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O&G Revision – Yr 4

O&G Revision – Yr 4. EMQs x 4 Data Analysis x 4 OSCEs x 4. Data Analysis Picture of lesion What is the condition ? What are the diagnostic features ? What are the causes/ pre-disposing factors ? Any other investigations? Treatment ?. Data Analysis

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O&G Revision – Yr 4

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  1. O&G Revision – Yr 4

  2. EMQs x 4 • Data Analysis x 4 • OSCEs x 4

  3. Data Analysis • Picture of lesion • What is the condition ? • What are the diagnostic features ? • What are the causes/ pre-disposing factors ? • Any other investigations? • Treatment ?

  4. Data Analysis • Graphs – CTG, IUGR charts, Partogram • Blood – PCOS, Fertility, Menopause, PET/HELP,OC, Down’s screening • Other – MSU, SFA, Smear, HVS, Karyotype, OCP/HRT packs

  5. Candidial discharge/plaques

  6. Vulval Warts

  7. IUGR

  8. IUGR

  9. Early Decelerations – Type 1

  10. Late Decelerations - Type 2

  11. Variable Decelerations

  12. PCOS • LH >>> FSH   • SHBG – reduced • Testosterone, DHEAS, Androstenedione- all increased • Insulin - increased

  13. Menopause • FSH & LH = increased (> 25iu/ml) • Oestradiol = < 75 iu/ml

  14. PET/ HELLP • Uric acid – raised • Platelets – reduced • Creatinine – raised • Urea – raised • LFTs – increased (ALT, AST, Bile acids) • Clotting time – INR increased

  15. Down’s Syndrome • Cut off risk = 1 in 250 • Decreased Alpha Fetoprotein • Increased Beta HCG

  16. NORMAL SEMEN ANALYSIS • Volume = 2-6 ml • Sperm count = 20-250 million/ml • Motility = >50% at 0.5-2 hrs • Morphology = >15%

  17. Cervical Smear • ‘Moderate dyskaryosis’ and koilocytosis

  18. HVS • Group B Streptococcus • Candida • Trichomonas • Bacterial vaginosis • Gonococcus

  19. Karyotype • Down’s syndrome • Turner’s syndrome

  20. EMQs x 4 • Case scenarios vs diagnosis • Therapeutics vs side-effects indications contraindications

  21. Theme: Therapeutics • Heparin • Levonorgesterol-only contraceptive pills • C. Levonorgesterol-releasing intrauterine device • Copper-containing intrauterine device • Danazol • Combination of natural oestrogens and progestagens • Warfarin • Combination of ethinyl oestradiol and progestagens • Unopposed oestrogens • Clomiphene citrate • Bromocriptine • Choose the most appropriate response from the above to match the statements below: • Highly effective contraceptive (failure rate =1-2/1000), also very effective against menorrhagia, pelvic infections and oestrogen-sensitive gynaecological disorders. • Effective in treating vasomotor, genitourinary and emotional symptoms of the menopause in non-hysterectomised women. • Side-effects include amenorrhoea, acne, hirsutism, voice changes, weight-gain, breast atrophy and teratogenicity. • Effective post-coital contraceptive if used within 72 hours of unprotected intercourse. • May be used safely in the first trimester of pregnancy by women requiring anticoagulation. • ANSWERS: K E D B A

  22. OSCEs x 4 • Hx taking – obs or gyn – 10mts • Explanation - investigation/treatment • Ethics – consent, TOP counselling • Examination – pelvic exam, obst exam

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