Podcast.
Tonight we managed an EMQ and 4 essay plans.
The EMQ was created due to the fact that the FSRH recently updated its advice on missed pills to simplify it.
It and the essays are below.
Missed pills. Starting the Pill. COC.
Lead-in.
The following scenarios relate to the combined oral contraceptive (COC) and missed pills.
For each, select the option that best fits the scenario.
Each option can be used once, more than once or not at all.
Abbreviations.
UPSI: unprotected sexual intercourse.
Option list.
A. pill that is ≥ 12 hours late.
B. pill that is > 12 hours late.
C. pill that is ≥ 24 hours late.
D. pill that is > 24 hours late.
E. two missed pills at any time in a single cycle.
F. the first pill taken in one’s first love affair, now recalled with fond nostalgia for its effectiveness in preventing pregnancy, the Prince having been truly a loathsome toad.
G. no additional contraception required.
H. additional contraception required for 7 days.
I. emergency contraception should be considered.
J. emergency contraception should be recommended.
K. take the missed pill immediately, but not if it means 2 pills in one day; no additional contraception needed; pill-free interval as normal.
L. take the missed pill immediately, even if it means 2 pills in one day; no additional contraception needed; pill-free interval as normal.
M. take the missed pill immediately, even if it means 2 pills in one day; additional contraception for 7 days; pill-free interval as usual.
N. take one of the missed pills immediately, discard the other missed pills, use extra contraception for 7 days and discuss emergency contraception with your doctor.
O. take the missed pills immediately, use extra contraception for 7 days and discuss emergency contraception with your doctor.
P. continuous combined preparation.
Q. bi-phasic preparation.
R. quadriphasic preparation.
S. cannot be answered from the data given.
T. none of the above.
Scenario 1.
What is the definition of a missed pill?
Scenario 2.
What is the definition of two missed pills?
Scenario 3.
A COC is begun on day 1 of menstruation. What advice should be given about temporary additional contraception?
Scenario 4.
A COC is begun 5 days after day 1 of menstruation. What advice should be given about temporary additional contraception?
Scenario 5.
A COC is begun for the first time on day 1 of menstruation. The fifth pill is missed. What advice should be given?
Scenario 6.
A pill is missed on day 14 of a 21-day pack. What advice should be given?
Scenario 7
A pill is missed on day 21 of a 21-day pack. What advice should be given?
Scenario 8
Two pills are missed in the first week of a 21-day pack. What advice should be given?
Answer:
Scenario 9
Two pills are missed in the second week of a 21-day pack. What advice should be given?
Scenario 10
Two pills are missed in the third week of a 21-day pack. What advice should be given?
Scenario 11
What kind of preparation is Qlaira?
Essays 25th. July 2011.
Question 1.
Critically evaluate the available options for analgesia in labour.
Question 2.
With regard to postnatal mental illness.
1. outline the different categories of mental illness. 2 marks
2. detail the methods of detecting postnatal mental illness. 2 marks
3. outline the risks to the mother. 4 marks
4. outline the risks to the child. 4 marks
5. outline the principles of management. 8 marks
Question 3.
A woman attends the antenatal booking clinic. She wishes to have a home birth.
1. Critically evaluate the pros and cons of home birth that you will discuss with her.
6 marks.
2. Outline the key components of the assessment of her suitability to have a home birth.
6 marks
3. Discuss the practical issues relevant to safe home delivery. 12 marks
Question 4.
A woman is referred after her third consecutive miscarriage at 10 weeks.
1. outline the key features in the history you will take. 4 marks
2. list the main causes of recurrent miscarriage. 4 marks
3. critically evaluate the investigations you will arrange. 6 marks
4 critically evaluate the available treatments for unexplained recurrent miscarriage.
6 marks
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