16 March 2023.
|
31 |
EMQ. Hepatitis E |
|
32 |
Role-play. Premature ovarian insufficiency |
|
33 |
Viva. Topic TBA during tutorial |
|
34 |
EMQ. Pertussis |
31. EMQ.
Hepatitis E.
Question
1.
What is the most
common cause of acute viral hepatitis in the UK?
Option list.
|
A |
hepatitis A virus |
|
B |
hepatitis B virus |
|
C |
hepatitis C virus |
|
D |
hepatitis D virus |
|
E |
hepatitis E virus |
|
F |
herpes simplex virus |
|
G |
HIV |
Question
2.
Which, if any, of
the following are correct about HEV.
Option list.
|
A |
it is a DNA virus |
|
B |
it belongs to the genus Hippieviridae |
|
C |
it belongs to the genus Hepeviridae |
|
D |
it belongs to the genus Hoppieviridae |
|
E |
there are six main genotypes |
|
F |
genotype 3 is the one of greatest importance in the UK |
|
G |
the main reservoir of genotype 3 is intensively-reared
chickens |
|
H |
the main reservoir of genotype 3 is domestic cats |
|
I |
a vaccine exists but is only licensed in Russia |
|
J |
none of the above |
Question
3.
Which, if any, of
the following statements about HEV and pregnancy are true?
Option list.
|
A |
pregnant women are more susceptible to HEV infection |
|
B |
pregnant women are more likely to develop serious
disease that the non-pregnant |
|
C |
the main risk is neonatal death due to vertical transmission |
|
D |
the main risk is maternal death |
|
E |
the risk of maternal death is highest with infection in
the 1st. trimester |
|
F |
↑ rates of preterm birth have been
reported |
|
G |
↑
rates of stillbirth have been reported |
32. Role-play.
Premature ovarian insufficiency.
Candidate’s instructions.
You are a SpR5 in the gynae clinic and about to see
Caroline Faulkner. Your tasks are to take an appropriate history and advise
about investigation and management.
GP referral letter.
The Health Centre,
Middle Brook.
Dear Doctor,
Please see Caroline who appears to have an early
menopause. Her periods were infrequent for six months or so and she last had
one three months ago. She is having some hot flushes. I checked her FSH level
and it was reported to be in the menopausal range. I have not dealt with this
condition previously and look forward to reading your expert advice.
33. Viva.
The
examiner will ask 22 questions about a subject to be revealed during the
tutorial.
34. EMQ.
Pertussis.
Abbreviations.
JCVI: Joint
Committee on Vaccination and Immunisation .
PIPP: pertussis immunisation
programme for pregnancy.
Question 1. Why is pertussis of current concern in obstetrics?
|
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. Which organism causes whooping cough?
|
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 and there may be more than one correct answer.
|
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 |
Question 4.
Which of the
following statements is true?
|
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?
|
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?
|
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?
|
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?
|
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?
|
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?
|
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?
|
A |
50% |
|
B |
60% |
|
C |
70% |
|
D |
80% |
|
E |
90% |
Question 12.
Which of the
following best describe the DOH’s advice about pertussis? This is not a true
SBA as there may be > 1 connect answer.
|
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 routine child immunisation was
introduced?
|
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.
|
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?
|
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?
|
A |
Yes |
|
B |
No |
|
C |
I don’t know |
|
D |
I don’t know |
|
E |
I hate this subject now |
Question 17.
A pregnant woman misses out on vaccination as part of the PIPP. Should
vaccination still be offered in the puerperium?
|
A |
Yes |
|
B |
No |
|
C |
I don’t know |
|
D |
I don’t know |
|
E |
I hate this subject now |
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