Monday, 7 January 2013

7 January 2013

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Tonight we had an EMQ on cystic fibrosis and 4 essays.

A 30-year-old woman has a booking scan at 10 weeks which shows monoamniotic twins.
1. Critically evaluate the risks associated with monoamniotic twins.  4 marks
2. Justify the history you will obtain.                                               2 marks
3. Evaluate the management options during the antenatal period.    10 marks
4.  Outline the key features of the management of labour.                 4 marks       

A 32 year-old woman with learning difficulty attends the gynaecology clinic with her mother. The referral is because of severe dysmenorrhoea and menorrhagia. The mother is keen for her to have hysterectomy and is prepared to give her consent.
1. What factors will you take into consideration before offering treatment?      8 marks.
2. Outline the treatment options, not including hysterectomy, that you will discuss. 6 marks.
3. If it is concluded that hysterectomy is the best option, justify the steps you will take to arrange this. 6 marks.

A six year old girl is referred to the gynaecology clinic with a 2 month history of vaginal discharge.
1. Justify the history you will take.            5 marks
2. Justify the investigations you will do.     5 marks
3. Critically evaluate the management.     10 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.

EMQ.     

This question is about cystic fibrosis.

For each scenario choose the option that gives the best answer.

Each option can be used once, more than once or not at all.

And, to make you behave in a model fashion, there is no option list, so you have to decide the correct answer.

Scenario 1.
A woman is 8 weeks pregnant and known to be a carrier of cystic fibrosis.
Her husband is Caucasian.
What is the risk of the child having cystic fibrosis?
Scenario 2.
A healthy woman attends for pre-pregnancy counselling.
Her brother has cystic fibrosis. Her husband is Caucasian.
He has been screened for cystic fibrosis. The test was negative.
What is the risk of them having a child with cystic fibrosis?
Scenario 3.
A healthy woman is a known carrier of cystic fibrosis.
She attends for pre-pregnancy counselling. Her husband has cystic fibrosis.
What is the risk of them having a child with CF?
Scenario 4.
A healthy woman attends for pre-pregnancy counselling. Her sister has had a child with cystic fibrosis.
What is her risk of being a carrier?
Scenario 5.
A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.
What is the risk that she is a carrier?
Scenario 6 .
A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.
The partner’s risk of being a carrier is 1 in X.
What is the risk that she will have a child with CF?
Scenario 7.
A healthy Caucasian woman is 10 weeks pregnant.
Her husband is a known carrier of cystic fibrosis.
Which test would you arrange?
Scenario 8.
A woman attends for pre-pregnancy counselling. She has read about diagnosing CF using cffDNA from maternal blood. Is it possible to test for CF in this way?
Scenario 9.
A woman and her husband are known carriers of cystic fibrosis.
What is the risk of them having an affected child.
Scenario 10.
A woman and her husband are known carriers of cystic fibrosis.
What can they do to reduce the risk of having an affected child?
Scenario 11.
A woman and her husband are known carriers of cystic fibrosis.
Can CVS exclude an affected pregnancy?


      

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