14
|
Viva.
Hydatidiform
mole. Genetics.
|
15
|
Viva. Laboratory
results
|
16
|
Viva. Breastfeeding
|
17
|
Roleplay. Teach breech delivery to new
trainee
|
18
|
Roleplay. Pre-pregnancy counselling.
Phenylketonuria
|
14. Viva.
Hydatidiform mole.
Candidate’s instructions.
This is a viva. Tell the
examiner what you know about the genetics of hydatidiform mole & placental
site trophoblastic tumour. The examiner will just listen and not guide you in
any way.
15. Viva.
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.
|
16. Viva.
Breastfeeding.
Candidate’s instructions.
This is a viva station.
The examiner will ask you 7 questions.
17. Roleplay. Teach breech delivery to new trainee .
Candidate’s instructions.
You are the SpR on call for the delivery unit. It is
still unusually quiet. The on-call consultant has been told that you did a
brilliant job of explaining normal labour and delivery. She has asked you to
explain vaginal breech delivery to a new FY2, who is keen on a career in
O&G.
18. 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.
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