Thursday, 15 October 2015

Tutorial 15th. October 2015

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15 October 2015

36
Roleplay. Cystic fibrosis.
37
Viva. Waiting list prioritisation.
38
Roleplay. Teach a FY1 about shoulder dystocia.
39
Viva. HPV vaccination.
40
Viva. Whooping cough & pregnancy.

36.  Roleplay. Cystic fibrosis. Teenager. Early pregnancy.
Candidate’s instructions.
You are a year-5 SpR and are running the antenatal clinic as your consultant is on sick leave.
You are about to see Helen Smith. She has an early pregnancy and has attended for booking. The midwife started to take the history, found that she had cystic fibrosis and has asked you to see her.
The midwife has taken a general, family and social history. She has not found any major issues apart from her age, she is 17 years old, and her BMI, which is 20 kg/m2. Your tasks are to take a history relevant to the CF and advise about management.
37.  Viva. Waiting list prioritisation.
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:
confirm the appropriateness of the proposed treatment,
decide the degree of urgency,
confirm the appropriateness of the proposed venue,
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.



38.  Roleplay. Teach a FY1 about shoulder dystocia.
Candidate’s instructions
It is a quiet day on the labour ward. You are working alongside a new FY1. There was a case of shoulder dystocia on her last labour ward on-call and she had very little idea of what was going on. She asked the consultant about the management and she has asked you to teach the FY1 the basics.
39.  Viva. HPV vaccination.
Candidate’s instructions.
This is a viva station about the UK programme for routine HPV immunisation.
The examiner will ask you 18 questions.
When you have finished a question, you will not be allowed to return to it as later questions may indicate earlier answer. If you return, no marks will be awarded, even for correct answers.
40.  Viva. Whooping cough & pregnancy.
Candidate’s instructions.

The examiner will ask you 4 questions about pertussis and pregnancy.

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