Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
Mid-term OSCE exam
Gyne 2
Group 33
1431
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‫‪Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com‬‬
‫شكرا لـ ‪:‬‬
‫عبدالرحيم عقلي‬
‫علي ضهيان‬
‫لكتابتهم لألسئلة كاملة ‪.‬‬
‫شكرا للمجموعة الرائعة ‪.. ) 33 ( :‬‬
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
:‫إهداء لـ‬
‫مهند العمري‬
. ‫سعيد القحطاني‬
. ‫مع خالص األمنيات بحياة ماتعة وآملة‬
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‫‪Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com‬‬
‫مالحظات قبل االمتحان ‪:‬‬
‫ميزت باللون األخضر السؤال المشكوك في صيغته أو في‬‫اإلجابة التي وضعتها له ‪.‬‬
‫ الرجاء عدم االلتفات يمينا أو يسارا أثناء االختبار ‪. ‬‬‫ الغش ‪ ..‬ظاهرة مرفوضة إنسانيا وأخالقيا ودينيا ‪.‬‬‫مع خالص األمنيات‬
‫أخوكم ‪:‬‬
‫محمد الشهري‬
‫‪Medicine-kku.com‬‬
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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1
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s your Dx.?
2) 2 mother
complications ?
3) 2 fetal
complications ?
4) What is the more
dangerous type ?
2
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s this ?
2) How dose it form ?
3) 2 symptoms ?
4) The Rx ?
3
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
colposcopy
1 ) what is the diagnosis ?
2) 2 symptoms ?
3) 2 indications for this procedure ?
4) what’s the management ?
4
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s is this ?
2) 2 symptoms
“other than the
symptoms in the Q ?
3) 2 medical
treatment ?
4) 2 surgical
treatment ?
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5
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s this
procedure ?
2) 2 indications ?
3) 2 complications ?
4) Alternative
medical Rx ?
6
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s this procedure ?
2) 2 advantages ?
3) 2 indications ?
4) 2 limitations ?
7
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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
- can’t treat submucous myomas
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s this ?
2) Name the
procedure that is
used In
3) 2 indications ?
4) 2 complications ?
8
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
Pic 1
1 ) describe (pic 1 )
160
2) In the labour the
CTG change to pic 2
.. What’s your dx ?
3)
4) what’s the mode
of delivery ?
9
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Pic 2
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
answer
1 ) fetal tachycardia ( baseline more than 160 )
2 ) late deceleration .
3)
4 ) CS
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s this ?
2) what’s its
accuracy ?
3) 2 diagnostic
measurements in 2nd
trimester ?
4) 2 complications ?
10
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) describe what you
see and what’s it ?
2) How can you
diagnose it in early
pregnancy ?
3) what’s the methods
of delivery ?
4) 2 complications ?
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11
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what's this
procedure ?
2) 2 therapeutic
indications ?
3) 2 diagnostic
indications?
4) 2 complications
12
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s this
procedure ?
2) 2 indications ?
3) 2 contraindications ?
4) 2 complications ?
13
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what's the
indication of this
procedure ?
2) 2 indications ?
3) 2 complications ?
4) Numerate 2
Alternative medical
methods.
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14
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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 PPHinfection . Toronto notes
4 ) Syntocinon infusion - Administration of
prostaglandins
. Essential
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) describe .
2) what’s the
commonest cause ?
3) How can you
confirm the dx ?
4) what’s the
treatment ?
15
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) identify .
2) Describe
3) 2 symptoms the
pts. Usually
complaining of ?
4) 2 investigations
and abnormality in
them .
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16
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
answer
1 ) US of polycystic ovary .
2 ) describe … about 12 cysts .. etc
3 ) - Menstrual irregularities -Hirsutism
- acne
4 ) high androstenedione - high
testosterone - high FSH
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) identify
Pap smear
2) 2 indications ?
3) what’s abnormal
cytology it can give
you ?
4) What’s is the next
step if there is
abnormality ?
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17
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
answer
1 ) pap smear
2 ) - cervical cancer screening .
- STD screening .
3 ) CIN - carcinoma in situ .. etc
4 ) histopathology and colposcopy .
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) 5 years girl come
with hx of blood spots
for the last 3 months ..
What’s your dx ?
Precious puperty
2) 3 causes ?
3) Best treatment ?
4) Mechanism of drug
action ?
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18
Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) what’s the
diagnosis?
Fibroid by hysteroscopy
2) 2 other indication for
this procedure ?
3) 2 complication for
this procedure ?
4) The treatment ?
19
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
answer
1 ) uterine fibroid by hysteroscopy .
2 ) dx of Uterine anomalies -Recurrent
pregnancy loss - Unexplained infertility see Dr
aymnan’s 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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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
1 ) pregnant with high BP
…….. The diagnosis ?
Pitting edema “ preeclampsia “
2) 2 clinical exam u do ?
3) 2 laboratory
investigations ?
4) The treatment ?
20
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
answer
1 ) PET .
2 ) tendon reflex - ophthalmoscope 3 ) - urine analysis ( for protein )
- CBC
- RFT .
- LFT .
4 ) antihypertensive
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‫‪Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com‬‬
‫أخيرا ‪ ..‬تقبلوا تحيات ‪:‬‬
‫عبدالرحيم عقلي‬
‫علي ضهيان‬
‫محمد الشهري‬
‫لتعديل أو مالحظة ‪baaoh@hotmail.com :‬‬
‫أو ابلغ أحدنا مباشرة ‪ ،‬ليستفيد الجميع ‪.‬‬
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Gyne 2 Osce - mid term - group 33 mohd.shehri baaoh@hotmail.com
.. ‫ ابتاله هللا بالهموم‬.. ‫من قصر في العبادة‬
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