Thursday, 20 December 2012

Tutorial 20 December 2012

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Tonight we answered 2 EMQs on haemophilia A and discussed 4 essay plans.


EMQ. Haemophilia A. Two questions.    


EMQ1.
Lead-in.
The following scenarios relate to haemophilia A, factor VIII deficiency  (HA).
For each, select the most appropriate answer  from the option list.
Each option can be used once, more than once or not at all.

Scenario 1.
A woman attends for pre-pregnancy counselling. Her brother has haemophilia A. What is her risk of being a carrier?
Scenario 2 .
A woman attends for pre-pregnancy counselling. Her father has haemophilia A. What is her risk of being a carrier?
Scenario 3.
If she is tested and found to be a carrier, what tests will you arrange for her partner?
Scenario 4.
If she is a carrier, what is the risk to her male offspring?
Scenario 5.
If she is a carrier, what is the risk to her female offspring?
Scenario 6.
If she is  a carrier and her partner has haemophilia A, what are the risks to their female offspring?
Scenario 7.
If she is a carrier and her partner has haemophilia A, what are the risks to their male offspring?


EMQ2. Haemophilia A. Pre-pregnancy counselling.

Lead-in.
The following scenarios relate to haemophilia A and pre-pregnancy counselling.
For each, select the most appropriate risk from the option list.
Pick one option from the option list.
Each option can be used once, more than once or not at all.

Scenario 1.
A nulliparous 20-year-old wishes to know the risk of her being a carrier as her father has mild haemophilia A.
Scenario 2.
A nulliparous 20-year-old wishes to know the risk of her being a carrier as her father has severe haemophilia A.
Scenario 3.
A para 3, 30-year-old wishes to know the risk of her being a carrier as her mother is a carrier.
Scenario 4.
A para 0+4, 25-year-old wishes to know the risk of her being a carrier as her sister has an affected son.
Scenario 5.
 A para 6, 40-year-old wishes to know the risk of her being a carrier as her daughter has had an affected baby.
Scenario 6.
 A nulliparous woman wishes to know the risk of a son having haemophilia as she is a carrier.
Scenario 7.
A nulliparous woman wishes to know the risk of a son having haemophilia as her husband has haemophilia A.
Scenario 8.
A nulliparous woman wishes to know the risk of a daughter being a carrier as she is a carrier.
Scenario 9.
A nulliparous woman wishes to know the risk of a daughter being a carrier as her husband has haemophilia A.
Scenario 10.
A nulliparous woman wishes to know the risk of a son having haemophilia as her paternal grandfather had haemophilia A.
Scenario 11.
A nulliparous woman wishes to know the risk of a son having haemophilia as her maternal grandfather had haemophilia A.
Scenario 12.
A nulliparous woman wishes to know the risk of a son having haemophilia as her husband’s paternal grandfather had haemophilia A.
Scenario 13.
A nulliparous woman wishes to know the risk of a son having haemophilia as her husband’s maternal grandfather had haemophilia A.
Scenario 14.
A nulliparous woman wishes to know the risk of a son having haemophilia as her mother’s brother has haemophilia A.
Scenario 15.
A nulliparous woman wishes to know her risk of being a carrier as she has read about it in a magazine. There is no family history of haemophilia A.



Option list.

A.
0 %
B.
0.1 %
C.
1 %
D.
12.5 %
E.
13.3%
F.
20 %
G.
25 %
H.
33 %
I.
50 %
J.
66.6%
K.
68 %
L.
75 %
M.
80 %
N.
90 %
O.
100 %
P.
200 %



1.      A 28-year-old woman is referred to the gynaecology clinic with suspected premature ovarian failure. She has “hot flushes”, has not menstruated for 8 months and a FSH level was found to be 40 iu/l.
1. Outline the main causes of premature ovarian failure. 10 marks
2. Critically evaluate the management options.              10 marks    

2.      A nulliparous woman of 30 years attends for pre-pregnancy counselling. Her father is a carrier of the Fragile X premutation. Her paternal uncle has Fragile X syndrome. Critically evaluate the management.

3.      With regard to endometrial cancer.
1. Outline the key features of Type 1 and Type 2 cancers.         4 marks
2. Outline the FIGO histological grading system.                      2 marks
3. Critically evaluate the FIGO staging for endometrial cancer.    6 marks
4. Detail the FIGO staging system for endometrial cancer.         8 marks.        

4.      Critically evaluate the statement: “fortification of flour is overdue in the UK”.      

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