obs&gyne oral exam 2009

8/7/2019 Obs&Gyne Oral Exam 2009

http://slidepdf.com/reader/full/obsgyne-oral-exam-2009 1/8

6th year Final Exam

2009

Obstetric and Gynecology

Oral Exam

Written by

Your colleagues

Class of 2003

e-Copy @ www.icareunit.com

http://www.icareunit.com/






6th year final Oral Exam 2009

Obstetric and Gynecology


In the exam there were 4 circuits, each one contains 2 station, 2 doctors in each one

Questions: I will post my answers briefly

Station 1: Dr. Ilais and another Dr. from PBH

the question was about APH as follows

define APH, hemorrhage after the age of viability

What is meant by (Age of viability) and what is it in our county: it is a medico-legal term and it

is 28 wks of gestation in Jordan, 24 wks according to WHO

what are the most common causes of APH? Placenta Previa (PP) and Abrubtio Placenta; AP

how can you differentiate clinically between them? here is a long story

By Hx and PE as follows

PP: recurrent painless unprovoked vaginal bleeding, commonly in early morning, abdomen

commonly soft and lax, Fundal height is normal, it may be associated with abnormal lie and

presentation, it may also interfere with engagement of the fetus . no effect on the baby

AP: vaginal bleeding associated with abdominal pain and tenderness, fundal height may be

large for gestational age specially in concealed Type, it may be associated with other disorders

like PET, the fetus may be distressed with acidosis and may die.







how do you manage a patient with Abrubtio placenta? here I did not answer because the was

no time, he was asking about immediate management and investigations>>>

Station 2 : Dr. Fayiz and another Dr. from PRH

a case, 16 year old female patient complaining of sever pain during menestruation that disable

her to go her school, what do you call this complain? dysmenorrhoea

what are the types of dysmenorrhea ? Primary and secondary

what is the different between these types? Primary is physiologic and secondary is associated

with organic disorder.

how do you approach this patient? Hx and PE

Hx of pain, and associated symptoms

what is the cause of pain in primary dysmenorrhea ? Prostaglandin release, myometriumischemia , and OVULATION (Dr. was looking for this) a

in this patient what type of dysmenorrhoea most likely she has? Primary

what investigation you will request? nothing, Why, it is physiologic

how do you manage her? relieve her symptoms, HOW? pain killer, anti-spasmodic drugs

what is the most effective drug in primary dysmenorrhoea? Combined oral contraceptive pills

Station 1: 35 year-old married P5 ask you about tubal ligation, Councel her

Station 2: Case Preeclampsia, Approach (Hx,, Investigations, when and how to deliver her,

management

A 34 wks pregnant woman presents with a sudden onset clear vaginal discharge. Thequestions were how to approach her according to history, physical examination &

investigation. Then I was asked to give DDx

Notes: I’ve been asked to give 2 confirmatory tests, I mentioned the posterior fornix & I

couldn’t get the other. Although I mentioned the netralazine test, which the doctor mentioned

that it’s not used anymore. & I was asked what to do if you don’t see the leakage at the time



of speculum examination other than the U/S. It was a stupid station really but do your best

A 25 year Female presents with vaginal bleeding after intercourse. How do you approach her?

Notes: the case was about Cervical Ectropion. Don’t forget to ask about using combined

contraceptive through your history & Pap smear too. Also if you are asked about what kind of

patient we use brush type pap smear not the spatula one? The answer is Postmenopause

woman because the transformation zone goes inside due to estrogen deficincy. I was asked

too about the mechanism of ecropion formation

1st station :

hyperstimulation syndrome (cause,classification,inves,treatment)

Vaginal discharge (approach)

2nd station (al ta5be9)

define booking visit ?

after NVD low risk mother and every thing is fine

what u r going to tell her???

what do u know about breast feeding?!

APH (define, Hx, exam)

then what about the vaginal examination??

if no or contraindicated he asked me WHY?and when to deliver this ptn

25 year old pt wants to yse coc .... what should u do to make sure that it will fit her ?

25 year old pt with bleeding? take hx , what will u do in exam , invistigation?

pt wid placenta previa , hx approach

ANC , what should u do in booking visit?

a pregnant lady in her 27th wk of gestation presented to the clinic with SOB her Hb is 7

take a proper Hx

what's you Dx

how to confirm IDA

how to differentiate between IDA and Thal by Hx



what's ur Mx

if she was in the 39th wk what's the Mx

a case of primary PPH

what's the cause

step by step you'll reach a cervical tear ... how to Mx

Q about HRT: definition, types, use of each type, symptoms of menopause how to Mx

first station :

1- puerperium

Definition - complication - if thhe lady came to u after 9 days after delivery complaining of red

vaginal bleeding what is ur dx inx tx and if she came at 20 days same question

2-25 yr old primigravida complaining of spoting vaginal bleeding ( threatened abortion )

hx dx inx

second station :

1- cervical erosion

definition - causes - tx

2- missed abortion 10 weeks management

dr zuhair ammari : pph definition, causes, management

dr haifa galabi : infertility, define, causes, investigations, about tubal factors how to

diagnose,why is hysteroscopy useful in assessing tubal factors, is DnC helpful and why?

complications of hystroscope, wt do u see in laparoscope, how to diagnose premature ovarian

failure

dr.fayez and a doctor from PBH : everything about anemia in pregnancy

dr.nael obedat and dr.m7mood alkhateb

everything about ectopic pregnancy and postmenopausal bleeding

dr.fayez and a dr.nahar :Threatened abortion & Rh iso.



dr.nael obedat and dr.m7mood alkhateb: endometriosis & infertility

station 1 dr. 3esam la6ayfeh

case 30 wk gestation came with abdominal pain how do u approach

Hx, then he asked about differential, then he concentrates on PTL

what r the possible causes of PTL in the Hx: multiple pregnancy, polyhydraminos, previous PTLprevious abortions, medical disorder HTN....

P/E if large what is the cause other than multiple and poly? fibroid

what next? pelvic exam inspection speculum and PV

dr. 3esam asked if it's necessary to do PV, and can't it be enough to assess the cervical changes

with the speculum,,, i answered sure u have to do the PV, he doesn't seem much convinced...

dr. mn wazarat l se7ah

what do u know about CTG

definition, normal parameters , causes of all types of decelerationsif it happened to have a pregnant with late deceleration and liquor became meconium stained

what next? C/S

station 2 dr. faheem zayed

what do u know about cervical smear

he asked me v. much everything in cervical smear lecture

dr. mn bade3ah

fibroid what r the 3 locations and associated presentationsinvestigations

complications in pregnancy

what is the medical treatment and when to use it?

what is an invasive non surgical Rx for fibroid? uterine a embolization

salam the exam was 2 stations

first dr.na2el 3bedat and dr from PBHapproach to 41 wks pregnancy>> hx, examination,what to do what u found on us, and then

every thing about induction of labor

breech presentation almost every thing

ECV also almost every thing

station 2 dr.fayez aljallad and dr from mafraq i think!!

approach to 60 year female 10 years postmenopause with vagainal bleeding



it was atrophic endometritis (after taking hx,, examination,, us and bx)

what is ur treatment? HRT

what type? COCP, cuz she still has her uterus

what COCP? monophasic

what do u call this type of COCP? non bleeding

note: dn't answer in preterm labor the nit. test as an investigation cuz dr.na2el kan m3asebmn altollab elle jawabo heik

my stations were

1. placenta abruption

2. ectopic pregnancy

3. contraception

the exam was nice ... and it really is all about luck ... wish u the best of it ..

Menorrhagia in 18 year old

Dr:Nael Obaidat:

Pregnant at 31 weeks,you discovered that presentation is breech,what you will do???Asked many Qs about ECV

Foreign examiner + Dr. Zuheir Ammareen

A 24 year-old lady, G2P1, GA=8 wks, known case of bronchial asthma, on B2 agonists. Her first

son was SGA (2 kg), and she's afraid that this pregnancy will be the same. Counsel her

regarding her asthma & pregnancy. What's the cause of SGA due to asthma (hypoxia). Would

you tell her to continue her medications normally? What would be the effect of labor on her

asthma (exacerbate it or not?)

2nd station:

Dr Haifa + Dr. from PBH

What's the definition of ectopic pregnancy. What are the risk factors. What are the

commonest sites. How you treat it (surgically & medically). Compare between the 3 surgical

procedures!!

What's menorrhagia? What's the differential diagnosis? What's endometriosis? How they



present usually? What's adenomyosis? What's fibroids? The commonest site of fibroids to

cause menorrhagia? How do you treat fibroids medically?

Dr Na2el + Dr Francees

Pregnant 32 weeks, presented with abdominal pain...how would u approach her? it was acuteonset, generalized and continuous....everything else was pretty much negative!

i asked questions in the history, told him the exam, investigation and treatment based on that

it's abruption!

bel akher be7kele 6ayeb msh momken tkoon ACUTE POLYHYDRAMINOS? m3 el 3elm eno ma

7akale enu bel exam LGA aw bel US fe polyhydraminos....anyway kan be7awel eikhabe el

diagnosis! lol

Dr Francis sa2latni 3an el management of 3rd stage of labor..how would u give the oxytocin?

how long it takes to start its action? give it WITh or AFTER delivery of teh anterior shoulder?

Second Station: Dr jallad + Dr unknown:

dysmenorrhea....went smooth till Dr jallad start asking about 7year-old female with vaginal

discharge? ddx: F.B, infections but NOT candida...tx: antibiotic + estrogen

1) dr.layla : about HELLP syndrome (all things from presentation till treatment)

options of treatment for 31 wks with HELLP syndromes .

2) external : vaginal discharge ( history+exam+investi+treatment ) .






obs&gyne oral exam 2009

Documents