Tutorial 30 June 2014

 

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30 June 2014

7	EMQ. Ulipristal.	30	June	2014
2	A nulliparous woman of 30 years attends for pre-pregnancy counselling. Her father is a carrier of the Fragile X pre-mutation. Her paternal uncle has Fragile X syndrome. Critically evaluate the management.	30	June	2014
2	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	30	June	2014
2	Critically evaluate “Enhanced Recovery” in Obstetrics and Gynaecology.	30	June	2014
2	With regard to endometrial cancer. 1. Outline the key features of Type 1 and Type 2 cancers.        4 marks 2. Outline the FIGO histological grading system.                          2 marks 3. Critically evaluate the FIGO staging for endometrial cancer. 6 marks 4. Detail the FIGO staging system for endometrial cancer.        8 marks.	30	June	2014
7	Roleplay. Healthy, nulliparous woman referred for pre-pregnancy counselling. Brother has cystic fibrosis. You are asked to explain cystic fibrosis and the implications for her.	30	June	2014

EMQ  Ulipristal.

Lead-in.

The following scenarios relate to ulipristal. For each, select the most appropriate from the option list.

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

Option list.

GnRH analogue.

Selective serotonin reuptake inhibitor.

19-nortestosterone derived progestagen.

21-hydroxyprogesterone-derived progestagen.

mifepristone derivative.

Selective oestrogen receptor modulator.

Selective progesterone receptor modulator.

Urinary excretion.

Metabolised by renal cytochrome P450 enzyme system.

Metabolised by hepatic cytochrome P450 enzyme system.

30 mg. with dose repeated if vomiting occurs within 3 hours.

100 mg. with dose repeated if vomiting occurs within 3 hours.

150 mg. with dose repeated if vomiting occurs within 3 hours.

phenobarbitone

valium

erythromycin

12 hours.

18 hours.

32 hours.

72 hours.

120 hours.

Depot-contraception.

Depression.

Emergency contraception.

Menorrhagia.

Termination of pregnancy.

Yes.

No.

Maybe.

Continue.

Discontinue for 36 hours.

Discontinue for 72 hours.

May interfere with contraception containing progestagen.

May interfere with contraception containing oestrogen.

No action if LARC being used.

Scenario 1.

What type of drug is ulipristal?

Scenario 2.

How is ulipristal broken down / excreted?

Scenario 3.

What is the half-life of ulipristal?

Scenario 4.

Which drug may prolong the half-life of ulipristal?

Scenario 5.

What is the main use of ulipristal?

Scenario 6.

What is the dose of ulipristal?

Scenario 7.

What time-scale applies to the licensed use of ulipristal?

Scenario 8.

What contraceptive advice is given to those using ulipristal?

Scenario 9.

What advice is given to women who are breast-feeding?

Scenario 10.

Can treatment with ulipristal be repeated within 1 month?