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10 March 2014
10 March 2014
1. How to prepare. Picking a course.
2. Roleplay: how to introduce oneself.
3. Labour ward scenario 1.
4. Labour ward scenario 2.
5. Roleplay: Woman attends for pre-pregnancy
counselling as she plans her 1st. pregnancy. She is healthy. Her brother has cystic fibrosis
Sunday 13.00 hours.
You are given 15 minutes to prepare and you then have a viva with an examiner. Your instructions are to prioritise the patients and allocate staff to go to see them.
1
|
Mrs JH
|
Primigravida. T+8. In labour. 6 cms.
|
2
|
Mrs AH
|
Primigravida at T. In labour. 5 cms.
|
3
|
Mrs. BH
|
Para 2. 30 days post delivery. 2ry. PPH
> 1,000 ml. Hb. 9.3.
|
4
|
Mrs SB
|
Primigravida. 32/52 gestation. Admitted 30 minutes ago.
Abdominal pain + 200 ml. bleeding. Nephrostomy tube in situ - not draining
since this morning. Low placenta on 20 week scan.
|
5
|
Mrs KW
|
Para 1. In labour. Cx. 5 cm. Ceph at
spines.
|
6
|
Mrs KT
|
Para 0+1. 38 weeks. SROM. Ceph
2 cm. above spines. Clear liquor.
|
7
|
Mrs TB
|
Para 1. T+4. Clinically big
baby. Cx fully dilated for 1 hour. Type 1 decelerations.
|
8
|
Mrs RJ
|
Primigravida. Epidural. RIF
pain. Cx fully dilated for 1 hour. Shallow late decelerations. OT position.
Distressed ++. BP /105. ++ protein. Urine output 50 ml in past 4 hours.
|
9
|
Mrs KC
|
Transfer from ICU. 13 days after delivery of 32 week
twins. Laparotomy on day 7 for pelvic pain and fever. Infected endometriotic
cyst removed. IV antibiotics changed to oral.
|
Gynaecology ward.
8 major post operative cases who have been seen on the
morning ward round and are stable. Husband of patient who has had Wertheim's hysterectomy asking to see a doctor for a report
on the operation.
1
|
Mrs JB
|
10 week incomplete miscarriage. Hb. 10.8. Moderate fresh
bleeding.
|
2
|
Ms AS
|
19 years old. Nulliparous. Just admitted with left iliac
fossa pain. Scan shows unilocular 5 cm. ovarian cyst.
|
Medical staff:
Consultant at home. Registrar - you.
Senior House Officer with 12 months experience.
Registrar in Anaesthesia.
Consultant Anaesthetist on call at home.
Midwifery staff:
Senior Sister. Trained to take theatre cases. Able to
site IV infusions and suture episiotomies and tears.
3 staff midwives.
1 trained to take theatre cases. Two able to site IV infusions.
1 Community
midwife looking after Mrs. KW.
2 Pupil Midwives.
Scenario 2.
Monday. 0900 hours. You have just come on duty.
1
|
Mrs
A
|
Para
0+0
|
25
yrs
|
41
weeks. In labour 12 hours. Cx 8 cm. No progress for 4 hours. "Dips"
reported on CTG
|
2
|
Mrs
B
|
Para
1+2
|
31
yrs
|
28
weeks. Just admitted. "Show" + contractions
|
3
|
Mrs
C
|
Para
5+3
|
40
yrs
|
In
labour 8 hours. Cx 6 cm. dilated
|
4
|
Mrs
D
|
Para
1+3
|
27
yrs
|
37
weeks. Diabetes. Admitted ½ hour previously. Previous Caesarean section.
|
5
|
Mrs
E
|
Para
1+2
|
32
yrs
|
40
weeks. Previous 9 lb. baby. In the second stage for 1 ½ hours.
|
6
|
Miss
F
|
Para
0+0
|
15
yrs
|
34
weeks. Concealed pregnancy. In labour. Just admitted. Breech presentation
|
7
|
Mrs
G
|
Para
1+2
|
26
weeks. Admitted with severe abdominal pain
|
|
8
|
Mrs
H
|
Para
2+1
|
39
weeks. In early labour.
|
|
9
|
Mrs
I
|
Para
1+0
|
Delivered
two hours previously by Caesarean section for severe pre-eclampsia. Diastolic
BP / 110. Urine output 50 ml. since delivery
|
|
10
|
Mrs
J
|
Para
1+0
|
Normal
delivery + PPH >1,500 ml. one hour ago
|
Medical
staff:
Consultant: in his Rooms.
You: Registrar.
Foundation
Year 2 six months’ experience.
Registrar
in anaesthetics.
Midwifery
staff:
Senior
Sister.
Two
staff midwives.
One
community midwife.
Two
student midwives.
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