Tutorial 9 April 2015

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I messed up with the podcast for this tutorial - I forgot to record it. Aged brain, I reckon!
However, I have written fairly detailed answers, so send your answers and I'll link you to my versions on Dropbox.

27	Viva. Enhanced recovery
28	Roleplay. Phenylketonuria
29	Viva. Diathermy.
30	Viva. Obstetric surveillance systems.

27    Viva. Enhanced recovery

You are a newly-appointed consultant.

The Clinical Director has asked you to develop a programme for enhanced recovery for inpatient gynaecological surgery.

As a first step, she has asked you to deliver a talk to a unit meeting (all staff can attend) to outline the key features of enhanced recovery.

She suspects that little is known by most of the staff about the subject and hopes that your talk will encourage their enthusiastic participation.

Your task is to tell the examiner the key points you would wish to cover in the talk.

This is not a structured viva: the examiner will not ask questions or help you in any way.

28    Roleplay. Phenylketonuria

Candidate’s instructions.

You are the SpR in the pre-pregnancy clinic. Your consultant is off on sick leave and you are the most senior doctor in the clinic.

You are about to see Jane White who is planning her first pregnancy. Your task is to take a history and discuss the optimum management now and during pregnancy.

The GP letter reads:

Prime Health Practice,

Primetown,

Sussex.

0298766543.

Practice Manager:

Mrs Willhelmina Bland.

Dear Doctor,

Please see Jane White, 35 years of age and planning her first pregnancy. Her health is good – she seems only to attend the Practice for routine checks such as cervical smears – the most recent of which was taken last year and was normal. From talking to her and examining her records, it is clear that she is very healthy and has always had good physical and mental health. Her social circumstances are good. The one thing of concern is that she told me she was on a diet in childhood supervised by the local paediatric team. She can’t recall what it was about and she stopped the diet at about the age of 14. Both of her parents are dead – her mother fifteen years ago at the age of 40 and her father two years ago in a RTA, so cannot shed light on what the diet was for. Fortunately, when I checked through her notes I came across correspondence indicating that the problem was phenylketonuria. I have told her that I am no expert in phenylketonuria and the implications for pregnancy, so have eschewed the temptation to provide any advice.

I look forward to receiving your expert report.

Dr. John Worthy.

29    Viva. Diathermy.

The examiner will ask you 8 questions about diathermy.

1.   What is diathermy?

 

2.   What kind of current is used?

 

3.   Why use high frequency current?

 

4.   What types of diathermy are used?

 

5.   How is diathermy applied?

 

6.   Risks of diathermy.

7.   Discuss direct coupling and its implications

8.   Discuss capacitive coupling and its implications.

30    Viva. Obstetric surveillance systems.

This is a viva station.

The examiner will ask you 2 questions about surveillance systems used in obstetrics.

The examiner will suggest that you move to the next question when you appear to have completed the one you are answering to ensure that you have time for the remaining answers.

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