|
29 |
Role-play. Freebirth. |
|
Structured discussion. The
uses of MgSO4 in O&G |
|
|
31 |
Blurb. Autosomal recessive condition |
|
32 |
EMQ. The MAGPIE trial |
|
33 |
EMQ. Brexanolone |
29. Role-play. Freebirth.
Candidate’s instructions.
You are an SpR5 in charge of the antenatal clinic as the
consultant is on sick leave. Ms Jones has attended the booking clinic but the
midwives don’t know what to do with her as she does not wish to be booked. They
have asked you to see her. Your tasks are to deal with her as you would in real
life.
GP letter.
The Health Centre,
Utopia-on-Sea.
Re Helen Jones,
287 Main Street,
Utopia-on-Sea.
Dear Doctor,
Ms Jones has an appointment in the booking clinic when
she will be about 10 weeks advanced in her first pregnancy. She intends to have
no medical or midwifery care during the pregnancy or labour and delivery,
planning what she calls ‘free birth’ after reading newspaper reports about the
dangers of maternity hospitals. I have not come across ‘free birth’ before and
plan to speak to my medical defence body about the implications for the medical
and midwifery staff at the Health Centre.
Ms. Jones wishes to attend the booking clinic, but not to
book! Her wishes are to arrange screening for Down’s syndrome and she would
like to have a 20-week scan to check the baby looks normal, but does not want
any other involvement with the maternity department or its staff.
She is an intelligent and articulate young woman with no
significant health record. Her only dealings with the Health Centre have been
to have cervical smears, which have been normal, prescriptions for the Pill and
treatment a couple of years ago for a badly-sprained ankle.
I shall be most appreciative of your advice in this
matter. I have asked her to return to see me and the midwife after the hospital
visit so that we can clarify what we can do to help her and our
responsibilities in this matter, which, I am sure are going to cause the
professionals with whom she has dealings a lot of head-scratching.
John Williams. FRCGP.
30. Structured discussion. The uses of MgSO4
in O&G.
Candidate’s instructions.
This is a structured discussion about the uses of MgSO4
in O&G, but it is an extreme example. The examiner will not ask questions,
prompt or otherwise assist. It is up to you to give as full an account of the
uses as you can muster.
31. Blurb. Autosomal recessive condition.
Discussion of the key facts to include in this blurb and its
possible wording.
32. The MAGPIE trial.
It is useful to have the basic facts to show how smart you
are in a viva.
Question 1.
Which of the following is true of the Magpie
trial?
Option list.
|
A |
it compared
MgSO4 with placebo in the management of eclampsia / severe PET |
|
B |
it compared
MgSO4 with lytic cocktail in the management of eclampsia / severe
PET |
|
C |
it compared
MgSO4 with phenytoin in the management of eclampsia / severe PET |
|
D |
it compared
MgSO4 with alcohol in the management of threatened premature
labour |
|
E |
it compared
MgSO4 with atosiban in the management of threatened premature
labour |
|
F |
it compared
MgSO4 with ritodrine in the management of threatened premature
labour |
|
G |
it compared
MgSO4 with dexamethasone in the prevention of cerebral palsy due
to extreme prematurity |
|
H |
it compared
MgSO4 with placebo in the prevention of cerebral palsy due to
extreme prematurity |
|
I |
none of the
above |
Question
2. Which
if any of the following are true of the Magpie trial?
Option list.
|
A |
it involved ~ 1,000 women |
|
B |
it involved ~ 10,000 women |
|
C |
it involved ~ 20,000 women |
|
C |
it involved > 20,000 women |
|
D |
it involved ~ 30 hospitals |
|
E |
it involved ~ 50 hospitals |
|
F |
it involved ~ 80 hospitals |
|
G |
it involved > 150 hospitals |
|
H |
it involved 5 countries |
|
I |
it involved 10 countries |
|
J |
it involved 20 countries |
|
K |
it involved 30 countries |
|
L |
it involved 50 countries |
|
M |
it involved >50 countries |
Question
3. Which
if any of the following are true?
Option list.
|
A |
almost 50% of the women were in Africa |
|
B |
almost 50% of the women were in America |
|
C |
almost 50% of the women were in Asia |
|
D |
almost 50% of the women were in Australia / New Zealand |
|
E |
almost 50% of the women were in Europe |
Question
4. Which,
if any, of the following is true of the Magpie trial?
Option list.
|
A |
cerebral palsy rates at 2 years were ↓ by the use of MgSO4
in babies born < 34 weeks |
|
B |
cerebral palsy rates at 2 years were unchanged by the use of MgSO4 in babies
born < 34 week |
|
C |
eclampsia rates were reduced by about half by the use
of MgSO4 |
|
D |
eclampsia rates were reduced by about half by the use
of MgSO4 but only in underdeveloped countries |
|
E |
maternal mortality was significantly ↓ by the use of
MgSO4 |
|
F |
maternal mortality was significantly ↓ by the use of
MgSO4, but only in underdeveloped countries |
|
G |
premature delivery was significantly ↓ by the use of
MgSO4 |
|
H |
perinatal mortality from prematurity was significantly
↓ by the use of MgSO4 |
33. Brexanolone.
Abbreviations.
GABAA: γ-aminobutyric acid type A.
Scenario 1.
Which, if any, of
the following statements are true?
Option list.
|
A |
Brexanolone it is a water soluble form of
allopregnanolone |
|
B |
allopregnanolone is an oestrogen metabolite and levels
mirror those of oestrogen |
|
C |
allopregnanolone is a potent modulator of GABAA receptors in the brain |
|
D |
brexanolone is effective in the treatment of postpartum
depression |
|
E |
brexanolone is administered orally |
|
F |
brexanolone is licensed for use in the UK |
