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Only one person attended, so there was no tutorial.
The topics we would have discussed are below.
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13
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EMQ Haemophilia A. Prepregnancy counselling.
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43
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You are the SpR
in the fertility clinic.
A couple have been referred by their General
Practitioner after basic investigation of their three years of infertility.
She has a 5-year-old daughter by a previous partner. The pregnancy, delivery
and puerperium were normal. Her menstrual cycle is normal and a serum
progesterone has confirmed ovulation.
He has never made a partner pregnant and the GP letter
states that he has a low sperm count.
1. Justify the history you will take. 4 marks
2. How do you categorise male infertility? 4 marks
2. Justify the investigations you will arrange. 4 marks
3. Outline the management and available options. 8 marks
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44
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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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45
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With regard to cervical cancer:
1. Critically evaluate the FIGO staging
classification. 8 marks
Describe the FIGO
staging. 12 marks
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46
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A 25-year-old
midwife sustains a needle-stick injury during a normal delivery and requests
advice.
1. Which potential infections are of concern in
needle-stick injuries? 2 marks.
2. What characteristics of needle-stick or “splash”
exposure increase the risk of infection? 4 marks.
3. What history will you take? 6 marks.
4. What should be done to minimise the risks? 8 marks.
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Lead-in.
The
following scenarios relate to haemophilia A and pre-pregnancy counselling.
For
each, select the most appropriate risk from the option list.
Pick
one option from the option list.
Each
option can be used once, more than once or not at all.
Scenario 1.
A nulliparous 20-year-old wishes to know the risk of her being a
carrier as her father has mild haemophilia A.
Scenario 2.
A
nulliparous 20-year-old wishes to know the risk of her being a carrier as her
father has severe haemophilia A.
Scenario 3.
A
para 3, 30-year-old wishes to know the risk of her being a carrier as her
mother is a carrier.
Scenario 4.
A
para 0+4, 25-year-old wishes to know the risk of her being a carrier
as her sister has an affected son.
Scenario 5.
A para 6, 40-year-old wishes to know the risk
of her being a carrier as her daughter has had an affected baby.
Scenario 6.
A nulliparous woman wishes to know the risk of
a son having haemophilia as she is a carrier.
Scenario 7.
A
nulliparous woman wishes to know the risk of a son having haemophilia as her
husband has haemophilia A.
Scenario 8.
A
nulliparous woman wishes to know the risk of a daughter being a carrier as she
is a carrier.
Scenario 9.
A
nulliparous woman wishes to know the risk of a daughter being a carrier as her
husband has haemophilia A.
Scenario 10.
A
nulliparous woman wishes to know the risk of a son having haemophilia as her
paternal grandfather had haemophilia A.
Scenario 11.
A
nulliparous woman wishes to know the risk of a son having haemophilia as her
maternal grandfather had haemophilia A.
Scenario 12.
A
nulliparous woman wishes to know the risk of a son having haemophilia as her
husband’s paternal grandfather had haemophilia A.
Scenario 13.
A
nulliparous woman wishes to know the risk of a son having haemophilia as her
husband’s maternal grandfather had haemophilia A.
Scenario 14.
A
nulliparous woman wishes to know the risk of a son having haemophilia as her
mother’s brother has haemophilia A.
Scenario 15.
A
nulliparous woman wishes to know her risk of being a carrier as she has read
about it in a magazine. There is no family history of haemophilia A.
Option list.
A.
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0 %
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B.
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0.1 %
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C.
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1 %
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D.
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12.5 %
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E.
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13.3%
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F.
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20 %
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G.
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25 %
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H.
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33 %
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I.
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50 %
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J.
|
66.6%
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K.
|
68 %
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L.
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75 %
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M.
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80 %
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N.
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90 %
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O.
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100 %
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P.
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200 %
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