Tutorial 18th. October 2021

 

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19	Role-play. Anencephaly
20	Role-play. Teach an FY1 the basics of audit.
21	Structured discussion. Coroners & Medical Examiners
22	MCQ. Folic acid fortification of flour

 

19.      Role-play 1. Candidate’s instructions.

You are an SpR5 and running the ante-natal clinic – your consultant has been called to help a consultant colleague with an emergency on the labour unit and is not available for advice.

You are about to see Jean Hathersage. She is 25 years old and had a 10-week scan last week that showed anencephaly. She stated that she did not want TOP. She was counselled, given information leaflets and asked to return to the antenatal clinical today for further discussion. Conduct that discussion.

20.      Role-play 2. Candidate’s instructions.

You are the SpR on call for the labour ward. It is a quiet afternoon: all the patients are healthy and in normal labour. Dr. Jane Jones has started in the department as a new FY1. She is keen to specialise in O&G and has already passed the Part 1 examination. A measure of her enthusiasm is that she has asked her consultant if she can be involved in doing an audit, but she is aware that she knows little about it. Her consultant is the consultant on duty for the labour ward and has asked you to ensure that she has enough knowledge to be a useful member of a team conducting an audit.

21.      Structured discussion. Coroners & Medical Examiners.

Candidate’s instructions.

This is a structured discussion. The examiner will ask you 7 questions.

22.      MCQ. Folic acid supplementation of flour.

This is a topical subject. These MCQs were written many years ago and last updated in 2007. I have updated them so that you have all the key facts.

Answer ‘true’ or ‘false’ for each statement.

MCQ Paper 2. Question 13. Neural Tube Defect.

a.  has uniform geographical spread.

b.  occurs in one pregnancy in 200.

c.   the risk of recurrence is 10% after an affected pregnancy.

d.  is more common after maternal consumption of sodium valproate.

e.  is more common in the white than the black population.

f.   is prevented by pre and early pregnancy folic acid.

g.  is suggested by the pineapple sign.

MCQ Paper 7. Question 23. Folic acid & pregnancy.

a.  the dosage for routine prophylaxis of neural tube defect is 0.4 mg. daily.

b.  the dosage for prophylaxis for patients with spina bifida or who have had a pregnancy affected by neural tube defect is 5mg. daily.

c.   folic acid reduces the risk of neural tube defect by more than 70%.

d.  folic acid and anti-epilepsy drugs may interact adversely.

e.  folic acid reduces the risk of placental abruption.

f.   folic acid can provoke sub-acute combined degeneration of the cord.

g.  fortification of flour with folic acid was introduced in the USA in 1998.

h.  fortification of flour with folic acid in the USA has been linked to a 50% reduction in the incidence of neural tube defects.

i.   fortification of flour with folic acid was introduced in the UK in 2005.