Monday, 29 July 2013

Tutorial 29 July 2013

Tutorial.
Website.
Contact us.

You can click on the title or "Tutorial" above to go to Soundcloud and access and download the tutorials.
I am also putting them on Dropbox.
If you want to access the ones on Dropbox, you need a Dropbox account.
You also need to let me know the e-mail address you use for the account.
I can then link your account to my Dropbox files and you can access them whenever you want.

I was a bit late starting the recording, so the first couple of EMQ scenario discussions are missing.
Send me your answer and you will get my written version.
You will note that we are up to essay number 53.
How many have you written?



14
EMQ. Cystic fibrosis
50
You have been asked to give a tutorial on essay-writing to MRCOG part II candidates.
Outline the key aspects of the advice you will wish to convey.
51
You are the SpR in the antenatal clinic. The consultant is absent due to illness and no other consultant is available. A midwife asks you to see a woman whose scan has shown anencephaly.
1. What steps will you take before seeing the woman?         6 marks
2. Justify the approach you will use during the interview.   10 marks
3. What will you do when the interview is over?                     4 marks
52
A 25 year-old woman books at 8 weeks. She has one child, aged 3 years. He has recently had chickenpox diagnosed. Her sister is 38 weeks pregnant.
1.  Justify your initial management.                                            8 marks.
2.  Justify your management for the rest of the pregnancy.  8 marks.
3.  Justify the advice you will give with regard to her sister.  4 marks.
53
Question. Critically evaluate HPV vaccine and its uses.




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?
Scenario 12.
A woman with cystic fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been advised not to breastfeed because her breast milk will be protein-deficient due to malabsorption.
Is this advice correct?
Scenario 13.
A woman with cystic fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been advised not to breastfeed because her breast milk will contain abnormally low levels of sodium.
Is this advice correct?




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