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Mid-term OSCE exam Gyne 2 Group 33 1431

Mid-term OSCE exam Gyne 2 Group 33 1431. شكرا لـ : عبدالرحيم عقلي علي ضهيان لكتابتهم للأسئلة كاملة . شكرا للمجموعة الرائعة : ( 33 ). إهداء لـ: مهند العمري سعيد القحطاني . مع خالص الأمنيات بحياة ماتعة وآملة. ملاحظات قبل الامتحان :

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Mid-term OSCE exam Gyne 2 Group 33 1431

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  1. Mid-term OSCE exam Gyne 2 Group 33 1431

  2. شكرا لـ : عبدالرحيم عقلي علي ضهيان لكتابتهم للأسئلة كاملة . شكرا للمجموعة الرائعة : ( 33 ) ..

  3. إهداء لـ: مهند العمري سعيد القحطاني . مع خالص الأمنيات بحياة ماتعة وآملة .

  4. ملاحظات قبل الامتحان : • ميزت باللون الأخضر السؤال المشكوك في صيغته أو في الإجابة التي وضعتها له . • الرجاء عدم الالتفات يمينا أو يسارا أثناء الاختبار  . • الغش .. ظاهرة مرفوضة إنسانيا وأخلاقيا ودينيا . مع خالص الأمنيات أخوكم : محمد الشهري

  5. 1 ) comment on this picture , what is your dx . ? 2) Give to lap. Abnormality ? 3) Two causes ? 4) Give to fetal complications ? 1

  6. 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

  7. 1 ) what’s your Dx.? 2) 2 mother complications ? 3) 2 fetal complications ? 4) What is the more dangerous type ? 2

  8. 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

  9. 1 ) what’s this ? 2) How dose it form ? 3) 2 symptoms ? 4) The Rx ? 3

  10. answer 1 ) clue cells 2 ) epithelial cells covered with bacteria . 3 ) discharge , itching , dysuria and bad odor. 4 ) metronidazol or clindamycin 1 week

  11. colposcopy 1 ) what is the diagnosis ? 2) 2 symptoms ? 3) 2 indications for this procedure ? 4) what’s the management ? 4

  12. 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 .

  13. 1 ) what’s is this ? 2) 2 symptoms “other than the symptoms in the Q ? 3) 2 medical treatment ? 4) 2 surgical treatment ? 5

  14. 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

  15. 1 ) what’s this procedure ? 2) 2 indications ? 3) 2 complications ? 4) Alternative medical Rx ? 6

  16. 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

  17. 1 ) what’s this procedure ? 2) 2 advantages ? 3) 2 indications ? 4) 2 limitations ? 7

  18. answer 1 ) Thermachoiceballon 2 ) - not time consuming . - fewer complications . 3 ) - abnormal uterine bleeding . - benign lesions as small submucusmyomas or endometrial polyps. - heavy menstrual bleeding with no indication for hysterectomy . 4 ) - uterine cavity size 6-10 cm - can’t treat submucousmyomas

  19. 1 ) what’s this ? 2) Name the procedure that is used In 3) 2 indications ? 4) 2 complications ? 8

  20. 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.

  21. Pic 1 1 ) describe (pic 1 ) 2) In the labour the CTG change to pic 2 .. What’s your dx ? 3) 4) what’s the mode of delivery ? 160 9 Pic 2

  22. answer 1 ) fetal tachycardia ( baseline more than 160 ) 2 ) late deceleration . 3 ) 4 ) CS

  23. 1 ) what’s this ? 2) what’s its accuracy ? 3) 2 diagnostic measurements in 2nd trimester ? 4) 2 complications ? 10

  24. answer 1 ) crown-rump measurement 2 ) till 12 weeks is 3-5 days 3 ) femur length - Biparietal diameter - head circumference- abdominal circumference 4 ) …..

  25. 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 ? 11

  26. 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

  27. 1 ) what's this procedure ? 2) 2 therapeutic indications ? 3) 2 diagnostic indications? 4) 2 complications 12

  28. 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

  29. 1 ) what’s this procedure ? 2) 2 indications ? 3) 2 contraindications ? 4) 2 complications ? 13

  30. answer 1 ) Cervical Cerclage 2 ) - cervical incompetence . - 3 ) Labor- Active uterine bleeding. Chorioamnionitis- Premature rupture of membranes ... 4 ) - Cervical lacerations - Cervical dystocia - Chorioamnionitis

  31. 1 ) what's the indication of this procedure ? 2) 2 indications ? 3) 2 complications ? 4) Numerate 2 Alternative medical methods. 14

  32. answer 1 ) nduction of labourforewater rupture 2 ) Pre-eclampsia - Prolonged pregnancy - Placental insufficiency & IUGR -Antepartumhaemorrhage - placental abruption - Rhesus isoimmunization . Essential 3 ) failure to achieve labour - uterine hyperstimulation and fetal compromise - uterine rupture - uterine atony and PPH-infection . Torontonotes 4 ) Syntocinon infusion - Administration of prostaglandins . Essential

  33. 1 ) describe . 2) what’s the commonest cause ? 3) How can you confirm the dx ? 4) what’s the treatment ? 15

  34. 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

  35. 1 ) identify . 2) Describe 3) 2 symptoms the pts. Usually complaining of ? 4) 2 investigations and abnormality in them . 16

  36. answer 1 ) US of polycystic ovary . 2 ) describe … about 12 cysts .. etc Hirsutism- 3 ) - Menstrual irregularities - acne 4 ) high androstenedione - high testosterone - high FSH

  37. 1 ) identify 2) 2 indications ? 3) what’s abnormal cytology it can give you ? 4) What’s is the next step if there is abnormality ? Pap smear 17

  38. answer 1 ) pap smear 2 ) - cervical cancer screening . - STD screening . 3 ) CIN - carcinoma in situ .. etc 4 ) histopathology and colposcopy .

  39. 1 ) 5 years girl come with hx of blood spots for the last 3 months .. What’s your dx ? 2) 3 causes ? 3) Best treatment ? 4) Mechanism of drug action ? Precious puperty 18

  40. 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 )

  41. 1 ) what’s the diagnosis? 2) 2 other indication for this procedure ? 3) 2 complication for this procedure ? 4) The treatment ? Fibroid by hysteroscopy 19

  42. 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

  43. 1 ) pregnant with high BP …….. The diagnosis ? 2) 2 clinical exam u do ? 3) 2 laboratory investigations ? 4) The treatment ? Pitting edema “ preeclampsia “ 20

  44. answer 1 ) PET . 2 ) tendon reflex - ophthalmoscope - 3 ) - urine analysis ( for protein ) - CBC - RFT . - LFT . 4 ) antihypertensive

  45. أخيرا .. تقبلوا تحيات : عبدالرحيم عقلي علي ضهيان محمد الشهري لتعديل أو ملاحظة : baaoh@hotmail.com أو ابلغ أحدنا مباشرة ، ليستفيد الجميع .

  46. من قصر في العبادة .. ابتلاه الله بالهموم ..

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