30 March 2017
10.
|
Role-play.
Primigravida.
8 weeks. Some bleeding.
Scan = IUP. CRL = 12 mm. No fetal heart activity.
Counsel.
|
11.
|
Viva.
Critique
of Menozac website
|
12.
|
Viva. Laboratory results
|
13.
|
Roleplay.
PMB
|
10. Role-play. Bleeding
in early pregnancy.
Candidate's Instructions.
This is a
role-play station. The role-player will act as the patient. An examiner will be
present.
You are the SpR
in the ante-natal clinic. The Consultant who was in clinic has been asked to
assist her Consultant colleague in the labour ward theatre. She is unlikely to
return for some time as the case is one of massive PPH and hysterectomy may be
necessary.
One of the
midwives asks you to see a patient who has just had a scan in the EPU.
She is
primigravid and the gestation is 8 weeks. She has had some bleeding.
An ultrasound
scan = IUP. CRL = 12 mm. No fetal heart activity. No adnexal masses.
11. Critique of website.
Your task is to read
the extract from the Menozac website, prepare a critique and present it to the examiner.
The examiner will not prompt or help you in any way.
12. Laboratory results.
Candidate’s instructions.
Your consultant
is on annual leave.
Her secretary has
asked you to look through the following results and decide what administrative
action should be taken in relation to each.
1
|
+ve MSSU at
booking. No symptoms.
|
2
|
GTT at 34
weeks. Peak level 11.5.
|
3
|
FBC with MCV at booking.
|
4
|
Thrombocytopenia
at booking. 50,000.
|
5
|
Hydatidiform
mole after evacuation of suspected miscarriage.
|
6
|
Histology after
ERPC for incomplete miscarriage: no trophoblastic tissue.
|
7
|
Endometrial
cancer: hysteroscopy: thickened endometrium. Histology: Anaplastic
malignancy.
|
8
|
Endometrial
cancer: MR scan: reaching serosa and upper endocervical canal.
|
9
|
Consultant does
lap drainage of normal looking ovarian cyst. Malignant cells. Nulliparous.
Wants children.
|
10
|
HVS:
trichomonas.
|
11
|
Clue cells on
smear. 12/52 pregnant.
|
12
|
Antenatal
discharge: endocervical swab: chlamydia
|
13
|
Actinomyces on
smear.
|
14
|
Herpes in
pregnancy
|
15
|
Severe
dyskaryosis on cervical smear at booking.
|
16
|
Primary infertility:
FSH & LH at 25 on day 3 of cycle.
|
17
|
Primary
infertility. FSH 3, LH 12 on day 3 of cycle.
|
18
|
Treated with
cabergoline for prolactin and pituitary
adenoma. +ve beta HCG.
|
19
|
3 cm. ovarian
cyst. Ca 125.
|
13. Roleplay. PMB.
Candidate’s Instructions.
You are an SpR in
the “one-stop” PMB clinic. You are about to see a woman with bleeding some
years since her menopause.
A 55 year old
woman is referred by her General Practitioner.
Your task is to
take an appropriate history and advise her about the investigations you feel
are appropriate and why.
Referral letter
from the General Practitioner.
Manor Lodge,
High Street,
Bestown.
BE5 S00
Re: Mrs. Mary
Smith, Age 55.
5b High Street,
Bestown.
BE5 SO1
Dear Doctor,
Please see Mrs. Smith
who has had bleeding down below. It is a number of years since she reached the
menopause.
Yours sincerely,
James Fewords,
General
Practitioner.
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