Monday, 20 October 2014

Tutorial 20 October 2014

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35.
Viva. MBRRACE.
36.
Viva. Obstetric surveillance systems.
37.
Role-play.  Request for labial reduction.
38.
Viva. Waiting list prioritisation.
49.
Role-play. Teach trainee fetal blood sampling.

35.   MBBRACE.

Candidate's Instructions.
This is a viva station.
The examiner will ask you 3 questions.
1. What is MBRRACE?                                                  2 marks
2. What is the role of MBRRACE?                              4 marks
3. How will MBRRACE differ from its precursor?   14 marks

36.   Obstetric surveillance systems.

Candidate's Instructions.
This is a viva station.
The examiner will ask you 2 questions.
1. What general data collection systems exist in the UK?                                    4 marks
2. What obstetric surveillance systems exist in the UK and what do they do?   16 marks                 

37.   Role-play. Request for labial reduction.

Candidate's Instructions.
You are the SpR in the gynaecology clinic. Your consultant is on holiday.
You are about to see Mary Adams. The GP letter reads: “Please see Mary who is convinced that her labia are too large and is adamant that she wishes to have them reduced. I have not examined her. Please see and advise”.
Your task is to take a relevant history and advise about investigation and management.

38.   Viva. Operation waiting list prioritisation.

Candidate’s instructions.
Your consultant is away. The waiting-list manager comes to see you. The following patients have been listed by junior staff. The waiting-list manager wants you to:
a. confirm the appropriateness of the proposed treatment,
b. decide the degree of urgency,
c. confirm the appropriateness of the proposed venue,
d. decide any special requirement(s) for each patient.

Name
Age
Clinical Problem
Proposed operation
Venue
Special Needs
Urgency
JK
5
chronic discharge.
? foreign body
EUA
Main theatre


JM
32
1ry. infertility
Laparoscopy + tubal patency tests
Main theatre


GN
77
Vulval cancer. Coronary thrombosis x 2. Unstable angina.
Radical vulvectomy agreed at MDT.
Main theatre


RU
55
PMB x1. Weight 20 stones. (127 kg.)
1 kg. = 2.2 lb.
1 stone = 14 lb.
D&C.

DCU.


LD
32
Menorrhagia. Fibroids. Anaemia.
Vaginal hysterectomy.

Main theatre.


DT
22
Does not want children.
Lap. Steril.
DCU


HB
14
Unwanted pregnancy at 10/52.
TOP
DCU. TOP list.
.

JY
44
GSI.
Anterior colporrhaphy.

Main theatre.


JS
23
Vaginal discharge. Cervical ectropion.
Diathermy to cervix.

DCU


DT
55
3 cm. ovarian mass.
Laparoscopy ? proceed to Hyst + BSO.

Main theatre.


EV
32
CIN3.
Cone biopsy.

DCU


UW
34
Endometriosis
Laparoscopic ablation
DCU


HT
88
Cystocoele/ rectocoele/ 2nd. degree uterine prolapse
Manchester Repair.

Main theatre.


KN
58
Haematuria
Cystoscopy
DCU


JW
18
Menorrhagia & copes badly with menstrual hygiene. Has Down’s syndrome. Sexually active.
Hysterectomy
Main theatre


TB
30
Menorrhagia. 2nd. degree uterine descent. Been sterilised. Jehovah’s witness.
Vaginal hysterectomy and repair.
Main theatre.


BM
55
Stage Ib cancer cervix. Been discussed at MDT. For Wertheim’s hysterectomy. Factor V Leiden. VTE on Pill. On warfarin.
Wertheim’s hysterectomy.
Main theatre.


NU
60
Recurrent rectocoele.
Posterior colporrhaphy.
Main theatre.




39.   Role-play. Teach trainee fetal blood sampling.

Candidate’s instructions.
You are the SpR for the labour ward. Things are temporarily quiet. A new FY2 has joined the department and the Consultant has asked you to teach her the basics of fetal blood sampling.




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