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Contact us.
19
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EMQ.
Vulval conditions
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13
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Feb
|
2014
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20
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EMQ.
Down’s syndrome screening
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13
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Feb
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2014
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21
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EMQ.
Drugs in O&G.
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13
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Feb
|
2014
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84
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With
regard to adhesions that result from abdominal surgery.
1. Outline the incidence and possible adverse consequences
of adhesion formation after surgery. 8
marks.
2. How may the incidence of surgical adhesions be reduced?
12 marks.
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13
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Feb
|
2014
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85
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With
regard to Gestational Trophoblastic Neoplasia.
Outline the factors influencing prognosis.
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13
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Feb
|
2014
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86
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Ovarian torsion.
1.
Critically evaluate the diagnosis of ovarian torsion. 8 marks.
2.
Justify your management of ovarian torsion. 12
marks.
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13
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Feb
|
2014
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Lead-in.
The following
scenarios relate to vulval conditions.
Choose the
most likely vulval condition from the option list.
Each option
can be used once, more than once or not at all.
Scenario 1.
A
22 year-old woman attends the colposcopy clinic after 2 smears showing minor
atypia. The cervical appearances are of aceto-white with punctation.
Scenario 2.
A
60-year old woman has an erythematous rash of the vulva extending to the inner
thighs. A similar rash is noted under the breasts. She is not known to have
diabetes.
Scenario 3.
A
woman attends the gynaecology clinic with a vulval rash. It has a “lacy”
appearance.
Scenario 4.
A
35-year old woman attends is noted to have a vulval fistula. She has a history
of episodic diarrhoea.
Scenario 5.
A
25-year old woman attends the gynaecology clinic with a history of intense
vulval itching and soreness. The appearances are of diffuse erythema with
excoriation. Diabetes, candidiasis and other local infections have been
eliminated by the GP.
Scenario 6.
A
35-year old woman attends the gynaecology clinic with vulvitis. She also has a
scalp rash. Clinical examination shows scaly, pink patches with signs of
excoriation. Skin samples grow Malassezia
ovalis.
Scenario 7.
A
40-year old woman has evidence of chronic vulval ulceration. She has recently
been seen by a dermatologist for mouth ulceration and has been started on
thalidomide.
Scenario 8.
An
African woman of 35 years attends the gynaecology clinic. She has a ten-year
history of chronic vulval ulceration. Examination shows multiple, tender vulval
and pubic subcutaneous nodules, some of which have ulcerated.
Scenario 9.
A
Caucasian woman of 29 years attends the gynaecology clinic with a chronic
vulval rash. Examination shows erythematous areas with clearly defined margins
and white scaly patches.
Scenario 10.
A
30-year old woman attends the gynaecology clinic with vulval itching. Examination
shows erythema of the labia minora and perineum. Full-thickness biopsy shows
abnormal cell maturation throughout the epithelium with increased mitotic
activity.
Option list.
A.
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Acne.
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B.
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Behçet’s
syndrome.
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C.
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Candidiasis.
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D.
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CIN
3
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E.
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CIN1
|
F.
|
Crohn’s
disease.
|
G.
|
Dermatitis.
|
H.
|
Eczema.
|
I.
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Genital
warts.
|
J.
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Hidradenitis
suppurativa.
|
K.
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Leprosy.
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L.
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Lichen
planus
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M.
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Lichen
sclerosis
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N.
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Lymphogranuloma
venereum
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O.
|
Normal
skin.
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P.
|
Psoriasis.
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Q.
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Seborrhoeic
dermatitis.
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R.
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Type
1 diabetes mellitus
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S.
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Type
2 diabetes mellitus
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T.
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Ulcerative
colitis.
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U.
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VIN
III.
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Lead-in.
The following scenarios relate to screening for Down’s
syndrome.
Pick one option from the option list.
Each option can be used once, more than once or not at
all.
Abbreviations.
DS. Down’s syndrome.
FASC: Fetal Anomaly Screening Programme.
NSC: National Screening Committee
Suggested reading.
Option list.
a.
1 in 2
b.
1 in 5
c.
1 in 10
d.
1 in 20
e.
1 in 40
f.
1 in 250
g.
1 in 400
h.
1 in 1,000
i.
5 mm.
j.
6 mm.
k.
7 mm.
l.
8 mm.
m.
10 mm.
n.
1%
o.
2%
p.
5%
q.
10%
r.
80%
s.
95%
t.
90%
u.
95%
v.
higher
w.
lower
x.
true
y.
false
z.
none of the above.
Scenario 1.
What is the age-related risk of
DS at 20 years?
Scenario 2.
What is the age-related risk of
DS at 30 years?
Scenario 3.
What is the age-related risk of
DS at 35 years?
Scenario 4.
What is the age-related risk of
DS at 40 years?
Scenario 5.
What is the age-related risk of
DS at 45 years?
Scenario 6.
AFP levels are lower in Ds.
Scenario 7
Inhibin levels are raised in
DS.
Scenario 8
Oestriol levels are raised in
DS.
Scenario 9
β-hCG levels are raised in DS.
Scenario 10
1st. trimester PAPP-A levels are lower in DS.
Scenario 11
2nd. trimester PAPP-A levels are normal in DS.
Scenario 12
What
characteristic is described in relation to the occipital hairline in DS?
Scenario 13
What
characteristic is described in relation to the frontal hairline in DS?
Scenario 14
What is the
incidence of congenital heart anomaly in DS?
Scenario 15
Which is the most
common congenital heart anomaly in DS?
Scenario 16
Which major
haematological condition is more common in those with DS?
Answer.
Scenario 17
Which major
neurological condition is more common in middle age in those with DS?
Scenario 18
Which spinal
anomaly is more common in DS and of concern to anaesthetists?
Drugs in Pregnancy. 2
Lead-in.
The
following scenarios relate to some common drugs used in pregnancy.
Pick
one option from the option list. Each option can be used once, more than once
or not at all.
Abbreviations.
NSAID. non-steroidal anti-inflammatory drug.
Option list.
I have not given one to make you think! And, in the exam, you
should be deciding your answer before you check the option list.
Scenario 1.
What is the generic name for Prostin?
Scenario 2.
What kind of drug is Prostin?
Scenario 3.
What is the generic name for Misoprostol?
Scenario 4.
What
kind of drug is Misoprostol?
Scenario 5.
What
is the generic name for Gemeprost?
Scenario 6.
What kind of drug is Gemeprost?
Scenario 7
What is the generic name for Mifepristone?
Scenario 8
What king of drug is Mifepristone?
Scenario 9
What are the constituents of a 1 ml. ampoule of Syntometrine?
Scenario 10
What
is the generic name for Carbetocin?
Scenario 11
What kind of drug is Carbetocin?
Scenario 12
What is the generic name for Hemabate?
Scenario 13
What kind of drug is Hemabate?
Scenario 14
What is the generic name for Atosiban?
Scenario 15
What kind of drug is atosiban?
Scenario 16
What
if the generic name for Cervagem?
Scenario 17
What
kind of drug is Cervagem?
Scenarion 18
What
is the cost of 1mg. of Prostin E2 gel and what are its storage requirements?
Scenarion 19
What
is the cost of a 1mg. Gemeprost pessary and what are its storage requirements?
Scenarion 20
What
is the cost of 200 mcg. of misoprostol and what are its storage requirements?
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