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Xerxes I
Century Club
Joined: 01 Mar 2007
Posts: 228
Location: Winchester
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 Posted: Wed Sep 03, 2008 12:21 pm Post subject: Most informative test |
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Pick the most informative test under the following scenarios:
A Intracervical swab
B Transvaginal ultrasound
C Serum beta hCG
D Serum anticlamydial Ab's
E MSU; M,C,&S
F Laparoscopy
G Laparotomy
H Colonoscopy
I Urethral swab
... other options?
Question 1:
18 year old, right iliac fossa pain. Apyrexial. reports vaginal discharge. had periods 2 days ago and was normal.
Question 2:
18 year old, pyrexial, WCC 18 I think, may be high CRP too, I think LIF pain, may be even cervical excitation. Periods started today, still on her periods.
Sorry for being so vague. Please change the wording if you remember better. |
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Maud
Joined: 11 Oct 2007
Posts: 73
Location: Bristol
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| Posted: Wed Sep 03, 2008 4:19 pm Post subject: Re: Most informative test |
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| Xerxes I wrote: |
1. 18 year old, right iliac fossa pain. Apyrexic. reports vaginal discharge. had periods 2 days ago and was normal.
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She had abdo pain for 5 days. |
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rpwalavalkar
Teale Fenning Administrator
Joined: 20 Jul 2006
Posts: 966
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| Posted: Wed Sep 03, 2008 4:31 pm Post subject: |
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anyone remember more options??
r
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Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region |
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docsubhi
Joined: 03 Sep 2007
Posts: 59
Location: london
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| Posted: Wed Sep 03, 2008 11:35 pm Post subject: Re: Most informative test |
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| Xerxes I wrote: |
1. 18 year old, right iliac fossa pain. Apyrexic. reports vaginal discharge. had periods 2 days ago and was normal.
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The first stem in the "important test" EMQ went on the lines of a young girl with right hypochondrial pain
Last edited by docsubhi on Thu Sep 04, 2008 10:59 am; edited 1 time in total |
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juliprakash
Joined: 08 May 2008
Posts: 29
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| Posted: Thu Sep 04, 2008 3:32 am Post subject: |
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OPTIONS include endocervical swab,urethral swabs.
1QN is it not Fitz Hugh curtis syndrome causin right hypochondrial pain
ans may be endocervical swab to detect both chlamydia and gonorrhea which cause the syndrome.Can anyone discuss,
2.Patient is pyrexic,WBC raised,intermittent lower abdominal pain has become constant,no urinary symptoms. Had normal periods 5 days back.NO WORD ON VAGINAL DISCHARGE.So may be ovarian torsion or PID,but in view of temperature canwe go for PID -and answer as swab test |
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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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| Posted: Thu Sep 04, 2008 6:43 am Post subject: |
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Options :
. serum anticlamydial ab
. MSU -C&S
. laparoscope
. laparotomy
. colonoscopy |
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drmmanish@yahoo.co.in
Joined: 05 Mar 2008
Posts: 42
Location: UK
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| Posted: Thu Sep 04, 2008 7:48 am Post subject: |
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i think with the rt hypochondrial pain there were other features s/o PID. also the question asks most informative test and if I thought in this case it would be Laparoscopy to r/o perihepatic adhesions. swabs are not most informative
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manish |
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1852
Location: Nottingham
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| Posted: Sat Sep 06, 2008 8:09 am Post subject: |
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I've updated the options - please check and confirm.
We need more info in these questions as there is insufficient data to make a call. From what I have heard PID is the most likely so yes laparoscopy or endocervical swab the best answer.
I would go through these options and ignore the question. For instance when could chlamydia antibodies be right? Not sure ever in this situation.
Be very careful when not putting serum hCG - this would be my default answer for all questions and I would force myself to not put it. Always be safe. They seem to think the same thing which is why they are giving info on periods.
Was urine hCG an option? |
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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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| Posted: Sat Sep 13, 2008 8:29 pm Post subject: |
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I don't think it was an option.
which is the most appropriate answer : serum antichlamydial Ab or laparoscopy ? it is obviously Fitz Hug Curtiz syndrome which is systemic compl. of chlamydia. 
Only need to know : Does this type of distractors enable the royal college of better candidates assessment ?
It is funy to select between laparoscopy and serumAB ?
a joke that cost us a trial.   |
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