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Tonight we had an EMQ then 4 essays.
Lead-in.
The following scenarios relate to parvovirus infection
Pick one option from the option list.
Each option can be used once, more than once or not at all.
Abbreviations.
GOVRIP: Guidance on Viral Rash in Pregnancy. HPA. 2011
PSVMCA: peak systolic velocity middle cerebral artery.
PvB19: parvovirus B19
PvIgG: parvovirus B19 IgG
PvIgM: parvovirus B19 IgM
Option list.
There is none: make up your own answers!
Scenario 1.
What type of virus is parvovirus?
Scenario 2.
Is the title B19 something to do with the American B19 bomber, its potentially devastating bomb load and the comparably devastating consequences of the parvovirus on human erythroid cell precursors?
Scenario 3.
PVB19 in the UK occurs in mini-epidemics at 3 – 4 year intervals, usually during the summer months.
Scenario 4.
Which animal acts as the main reservoir for infection?
Scenario 5.
What percentage of UK adults are immune to parvovirus infection?
Scenario 6.
What names are given to acute infection in the human?
Scenario 7.
What is the incubation period for parvovirus infection?
Scenario 8
What is the duration of infectivity for parvovirus infection?
Scenario 9.
What are the usual symptoms of parvovirus infection in the adult?
Scenario 10.
What is the incidence of parvovirus infection in pregnancy?
Scenario 11.
How is recent infection diagnosed?
Scenario 12.
How long does PvIgM persist and why is this important?
Scenario 13.
What is the rate of vertical transmission of parvovirus infection?
Scenario 14.
Are women with parvovirus infection who are asymptomatic less likely to pass the virus to their fetuses?
Scenario 15.
To what degree is parvovirus infection teratogenic?
Scenario 16.
What proportion of pregnancies infected with parvovirus are lost?
Scenario 17.
What is the timescale for the onset of hydrops?
Scenario 18.
Laboratories are advised to retain bloods obtained at booking for at least 2 years for possible future reference. True or false?
Scenario 19.
What ultrasound features would trigger consideration of cordocentesis?
Scenario 20.
Must suspected parvovirus infection be notified to the authorities?
Scenario 21.
Possible parvovirus infection does not need to be investigated after 20 week’s gestation.
Scenario 22
If serum is sent to the laboratory from a woman with a rash in pregnancy for screening for rubella, the laboratory should automatically test for parvovirus infection too.
Essays 16 July 2012
13 EMQ. Parvovirus
With regard to hyperemesis gravidarum.
1. Outline how the diagnosis is made. 2 marks
2. Outline the immediate consequences. 6 marks
3. Outline the consequences in later pregnancy. 6 marks
4. Justify your management of a woman seen with HG at 10 weeks. 6 marks
Epilepsy. Pre-pregnancy counselling.
1. Detail the history you will obtain. 4 marks
2. Outline the advice you will give. 8 marks
3. Outline the key features of the management of the pregnancy and labour. 8 marks
How can the perinatal morbidity and mortality associated with multiple pregnancy be reduced?
1. Discuss the steps that can be taken pre-conceptually to reduce the risks. 4 marks
2. Discuss the steps that can be taken during pregnancy to reduce the risks. 10 marks
3. Discuss the steps that can be taken during labour and delivery to reduce the risks. 6 marks.
A 20-year-old woman is referred to the gynaecology clinic with a complaint of hirsutism. Critically evaluate the management.
1. Outline the necessary facts to obtain from the history. 6 marks.
2. Justify the investigations you would arrange. 8 marks.
3. Outline the key aspects of the management. 6 marks.
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