Website.
Contact us.
https://soundcloud.com/drtmcf/30-december-2013
Tonight we discussed one EMQ and five SAQ plans.
I hope you have a happy and healthy New Year.
And a successful one if you are sitting the part 2 exam.
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4
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EMQ. Antenatal steroids
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30
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Dec
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2013
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42
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A 55-year-old
woman is referred to the gynaecology clinic. A friend of the same age has
recently been found to have osteopenia and has been started on a
bisphosphonate drug. She wishes to discuss her risk of osteoporosis and what
she can do to reduce it.
1. Discuss how her risk of osteoporosis can be
assessed. 6
marks
2. Critically evaluate the steps that can be taken to
reduce her risk. 14 marks
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30
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Dec
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2013
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43
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With regard to
nuchal translucency.
a. What is nuchal translucency, how is it measured and
what are
the important
values? 6 marks
b. When is it measured and why are other times not
used? 4 marks
c. Critically evaluate the uses and implications of NT
measurement. 10 marks.
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30
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Dec
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2013
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44
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With regard to
pertussis and pregnancy.
1. What
is pertussis caused by, how is it spread, what kind of vaccine is available
and can it be used in pregnancy?
4 marks.
2. What
are the important epidemiological facts in relation to pertussis in the UK in
2012 and 2 3 marks
3. What
is the current advice in the UK about pertussis in pregnancy and who creates
the advice? 3
marks.
4. Critically
evaluate the justification for the advice.
10 marks.
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30
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Dec
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2013
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45
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A healthy,
25-year-old, nulliparous woman books at 8 weeks. She wishes to know what
particular advice is relevant to her as she is married to a farmer.
1. outline the history you will take. 6 marks
2. outline the investigations you will arrange. 4 marks
3. justify the advice you will give. 10 marks.
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30
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Dec
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2013
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46
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Your consultant
is on leave. The Secretary gives you a histology report relating to a
24-year-old woman who had suction evacuation for incomplete miscarriage 10
days before. The histology report is diagnostic of complete hydatidiform
mole.
1. Justify your
immediate management. 8 marks
2. Detail the
subsequent management. 12 marks.
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30
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Dec
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2013
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Antenatal steroids and the
neonate.
Lead-in.
The
following scenarios relate to antenatal steroid use and the neonate.
Pick
one option from the option list.
Each
option can be used once, more than once or not at all.
Abbreviations.
ANS: antenatal steroids.
FGR: fetal growth restriction.
GTG: Green-Top Guideline No 7 from the RCOG.
“Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality.”
RDS: respiratory distress syndrome. Now better
known as “surfactant-deficient lung disease of the new-born”.
Option list.
There is no option list.
I want you to come up with your answers.
Scenario 1.
What are the benefits to the neonate of appropriate administration
of antenatal steroids?
Scenario 2.
At what gestations should antenatal steroids be offered to women
with singleton pregnancies who are at risk of premature labour?
Scenario 3.
At what gestations should antenatal steroids be offered to women
with multiple pregnancies who are at risk of premature labour?
Scenario 4.
What advice is contained in the GTG in relation to very early
gestations, threatened premature labour and the use of antenatal steroids.
Scenario 5.
What
advice is contained in the GTG in relation to antenatal steroids and Caesarean
section?
Scenario 6.
What advice is given in the GTG about ANS in relation to the fetus
with FGR at risk of premature delivery?
Scenario 7
What advice is given in the GTG in relation to ANS for women with
IDDM?
Scenario 8
What advice is in the GTG in relation to adverse effects of ANS on
the fetus?
Scenario 9
What advice is in the GTG in relation to short-term maternal
adverse effects?
Scenario 10
What
contraindications to ANS are cited in the GTG?
Scenario 11
What
is the recommended drug regime for ANS administration?
Scenario 12.
What is the time-scale for maximum
effect of ANS in reducing RDS?
Scenario 13.
When should repeat courses of ANS be
given?
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