Tutorial.
Website.
Contact us.
This was the last tutorial before the written exam: next week is for last-minute-revision.
We usually re-start on the Monday after the exam, which will be Monday 11th. March.
I'll e-mail nearer the time.
It is important to start your OSCE practice straight away as there is a lot to do.
Don't leave it until the results of the written are published.
We managed 4 essay topics, bringing the total to 81.
We usually find that at least half of the SAQs have been covered in the tutorials.
We also managed an EMQ.
The subject matter may seem a bit specialist, but the questions are based on things that people have remembered from the exam.
With regard to
uterine rupture:
1. how is uterine rupture graded? 2
marks
2. critically evaluate the risk factors for uterine
rupture. 6 marks
3. critically evaluate the diagnosis of uterine
rupture. 6 marks
4. outline the management. 6 marks
You see a
25-year-old primigravida at 30 weeks’ gestation in the antenatal clinic after
referral by the community midwife who feels that the uterus is large-for-dates.
1. Justify your immediate management. 6
marks.
2. Justify the management of the remainder of the
pregnancy. 4 marks
3. Justify the management of the delivery. 6 marks
4. Justify the advice you will give post-delivery. 4 marks
A 53-year-old
woman is referred by her GP. She wishes to discuss HRT. She is recovering well
from treatment for endometrial cancer.
1. Outline the history you will take. 4 marks
2. Justify the investigations you will arrange. 2
marks
3. Critically evaluate your management. 14 marks
A 35 year-old
woman books at 6 weeks. She has noted a left breast mass. Breast cancer is
suspected.
1. What is the life-time risk of female breast
cancer. 1 mark.
2. How does pregnancy affect the risks of breast
cancer. 4 marks.
3. Outline the investigation. 5 marks.
4. Critically evaluate the management. 10 marks.
Lead-in.
The following
scenarios relate to vulval conditions.
Choose the most
likely vulval condition from the option list.
Each option can
be used once, more than once or not at all.
Scenario 1.
A 22
year-old woman attends the colposcopy clinic after 2 smears showing minor
atypia. The cervical appearances are of aceto-white with punctation.
Scenario 2.
A
60-year old woman has an erythematous rash of the vulva extending to the inner
thighs. A similar rash is noted under the breasts. She is not known to have
diabetes.
Scenario 3.
A
woman attends the gynaecology clinic with a vulval rash. It has a “lacy”
appearance.
Scenario 4.
A
35-year old woman attends is noted to have a vulval fistula. She has a history
of episodic diarrhoea.
Scenario 5.
A
25-year old woman attends the gynaecology clinic with a history of intense
vulval itching and soreness. The appearances are of diffuse erythema with
excoriation. Diabetes, candidiasis and other local infections have been
eliminated by the GP.
Scenario 6.
A 35-year
old woman attends the gynaecology clinic with vulvitis. She also has a scalp
rash. Clinical examination shows scaly, pink patches with signs of excoriation.
Skin samples grow Malassezia ovalis.
Scenario 7.
A
40-year old woman has evidence of chronic vulval ulceration. She has recently
been seen by a dermatologist for mouth ulceration and has been started on
thalidomide.
Scenario 8.
An
African woman of 35 years attends the gynaecology clinic. She has a ten-year
history of chronic vulval ulceration. Examination shows multiple, tender vulval
and pubic subcutaneous nodules, some of which have ulcerated.
Scenario 9.
A
Caucasian woman of 29 years attends the gynaecology clinic with a chronic
vulval rash. Examination shows erythematous areas with clearly defined margins
and white scaly patches.
Scenario 10.
A 30-year
old woman attends the gynaecology clinic with vulval itching. Examination shows
erythema of the labia minora and perineum. Full-thickness biopsy shows abnormal
cell maturation throughout the epithelium with increased mitotic activity.
Option list.
A.
|
Acne.
|
B.
|
Behçet’s syndrome.
|
C.
|
Candidiasis.
|
D.
|
CIN 3
|
E.
|
CIN1
|
F.
|
Crohn’s disease.
|
G.
|
Dermatitis.
|
H.
|
Eczema.
|
I.
|
Genital warts.
|
J.
|
Hidradenitis suppurativa.
|
K.
|
Leprosy.
|
L.
|
Lichen planus
|
M.
|
Lichen sclerosis
|
N.
|
Lymphogranuloma venereum
|
O.
|
Normal skin.
|
P.
|
Psoriasis.
|
Q.
|
Seborrhoeic dermatitis.
|
R.
|
Type 1 diabetes mellitus
|
S.
|
Type 2 diabetes mellitus
|
T.
|
Ulcerative colitis.
|
U.
|
VIN III.
|
