Tonight we discussed three essays.
Question 1.
A woman complains of breakthrough bleeding on oral contraception.
a. justify the history you will take. 6 marks.
b. justify the examination you will perform. 4 marks.
c. justify the investigations you will arrange. 4 marks.
d. justify the advice and treatments you will give. 6 marks.
Question 2.
Critically evaluate screening for gynaecological cancer.
Question 3.
You have been asked to review your departmental policy for the use of anti-D.
1. Justify how you will go about the process. 8 marks.
2. Outline the key issues to be included in the document. 12 marks.
I had planned to discuss a fourth but we did not have time.
Question 4.
You have been asked to write guidance for the unit in relation to labour and delivery in water.
Outline how you will go about the task. 8 marks.
Discuss the key issues to be included in the guidance. 12 marks.
I wrote an EMQ this afternoon. It will probably have flaws. Have a go at answering it. Send me what you think and I'll send my thoughts. If it needs to be changed, I'll sort that out.
Lead-in.
The following scenarios relate to vulval conditions.
Choose the most likely vulval condition from the option list.
Each option can be used once, more than once or not at all.
Scenario 1.
A 22 year-old woman attends the colposcopy clinic after 2 smears showing minor atypia. The cervical appearances are of aceto-white with punctation.
Scenario 2.
A 60-year old woman has an erythematous rash of the vulva extending to the inner thighs. A similar rash is noted under the breasts. She is not known to have diabetes.
Scenario 3.
A woman attends the gynaecology clinic with a white vulval rash. The main additional feature is a “lacy” appearance.
Scenario 4.
A 35-year old woman attends is noted to have a vulval fistula. She has a history of episodic diarrhoea.
Scenario 5.
A 25-year old woman attends the gynaecology clinic with a history of intense vulval itching and soreness. The appearances are of diffuse erythema with excoriation. Diabetes, candidiasis and other local infections have been eliminated by the GP.
Scenario 6.
A 35-year old woman attends the gynaecology clinic with vulvitis. She also has a scalp rash. Clinical examination shows scaly, pink patches with signs of excoriation. Skin samples grow Malassezia ovalis.
Scenario 7.
A 40-year old woman has evidence of chronic vulval ulceration. She has recently been seen by a dermatologist for mouth ulceration and has been started on thalidomide.
Scenario 8.
An African woman of 35 years attends the gynaecology clinic. She has a ten-year history of chronic vulval ulceration. Examination shows multiple, tender vulval and pubic subcutaneous nodules, some of which have ulcerated.
Scenario 9.
A Caucasian woman of 29 years attends the gynaecology clinic with a chronic vulval rash. Examination shows erythematous areas with clearly defined margins and white scaly patches.
Scenario 10.
A 30-year old woman attends the gynaecology clinic with vulval itching. Examination shows erythema of the labia minora and perineum. Full-thickness biopsy shows abnormal cell maturation throughout the epithelium with increased mitotic activity.
Option list.
A. | Acne. |
B. | Behçet’s syndrome. |
C. | Candidiasis. |
D. | CIN 3 |
E. | CIN1 |
F. | Crohn’s disease. |
G. | Dermatitis. |
H. | Eczema. |
I. | Genital warts. |
J. | Hidradenitis suppurativa. |
K. | Leprosy. |
L. | Lichen planus |
M. | Lichen sclerosis |
N. | Lymphogranuloma venereum |
O. | Normal skin. |
P. | Psoriasis. |
Q. | Seborrhoeic dermatitis. |
R. | Type 1 diabetes mellitus |
S. | Type 2 diabetes mellitus |
T. | Ulcerative colitis. |
U. | VIN III. |
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