TEALE FENNING

Nick Raine-Fenning · Posted: Wed Jul 15, 2009 2:15 pm Post subject: RCOG March 2009 Essays

We had very few comments and minimal feedback from the March 2009 exam.

I wonder if any of you recall the questions or have a copy of them (often sent if unsuccessful).

We had a very brief discussion here

Any recollection of EMQs and MCQs also appreciated.

N

Laura · Joined: 07 Feb 2009 Posts: 1 Location: Poole, Dorset

Here are the essays from March 2009...

(1) A 23 year old woman is admitted from the antenatal clinic with confirmed blood pressure of 150/115 mmHg and 2+ proteinuria at 28 weeks gestation.
A. Describe your initial assessment of the patient. [9 marks]
B. Discuss which drugs you would use, and indicate when and how you would initiate drug therapy. [11 marks]

(2) A 22 year old woman who had a renal transplant 12 months ago wishes to conceive.
A. Discuss the factors, related to her renal transplant, which indicate a good outcome in a future pregnancy. [10 marks]
B. Discuss, and justify, any additional monitoring you would undertake in the antenatal period. [10 marks]

(3) A woman unbooked in her third pregnancy is found to have a significantly raised Anti Rhesus D level at 30 weeks gestation.
A. Discuss the assessments that should be performed to determine the risk to the fetus, and their place in current obstetric management. [14 marks]
B. If you consider the fetus may be anaemic what management options can be considered? [6 marks]

(4) A low risk woman in advanced labour requires delivery for failure to progress.
A. Describe the prerequisites for safe operative vaginal birth. [9 marks]
B. Discuss the other factors to take into consideration when performing an operative vaginal birth. [6 marks]
C. Describe the situations where there is a higher rate of failure with operative vaginal birth. [5 marks]

(5) A 16 year old with normal growth, BMI and secondary sexual characteristics attends the gynaecology clinic with a history of primary amenorrhoea and cyclical lower abdominal pain. An endocrine profile, including FSH, LH, prolactin, testosterone and thyroid function tests, is reported as normal.
A. Discuss what additional information from the history and examination is helpful in establishing a diagnosis. [8 marks]
B. Discuss the differential diagnosis. [5 marks]
C. Justify which further investigations you would perform to establish the diagnosis, and outline the principles of management. [7 marks]

(6) A 19 year old sexually active single nulliparous woman with frequent severe migraine presents with a request for reliable long-acting contraception.
A. Describe the methods of long-acting reversible contraception (LARC) available. [4 marks]
B. Discuss the general [4 marks] and specific [12 marks] advantages and disadvantages of the various LARC methods with particular reference to this woman.

(7) A 38 year old woman presents with vaginal bleeding at 8 weeks gestation. An ultrasound scan suggests a likely complete molar pregnancy.
A. Discuss your clinical management, including how you would counsel the patient. [10 marks]
Four months after the initial diagnosis she has persistent vaginal bleeding and a rising BhCG.
B. Discuss the principles of her further management and outline what additional investigations are required. [10 marks]

( Cool

Menorrhagia and dysmenorrhoea can be managed medically.
A. Discuss when women should be referred for hospital specialist intervention. [7 marks]
B. Discuss which factors influence the treatments that you would offer, and their success. [13 marks]

I've completely forgotten the MCQs and EMQs apart from the gist of a particularly nasty EMQ whose stem was something to do with amenorrhoea and each stem gave a different set of biochemical results from which to make the diagnosis (e.g. pregnancy, sheehans, POF, ovarian tumour, etc).

Hope that helps.
_________________
Is it nearly over yet?!@*