Mid-term OSCE exam

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Mid-term OSCE exam Gyne 2 Group 33 1431
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1 ) comment on this picture , what is your dx .
? 2) Give to lap. Abnormality ? 3) Two causes
? 4) Give to fetal complications ?
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answer
1 ) macrosomic child in incubator .
2 ) hypoglycemia , hypocalcaemia , high bilirubin
level and hypomagnesaemia .
3 ) maternal obesity, gestational diabetes
mellitus, past history of macrosomic infant,
prolonged gestation, multiparity
4 ) shoulder dystocia and asphyxia
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1 ) whats your Dx.? 2) 2 mother complications
? 3) 2 fetal complications ? 4) What is the
more dangerous type ?
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answer
1 ) US showing multiple pregnancy.
2 ) - the risks of medical disorders are
increase ( DM , PET ) -
perinatal mortality ( 6 folds more ) - PPH
3 ) CP . - IUGR - TTTS
4 ) monochorionic
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1 ) whats this ? 2) How dose it form ? 3) 2
symptoms ? 4) The Rx ?
3
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answer
1 ) clue cells
2 ) epithelial cells covered with bacteria .
3 ) discharge , itching , dysuria and bad odor.
4 ) metronidazol or clindamycin 1 week
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colposcopy
1 ) what is the diagnosis ? 2) 2 symptoms ? 3) 2
indications for this procedure ? 4) whats the
management ?
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answer
1 ) cervical polyp .
2 ) postcoital bleeding and discharge .
3 ) Colposcopy see toronto notes - magnifies
surface structures of the vulva, vagina and
cervix - acetic acid wash applied to cervix to
detect abnormal cells . - Can take biopsy. - loop
electrosurgical excision procedure
4 ) polypectomy and histological conformation .
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1 ) whats is this ? 2) 2 symptoms other than
the symptoms in the Q ? 3) 2 medical treatment
? 4) 2 surgical treatment ?
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answer
1 ) 'powder-burn lesion. (Endometriosis)
2 ) Dysmenorrhea , Dyspareunia and Chronic
pelvic pain.
3 ) - COCPs - danazol - progestational
agents - GnRH analogs
4 ) Ablation - Semiconservative surgery - Radical
surgery
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1 ) whats this procedure ? 2) 2 indications
? 3) 2 complications ? 4) Alternative medical
Rx ?
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answer
1 ) Uterine Artery Embolization .
2 ) - Uterine Fibroid . - menorrhagia
- multiple health risks for surgery see NMS 266
3 ) - fibroid expulsion ( most common ) -
vaginal discharge - infection -
premature ovarian failure see NMS 266
4 ) Progesterones , NSAID, GnRH agonist and
Danazol
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1 ) whats this procedure ? 2) 2 advantages ?
3) 2 indications ? 4) 2 limitations ?
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answer
1 ) Thermachoice ballon
2 ) - not time consuming . - fewer
complications .
3 ) - abnormal uterine bleeding . -
benign lesions as small submucus myomas
or endometrial polyps. - heavy menstrual
bleeding with no indication for
hysterectomy .
4 ) - uterine cavity size 6-10 cm - cant
treat submucous myomas
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1 ) whats this ? 2) Name the procedure that
is used In 3) 2 indications ? 4) 2
complications ?
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answer
1 ) curette .
2 ) Dilatation Curettage .
3 ) dx of abnormal uterine bleeding - Rx of
endometrial hyperplasia with heavy bleeding -
removal of endometrial polyps.
4 ) 1.Perforation of the uterus. 2. Cervical
laceration. 3. Infection. 4.
Haemorrahge.
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Pic 1
1 ) describe (pic 1 ) 2) In the labour the CTG
change to pic 2 .. Whats your dx ? 3) 4)
whats the mode of delivery ?
160
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Pic 2
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answer
1 ) fetal tachycardia ( baseline more than 160 )
2 ) late deceleration .
3 )
4 ) CS
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1 ) whats this ? 2) whats its accuracy ?
3) 2 diagnostic measurements in 2nd trimester
? 4) 2 complications ?
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answer
1 ) crown-rump measurement
2 ) till 12 weeks is 3-5 days
3 ) femur length - Biparietal diameter - head
circumference- abdominal circumference
4 ) ..
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1 ) describe what you see and whats it ? 2)
How can you diagnose it in early pregnancy ? 3)
whats the methods of delivery ? 4) 2
complications ?
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answer
1 ) spina bifida describe ..
2 ) elevated a-fetoprotein .
3 ) CS to prevent infection ( meningitis ) and
rupture.
4 ) meningitis - rupture- paralysis of the legs -
mental retardation
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1 ) what's this procedure ? 2) 2 therapeutic
indications ? 3) 2 diagnostic indications? 4)
2 complications
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answer
1 ) AMNIOCENTESIS
2 ) - IOL Hypertonic solutions of saline or
urea are injected directly into the amniotic
cavity. - Injection of fluid in
Oligohydramnios will improve condition for 1
wk polyhydramnios ( amnioreduction )  -
3 ) - identification of genetic anomalies -
assessment of fetal lung maturity -
assessment of amniotic fluid bilirubin (RH -
ISOIMUNIZATION ) .
4 ) risk of spontaneous abortion and risk of
fetal limb injury
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1 ) whats this procedure ? 2) 2 indications
? 3) 2 contraindications ? 4) 2 complications ?
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answer
1 ) Cervical Cerclage
2 ) - cervical incompetence . -
3 ) Labor- Active uterine bleeding.
Chorioamnionitis- Premature rupture of membranes
...
4 ) - Cervical lacerations - Cervical
dystocia - Chorioamnionitis
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1 ) what's the indication of this procedure ?
2) 2 indications ? 3) 2 complications ? 4)
Numerate 2 Alternative medical methods.
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answer
1 ) nduction of labour forewater rupture
2 ) Pre-eclampsia - Prolonged pregnancy -
Placental insufficiency IUGR -Antepartum
haemorrhage - placental abruption - Rhesus
isoimmunization . Essential
3 ) failure to achieve labour - uterine
hyperstimulation and fetal compromise - uterine
rupture - uterine atony and PPH-infection .
Toronto notes
4 ) Syntocinon infusion - Administration of
prostaglandins . Essential
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1 ) describe . 2) whats the commonest cause
? 3) How can you confirm the dx ? 4) whats
the treatment ?
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answer
1 ) ambiguous genitalia .. Describe large
clitoris ..etc
2 ) congenital adrenal hyperplasia .
3 ) Serum 17-hydroxyprogesterone and
dehydroepiandrosterone (DHEA) both elevated .
4 ) Hydrocortisone to all patients
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1 ) identify . 2) Describe 3) 2 symptoms the
pts. Usually complaining of ? 4) 2
investigations and abnormality in them .
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answer
1 ) US of polycystic ovary .
2 ) describe about 12 cysts .. etc
Hirsutism - 3 ) - Menstrual irregularities
- acne
4 ) high androstenedione - high testosterone -
high FSH
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1 ) identify 2) 2 indications ? 3) whats
abnormal cytology it can give you ? 4) Whats is
the next step if there is abnormality ?
Pap smear
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answer
1 ) pap smear
2 ) - cervical cancer screening . - STD
screening .
3 ) CIN - carcinoma in situ .. etc
4 ) histopathology and colposcopy .
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1 ) 5 years girl come with hx of blood spots for
the last 3 months .. Whats your dx ? 2) 3
causes ? 3) Best treatment ? 4) Mechanism of
drug action ?
Precious puperty
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answer
1 ) Precocious puberty .
2 ) Constitutional - Neurological - Ovarian
tumors - Adrenal tumors - Gonadotrophin secreting
tumors
3 ) in this case ( idiopathic precocious puberty)
the treatment of choice is gonadotropin-releasing
hormone (GnRH) agonists
4 )
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1 ) whats the diagnosis? 2) 2 other indication
for this procedure ? 3) 2 complication for this
procedure ? 4) The treatment ?
Fibroid by hysteroscopy
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answer
1 ) uterine fibroid by hysteroscopy .
2 ) dx of Uterine anomalies -Recurrent pregnancy
loss - Unexplained infertility see Dr aymnans
slideshow about this procedure - gyne 1
3 ) Vasovagal attack-Bleeding-Perforation False
passage- Infection
4 ) medical Progesterones-NSAID-GnRH agonist -
Danazol Surgical Myomectomy- Hysterectomy Uterine
Artery Embolization
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1 ) pregnant with high BP .. The diagnosis ?
2) 2 clinical exam u do ? 3) 2 laboratory
investigations ? 4) The treatment ?
Pitting edema preeclampsia
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answer
1 ) PET .
2 ) tendon reflex - ophthalmoscope -
3 ) - urine analysis ( for protein ) - CBC
- RFT . - LFT .
4 ) antihypertensive
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