14th. December 2015.
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23
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EMQ. Cystic fibrosis.
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24
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EMQ. Parvovirus &
pregnancy
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25
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EMQ. Drugs in O&G 1
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26
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EMQ. Drugs in O&G 2
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27
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Communication skills.
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23. EMQ. Cystic fibrosis.
I know that we covered
this in the previous tutorial. But there was no podcast due to malfunction of
the software I use to record the tutorials. That is now sorted out. There are
sure to be questions about CF and I think it is sometimes easier to understand
after listening to a discussion than by wading through written explanations.
And it is such an important topic that repetition will do no harm.
For each
scenario choose the option that gives the best answer.
Each option can
be used once, more than once or not at all.
And, to make you behave in a model fashion,
there is no option list, so you have to decide the correct answer.
Scenario 1.
A woman is 8 weeks pregnant
and known to be a carrier of cystic fibrosis.
Her husband is Caucasian.
What is the risk of the
child having cystic fibrosis?
Scenario 2.
A healthy woman attends for
pre-pregnancy counselling.
Her brother has cystic
fibrosis. Her husband is Caucasian.
He has been screened for
cystic fibrosis. The test was negative.
What is the risk of them
having a child with cystic fibrosis?
Scenario 3.
A healthy woman is a known
carrier of cystic fibrosis.
She attends for
pre-pregnancy counselling. Her husband has cystic fibrosis.
What is the risk of them
having a child with CF?
Scenario 4.
A healthy woman
attends for pre-pregnancy counselling. Her sister has had a child with cystic
fibrosis.
What is her
risk of being a carrier?
Scenario 5.
A woman attends for
pre-pregnancy counselling. Her mother has cystic fibrosis.
What is the risk that she
is a carrier?
Scenario 6 .
A woman attends for
pre-pregnancy counselling. Her mother has cystic fibrosis.
The partner’s risk of being
a carrier is 1 in X.
What is the risk that she
will have a child with CF?
Scenario 7.
A healthy Caucasian woman
is 10 weeks pregnant.
Her husband is a known
carrier of cystic fibrosis.
Which test would you
arrange?
Scenario 8.
A woman attends for
pre-pregnancy counselling. She has read about diagnosing CF using cffDNA from
maternal blood. Is it possible to test for CF in this way?
Scenario 9.
A woman and her husband are
known carriers of cystic fibrosis.
What is the risk of them
having an affected child.
Scenario 10.
A woman and her husband are
known carriers of cystic fibrosis.
What can they do to reduce
the risk of having an affected child?
Scenario 11.
A woman and her husband are
known carriers of cystic fibrosis.
Can CVS exclude an affected
pregnancy?
Scenario 12.
A woman with cystic
fibrosis is planning pregnancy. Her husband is a known carriers of cystic fibrosis. What is
the risk of having an affected child?
Scenario 13.
A woman with cystic
fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been
advised not to breastfeed because her breast milk will be protein-deficient due
to malabsorption.
Is this advice correct?
Scenario 14.
A woman with cystic
fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been
advised not to breastfeed because her breast milk will contain abnormally low
levels of sodium.
Is this advice correct?
24 EMQ.
Parvovirus & pregnancy
Lead-in.
The following scenarios relate to parvovirus infection
Pick one option from the option list.
Each option can be used once, more than once or not at
all.
Abbreviations.
PvB19: parvovirus
B19
PvIgG: parvovirus B19 IgG
PvIgM: parvovirus B19 IgM
Option list.
There is none: make up your own
answers!
Scenario 1.
What type of virus is
parvovirus?
Scenario 2.
Is the title B19 something to do with the American B19
bomber, its potentially devastating bomb load and the comparably devastating
consequences of the parvovirus on human erythroid cell precursors?
Scenario 3.
PVB19 in the UK occurs in mini-epidemics at 3 – 4 year
intervals, usually during the summer months.
Scenario 4.
Which animal acts as the main
reservoir for infection?
Scenario 5.
What percentage of UK adults are immune to parvovirus
infection?
Scenario 6.
What names are given to acute
infection in the human?
Scenario 7.
What is the incubation period for parvovirus infection?
Scenario 8
What is the duration of infectivity for parvovirus
infection?
Scenario 9.
What are the usual symptoms of parvovirus infection in
the adult?
Scenario 10.
What is the incidence of parvovirus infection in
pregnancy?
Scenario 11.
How is recent infection diagnosed?
Scenario 12.
How long does PvIgM persist and why is this important?
Scenario 13.
What is the rate of vertical transmission of parvovirus
infection?
Scenario 14.
Are women with parvovirus infection who are asymptomatic
less likely to pass the virus to their fetuses?
Scenario 15.
To what degree is parvovirus infection teratogenic?
Scenario 16.
What proportion of pregnancies infected with parvovirus
are lost?
Scenario 17.
What is the timescale for the onset of hydrops?
Scenario 18.
Laboratories are advised to retain bloods obtained at
booking for at least 2 years for possible future reference. True or false?
Scenario 19.
What ultrasound features would trigger consideration of
cordocentesis?
Scenario 20.
Must suspected parvovirus infection be notified to the
authorities? Yes or No.
Scenario 21.
Possible parvovirus infection
does not need to be investigated after 20 week’s gestation. True or false?
Scenario 22
If serum is sent to the
laboratory from a woman with a rash in pregnancy for screening for rubella, the
laboratory should automatically test for parvovirus infection too. True or false?
25. EMQ. Drugs
in O&G. 1.
Abbreviations.
ACE: angiotensin-converting
enzyme
ACEI: angiotensin-converting enzyme
inhibitor
ARA: angiotensin II receptor antagonist
HG: hyperemesis gravidarum
IUGR: intra-uterine growth retardation
LDA: low-dose aspirin
MAOI: monoamine oxidase inhibitor
Option list.
a)
False.
b)
True.
c)
5
d)
10
e)
15
f)
18
g)
20
h)
24
i)
contraindicated in the
months before pregnancy
j)
contraindicated in the
1st. trimester
k)
contraindicated in the
2nd. trimester
l)
contraindicated in the
3rd. trimester
m) contraindicated in all trimesters
n)
not contraindicated in
pregnancy
o)
contraindicated in
breastfeeding
p)
not contraindicated in
breastfeeding
q)
an acute, severe
illness like rheumatoid arthritis
r)
an acute, severe
illness with encephalopathy and acute fatty liver
s)
an acute, severe
illness with gastro-intestinal tract bleeding.
Scenario 1.
When are ACE inhibitors
contraindicated in pregnancy?
Scenario 2.
When are ARAs contraindicated
in pregnancy?
Scenario 3.
Can St. John’s Wort (SJW) be
used in pregnancy?
Scenario 4.
Methyl dopa is an acceptable
option for the treatment of gestational hypertension. True / False.
Scenario 5.
Spironolactone is
contraindicated in pregnancy. True/False
Scenario 6.
Furosemide is an acceptable
option in the management of gestational hypertension. True / False.
Scenario 7.
When are thiazide diuretics
contraindicated in pregnancy?
Scenario 8.
Salbutamol is contraindicated
for the management of premature labour. True / False.
Scenario 9.
Ergometrine is an integral part
of active management of the 3rd. stage. True / False.
Scenario 10.
When is aspirin contraindicated
in pregnancy & the puerperium?
Scenario 11.
When are NSAID’s
contraindicated in pregnancy and why?
Scenario 12.
Pethidine: adverse
neonatal effects are most likely if the drug is administered in the six hours
before birth.
Scenario 13.
Pethidine: what
is the half-life in the mature neonate?
Scenario 14.
Pethidine: is contraindicated in those taking MOAIs
or who have taken them in the previous 2 months.
Scenario 15.
Pethidine: is relatively contra-indicated when there is significant
blood loss.
Scenario 16.
Pethidine:
has
greater analgesic effect in labour than Diamorphine.
Scenario 17.
What
is Reye’s syndrome?
Scenario 18.
What
is “torsades de pointes” and when is it of importance in the management of HG?
26. EMQ. Drugs
in O&G. 2.
Option list.
I have not given one to make
you think! And, in the exam, you should be deciding your answer before you
check the option list.
Scenario 1.
What is the generic name for
Prostin?
Scenario 2.
What kind of drug is Prostin?
Scenario 3.
What is the generic name for
Misoprostol?
Scenario 4.
What kind of drug is Misoprostol?
Scenario 5.
What is the generic name for Gemeprost?
Scenario 6.
What kind of drug is Gemeprost?
Scenario 7
What is the generic name for
Mifepristone?
Scenario 8
What king of drug is
Mifepristone?
Scenario 9
What are the constituents of a
1 ml. ampoule of Syntometrine?
Scenario 10
What is the generic name for Carbetocin?
Scenario 11
What kind of drug is
Carbetocin?
Scenario 12
What is the generic name for
Hemabate?
Scenario 13
What kind of drug is Hemabate?
Scenario 14
What is the generic name for
Atosiban?
Scenario 15
What kind of drug is atosiban?
Scenario 16
What if the generic name for Cervagem?
Scenario 17
What kind of drug is Cervagem?
Scenarion 18
What is the cost of 1mg. of Prostin E2 gel and what are
its storage requirements?
Scenarion 19
What is the cost of a 1mg. Gemeprost pessary and what are
its storage requirements?
Scenarion 20
What is the cost of 200 mcg. of misoprostol and what are
its storage requirements?
27. EMQ. Lead-in.
Communication skills.
As a sign of gratitude for how my son was saved from cystic fibrosis , i decided to reach out to those still suffering from this.
ReplyDeleteMy son suffered cystic fibrosis in the year 2013 and it was really tough and heartbreaking for me because he was my all and the symptoms were terrible, he always have shortness of breath , and he always complain of burning in the chest . we tried various therapies prescribed by our neurologist but none could cure him. I searched for a cure and i saw a testimony by someone who was cured and so many other with similar body problem, and he left the contact of the doctor who had the cure to cystic fibrosis. I never imagined cystic fibrosis has a natural cure not until i contacted him and he assured me my son will be fine. I got the herbal medication he recommended and my son used it and in one months time he was fully okay even up till this moment he is so full of life.cystic fibrosis has a cure and it is a herbal cure contact the doctor for more info on drwilliams098675@gmail.com on how to get the medication. Thanks for reading my testimony.