken. There were no polyps. The histology report is of well-differentiated
endometrial cancer. Jane is attending today for the results of the
histological examination. Your tasks are to explain the results and the
treatment options.
33. Viva. Headache.
The examiner will ask 13 questions about headache and
pregnancy.
34. Pertussis. SBA.
Question 1. 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.
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.
Which, if any, of the following
statements are 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 |
Question 4.
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. 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. 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.
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. 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.
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. 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. 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. 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 permanently |
Question 13.
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. 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.
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.
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.
A woman has proven pertussis in early pregnancy. Should she still be
offered vaccination? Use
the option list for question 16.
Question 18.
A pregnant woman misses out on vaccination as part of the TIPP. Should
vaccination still be offered in the puerperium? Use the option list for question 16.
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