Higher Specialist Diploma

Virology

Examination 2016

Paper 4

Seen Case Study

1. This seen case study will be the first question in the case studies examination.

2. There will be a further two unseen case studies in the examination.

3. Candidates should note that whilst they should spend time between the publication of the case study and the examination preparing their responses they are not permitted to take any prepared answers into the examination room.

HSD in Virology Paper 4 FINAL Seen case study

1. Your department (a large teaching hospital Virology service covering several Trusts) is contacted by the clinical lead of the GUM clinic on another acute hospital site. Clinicians there wish to introduce routine use of a Point of Care Test (POCT) for detection of syphilis infection, to be performed by nursing staff. Your department asks you to arrange a visit to the clinic to discuss this request, and to give a presentation outlining important points to consider, and to suggest appropriate action. a. Discuss all of the factors to be taken into consideration in implementing this plan, highlighting what you think are the most important “take home” messages and outlining what you would cover in your presentation.

(50 marks) b. Outline the most important considerations in selecting the POCT to use, and what you consider a safe testing and confirmatory algorithm.

(30 marks) c. Assume that the assay you recommend has a sensitivity and specificity of 99.5%. Comment on what this means in terms of results. Comment on the predictive value of a repeatable reactive sample if the population prevalence of syphilis in clinic patients is:

i. 0.1%

ii. 5%

(20 marks)

HSD in Virology Paper 4 FINAL