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What does "Speculum - NAD" mean?

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Just wanted to check that oligospermia is defined as less than 15 million per ml of semen? It wasn't stated in the resource but that is what I found when looking it up

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Hi there, I was just wondering why occupation is listed as a male specific question in the infertility history?
Are there specific jobs we should be aware of?

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Just to check, is it only surgical abortions that require antibiotic prophylaxis (with metronidazole if negative for STIs) or do medical abortions require antibiotic prophylaxis too?

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Just trying to clarify is 1st line treatment Doxy, Metronidazole and IM ceftriaxone or ofloxacin and metronidazole?
NICE says one whilst the eLFH the other

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In a woman with severe asthma, would you give nifedipine/ methyldopa to treat the hypertension?

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In delta cOGText it mentions that the criteria for IOL include: 1.Prolonged pregnancy (an excess of 42 weeks gestation), 2.Pre-eclampsia, 3. Placental insufficiency and intrauterine growth restriction, 4. Antepartum haemorrhage: placental abruption and antepartum haemorrhage of uncertain origin, 5. Rhesus isoimmunization, 6. Diabetes mellitus, 7. Chronic renal disease.

But would you not do an IOL if there is a preterm prelabour ROM/ if there is a prolonged first stage of labour? If so how long should the labour be prolonged for IOL to be considered?

Thank you!

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Would it be possible to email us any timetable changes rather than just update it on medblogs. It's quite stressful keeping up to date and ensuring we dont miss any sessions

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Hello, I was wondering about the definitions for oligo/polyhydramnios - am I correct in thinking that the normal DVP length is 2-8 - is and is this measurement specific to a gestational age?

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Could this please be uploaded online.

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When will we be required to submit our evidence, would it be ok to submit this at the end of the 4 weeks so does it have to be at the end of the week 2?

Also, are we required to meet all the outcomes when submitting the evidence document?

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Would performing a D+C in the investigation of endometrial cancer not increase the risk of seeding the cancer in the peritoneal cavity? Is there specific circumstances you would use D+C over pipelle biopsy for example?

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In a patient who was imminently going to start trying for a family (eg. within the year), would you go straight to antifibronolytics to manage problematic menorrhagia?

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Patient 2.
Initially with this patient presented a diagnosis of Pregnancy of Unknown Location is made and she is sent home with safety netting advice. she then represents with a ruptured ectopic pregnancy and is rushed to emergency theatre. I just wanted to clarify, is this what happens in reality or do you investigate for an ectopic pregnancy and intervene/discuss TOP early rather that waiting to see if she gets worse?

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Hi, when removing a Fallopian tube due to ruptured ectopic, would you spare the ipsilateral ovary? And if you do, does this not increase the risk of an abdominal ectopic pregnancy?

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Hi there,

For the POP, is the window for the missed pill 3h or 12h?  As I have seen conflicting advice.

Thanks!

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Hi there,
After patient has a miscarriage or elected to have a TOP, how long does it take for the HCG levels to normalise?  And is this effected by the gestation that this occurs at?
Thank you!

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Would you only give corticosteroids in PTL for 24-33+6w? Or is there a role for them in >34w? Also what is the steroid of choice? Thank you!

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Would you still do further investigations  (e.g. LFT,  viral screen) and regular monitoring in itch WITH rash or would you assume it was a polymorphic eruption and take no further action? Thanks!

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In one of the formative questions there is mention of forceps delivery under pudendal or spinal anesthesia- how would you choose between the two?

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It says in formative "All women screened for HPV routinely every 5 years, stopping aged 64" I thought women have 3 yearly screens up to 50 years then 5 yearly screens until 64?

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Are there answers for the perinatal infections quiz?

Thanks :)

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In the formative test  there is a question about a initial investigations to perform in a women with suspected pre-eclampsia (headache, visual changes, BP155/105 2+ protein on urinalysis) to assess severity. The answer was FBC, LFT, urine PCR. I was wondering why urate and U&Es would not be used to assess kidney function? Thank you!

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Legal and Safeguarding Issues Regarding FGM in the UK e-LfH

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Legal and Safeguarding Issues Regarding FGM in the UK e-LfH

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Page 13 says that practitioners are required to ask the patient or guardian to consent to adding an FGM risk indicator tab on their medical records in cases where a family history of FGM has been identified, but how does this safeguard when the guardian could just refuse?

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Obviously people should optimise their weight before falling pregnant, but if someone is already pregnant and obese do you then counsel them to lose weight during the pregnancy? If so, what advice should you give?

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Patient 10 in the obstetric clinic - When doing dopplers of the middle cerebral artery due risk of foetal anaemia are you just checking to ensure there is not low resistance flow? If there were pathological findings on the MCA doppler how would this be managed?

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Patient 7's labour plan states C-section is not done until >39 weeks due to association with "leaning needs" what is meant by this?

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For Bed 4 in the virtual ward round (para 3 elective c-section for placenta praevia 3 days ago now reporting right calf pain) what would be the calculation for treatment dose of fragmin in the BNF, treatment of VTE in pregnancy or treatment of DVT?

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I might be being stupid but in the answers section for patient 1 it says "helps in establishing if FSH high signifies spermatogenesis failure". Is this just saying that males with high FSH have infertility due to spermatogenesis failure or is it saying you need the hormone profile to decide if the high FSH is responsible for the infertility?

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It says in the powerpoint: "Assist the woman into a comfortable position, being upright or on all fours is ideal". Why are these positions preferred over lying on back (this is what I instinctively would thought)

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It says in the emergency SVD powerpoint that most babies respond to rescue breaths within 30 seconds, do you do the rescue breaths for 30 seconds in total then reassess? And if no response despite seeing chest movements - you move to chest compressions and rescue breath in ratio to 3:1?

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Are all Rh-ve women offered routine Anti-D prophylaxis or is anti-d only given if they have had a sensitizing event and the fetus is Rh+ve?

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If in breech position at 36 weeks or later but presenting cephalically at birth, why does the risk of developmental dysplasia of the hip remain?

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I read in the email that we are expected to upload a document to show that we have done our eLearning. I was just wondering, is there any examples of such a document? Or could it be as simple as adding a column to the curriculum document indicating we have done it? Thank you!

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Are GNRH agonists first line for uterine fibroids? And are they ever given in oral form or only IM/ SC?
Women with fibroids are at risk of complications during pregnancy, therefore is it common practice to try and surgically or medically manage fibroids prior to conception?

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Where can we find information regarding the formative OSCE stations? How do we work through these?

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What is the maximum gestation and minimum age that a patient needs to be for EMAH? The virtual clinic scenarios mentioned 9+6 weeks and age 16, however other guidelines state maximum of 9 weeks and 18 years of age
Cheers

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Is it sufficient to collate certificates etc from the proposed activities outlined in the guide to illustrate our e-learning?