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Tonight we had an EMQ and 4 essay plans.
Ulipristal.
Lead-in.
The following scenarios relate to ulipristal. For each, select the most appropriate from the option list.
Each option can be used once, more than once or not at all.
Scenario 1.
What type of drug is ulipristal?
Scenario 2.
How is ulipristal broken down / excreted?
Scenario 3.
What is the half-life of ulipristal?
Scenario 4.
Which drug may prolong the half-life of ulipristal?
Scenario 5.
What is the main use of ulipristal?
Scenario 6.
What is the dose of ulipristal?
Scenario 7.
What time-scale applies to the licensed use of ulipristal?
Scenario 8.
What contraceptive advice is given to those using ulipristal?
Scenario 9.
What advice is given to women who are breast-feeding?
Scenario 10.
Can treatment with ulipristal be repeated within 1 month?
Option list.
GnRH analogue.
Selective serotonin reuptake inhibitor.
19-nortestosterone derived progestagen.
21-hydroxyprogesterone-derived progestagen.
mifepristone derivative.
Selective oestrogen receptor modulator.
Selective progesterone receptor modulator.
Urinary excretion.
Metabolised by renal cytochrome P450 enzyme system.
Metabolised by hepatic cytochrome P450 enzyme system.
30 mg. with dose repeated if vomiting occurs within 3 hours.
100 mg. with dose repeated if vomiting occurs within 3 hours.
150 mg. with dose repeated if vomiting occurs within 3 hours.
phenobarbitone
valium
erythromycin
12 hours.
18 hours.
32 hours.
72 hours.
120 hours.
Depot-contraception.
Depression.
Emergency contraception.
Menorrhagia.
Termination of pregnancy.
Yes.
No.
Maybe.
Continue.
Discontinue for 36 hours.
Discontinue for 72 hours.
May interfere with contraception containing progestagen.
May interfere with contraception containing oestrogen.
No action if LARC being used.
Essays 5 July 2012.
A woman with BMI of 35 attends for pre-pregnancy counselling.
1. Outline the reasons that obesity is causing concern in relation to pregnancy. 4 marks
2. Justify the investigations you will arrange. 2 marks
3. Justify your management. 6 marks
4. Outline the key aspects of antenatal care. 8 marks.
With regard to smoking in pregnancy:
1. outline the hazards to the mother. 4 marks
2. outline the hazards to the fetus / child. 6 marks
3. critically evaluate how smoking cessation programmes can be made more effective. 10 marks
A primigravid woman attends the antenatal booking clinic at 5 weeks’ gestation. She smells strongly of alcohol. She admits to consuming at least ½ bottle of vodka each day.
1. Critically evaluate the public health advice available in the UK about alcohol and pregnancy. 4 marks.
2. Critically evaluate screening for alcohol abuse in pregnancy. 4 marks.
3. Critically evaluate the risks to the fetus and child of the mother who abuses alcohol in pregnancy. 6 marks.
4. Justify the management you would arrange for this patient. 6 marks.
A woman of 38 is referred to the gynaecology clinic as the tail of her IUCD could not be seen when she recently had a routine cervical smear.
1. Outline the history you will take. 6 marks.
2. Justify the investigations you will arrange. 4 marks.
3. Justify your management. 10 marks.
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