Tutorial 23 October 2014

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40	Viva.          Uterine inversion.
41	Role-play. Stillbirth. 6/52 follow-up.
42	Role-play. Sterilisation request.
43	Role-play. Cochrane.
44	Role-play. Neonatal screening.

40.   Uterine inversion.

Candidate's Instructions.

This is a viva station.

The examiner will ask you 7 questions.

1.     What are the risk factors for uterine inversion?

2.     What are the clinical features?

3.     What is the differential diagnosis?

4.     What are the diagnostic features?

5.     What would be your immediate management?

6.     What would be your subsequent management?

7.     What would be your management after the uterus has been replaced and the woman has been resuscitated?

41.   Role-play. Stillbirth. 6/52 follow-up.

Candidate's Instructions.

This is a role-play station.

This is a roleplay station.

Mrs. Brown has come for follow-up 6/52 after delivery of a stillborn baby.

Reduced fetal movements had been noted at 38 weeks.

She was admitted and FDIU was confirmed.

The scan also showed IUGR.

She opted for induction of labour.

Prostin was used and she had a normal delivery 12 hours later.

Effective analgesia was provided by epidural anaesthesia.

There were no complications.

Full investigation, including PM, was normal apart from the birthweight, which was < 5^th. centile.

Your task is to explain the results and advise about the next pregnancy.

42.   Role-play. Sterilisation request.

Candidate's Instructions.

You are a 5^th. year SpR. You are about to see Mrs. Mary Fecund in the gynaecology clinic. There is a referral letter from the GP.

Read the letter and then conduct the consultation with Mrs. Fecund as you would do in the clinic in your hospital.

Perfect Health Centre,

Paradise Lane,

Slagheap.

SLH 678.

Your ref: BRI 07/54843.

Re. Mary Fecund,

The Shoe, High Street, Slagheap.

Dear Doctor,

Please see Mrs Fecund who has too many children. She wishes to be sure she has no more and has asked to be sterilised – one of her friends was sterilised recently which has put her in the mood to have it done.

Yours sincerely,

Dr. John Williams.

43. Role-play. Cochrane.            

Candidate’s instructions.

You are a SpR in year 5.

1.     You have been asked to explain the Cochrane Collaboration and Cochrane Reviews to a new trainee. The trainee will ask 7 questions suggested by the Consultant.

2.     Explain the main elements and findings of the Forest plot below.

44.   Role-play. Neonatal screening.

Candidate’s instructions.

You are a SpR in year 5.

You are in the antenatal booking clinic and about to see Mary Eccles. She has been booked in by a midwife at 10 weeks’ gestation and all is well. She has recently arrived in the UK from the USA and asked about the routine neonatal screening that is done in the UK. She will be having the baby in the UK.