15 April 2024.
|
80 |
Hannah
Ribbans. Breech |
|
81 |
Viva. Waiting list prioritisation |
|
82 |
EMQ. Hepatitis D |
80. Hannah Ribbans. Breech. Tutorial + role-play
81.
Viva. Waiting list prioritisation.
Your consultant is away. The
waiting-list manager comes to see you. The following patients have been listed
by junior staff. The waiting-list manager wants you to:
confirm the
appropriateness of the proposed treatment,
decide the degree of
urgency,
confirm the
appropriateness of the proposed venue,
decide any special
requirement(s) for each patient.
Name Age
Clinical problem Proposed operation
|
JK |
5 |
chronic discharge. ? foreign body |
EUA |
|
JM |
32 |
1ry. infertility |
Laparoscopy + tubal
patency tests |
|
GN |
77 |
Vulval cancer. Coronary
thrombosis x 2. Unstable angina. |
Radical vulvectomy
agreed at |
|
RU |
55 |
PMB x1. BMI 35. |
D&C. |
|
LD |
32 |
Menorrhagia. Fibroids.
Anaemia. |
Vaginal hysterectomy. |
|
DT |
22 |
Does not want children. |
Lap. Steril. |
|
HB |
14 |
Unwanted pregnancy at
10/52. |
TOP |
|
JY |
44 |
GSI. |
Anterior colporrhaphy. |
|
JS |
23 |
Discharge. Cervical
ectropion. |
Diathermy
to cervix. |
|
DT |
55 |
3 cm. ovarian mass. |
Laparoscopy
? proceed to Hyst + BSO. |
|
EV |
32 |
|
Cone
biopsy. |
|
UW |
34 |
Endometriosis |
Laparoscopic
ablation |
|
HT |
88 |
Cystocoele/ rectocoele/
2nd. degree uterine prolapse |
Manchester
Repair. |
|
KN |
58 |
Haematuria |
Cystoscopy |
|
JW |
18 |
Menorrhagia & copes
badly with menstrual hygiene. Has Down’s syndrome. Sexually active. |
Hysterectomy |
|
TB |
30 |
Menorrhagia. 2nd.
degree uterine descent. Been sterilised. Jehovah’s witness. |
Vaginal
hysterectomy and repair. |
|
BM |
55 |
Stage Ib cancer cervix.
Been discussed at MDT. For Wertheim’s hysterectomy. Factor V Leiden. VTE on
Pill. On warfarin. |
Wertheim’s
hysterectomy. |
|
NU |
60 |
Recurrent rectocoele. |
Posterior
colporrhaphy. |
82.
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 |
Coi coinfection is
when HDV and another viral infection are present at the same time |
|
H |
Susu 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 |
ppe pegylated
interferon alpha is highly effective as treatment |
|
P |
m 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 |
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