Obstetric Uterotonics, Perioperative Endocrine Pharmacology, and Antimicrobial Stewardship — WACS Viva & Clinical Scenarios (Pharmacology and Applied Pharmacology)

Exam-style obstetric uterotonics, perioperative endocrine pharmacology, and antimicrobial stewardship viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: Following delivery of the placenta during a Caesarean section for twin gestation under spinal anaesthesia, the uterus remains atonic with heavy vaginal bleeding. The patient's blood pressure is 88/50 mmHg. Detail your pharmacological cascade of uterotonic agents, including dosages, routes, hemodynamic contraindications, and rationale.
• SCENARIO 2: A 22-year-old primigravida at 36 weeks gestation presents with eclamptic convulsions and blood pressure 180/115 mmHg. Detail the pharmacological protocol for seizure termination and recurrence prevention using Magnesium Sulphate, and describe your monitoring for clinical toxicity.
• SCENARIO 3: A 58-year-old diabetic male on long-term oral hypoglycaemics presents for an emergency 4-hour laparotomy for acute peritonitis. His random blood glucose is 18.5 mmol/L. Formulate your perioperative insulin regimen, target blood glucose range, and potassium management.
• SCENARIO 4: A 40-year-old female taking 20 mg oral prednisolone daily for systemic lupus erythematosus presents for total abdominal hysterectomy. Formulate an evidence-based perioperative steroid replacement protocol and justify your dosing schedule.