425 OSCE slide show

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425 OSCE slide show

• By 425 people D

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Hi everyone D

• Welcome everyone )
• This is a 425 OB/GYN slide show exam, most of the
  pictures here were the exact pictures showed in
  exam, some were almost the same. Im ganna put
  () next to pictures that were the exact ones.
• The answers here were my answers in exam, so
  there is a chance to be wrong, so please tell
  others whenever there is a mistake and feel free
  to edit the slides.
• And for the next groups in 425, feel super free
  to add your slide show exam to this slides right
  after our exam with your beautiful names for
  years after us )
• thanks a LOT guys.
• And BIG FAT good luck to you all.

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425 Femalemidcycle Slide Show Exam
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Slide 1
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Qs

1. What is this procedure?
2. Name 4 indications for this procedure.
3. Name 2 other antenatal diagnostic tests.

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• Amniocentesis.
• Chromosomal abnormality (cells)
• Infections
• Bilirubin (in case of haemolysis)
• Check lung maturity.

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• 3. Name other 2 antenatal diagnostic tests.
• PUBS (percutanous umbilical cord blood
  sampling)
• CVS (Chorionic villia sampling)

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Slide 2
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Qs

• What is this condition?
• Name 4 causes.
• Which of them has highest dangerous
  complications. And why?
• Name 2 complications you would anticipate.

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• Macrosomic baby
• Diabetic mother (GDM or pre-existing)
• Post date
• Family history of big babies
• Undiagnosed DM
• Obese mothers.
• Gaining a lot of weight during pregnency.

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• 3.Diabetic mother, because it is associated with
  fetal poor health and delayed lung maturity and
  respiratory distress.
• 4.Complications
• Polycythemia, hypoglycemia, hyperbilirubinemia,
  delayed lung maturity, shoulder dystotia,
  prolonged labour and risk of fetal distress.

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Slide 3
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Qs

• Identify the defect in arrow 1.
• Identify the anatomic structure in (1, 2, 3, 4
  ).
• Name 3 risk factors for this condition.

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• Cystocele.
• 1 urinary bladder wall, anterior vaginal wall.
• 2rectum
• 3uterus
• 4urinarry bladder
• 3. multiparty, old age, genetic connective tissue
  weakness, previous injury

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Slide 4
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Qs

• What is the defect in arrow 3?
• What is the position of this uterus?
• Identify instruments in arrow (1, 2).
• How can you prevent this condition.

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• Perforated uterus.
• Sharply anteflexed uterus.
• (1Sims uterine sound, 2metallic vaginal
  speculum ).
• 1.US-guided procedure
• 2.Gentle and gradual insertion.

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Slide 5
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Qs

1. Name this organism.
2. How would it present clinically?
3. What is the treatment?
4. Would you treat the partner? Why?

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• Trichomonus vaginalis.
• It could present with itching and discharge.
• Treat with metronidazole.
• Yes treat the husband, because it is infectious
  sexually transmitted disease.

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Slide 6
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Qs

• Identify
• Name three indications.
• Name three complications

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• Plastic ventous suction cup
• Indications
• Prolonged labour
• maternal exhaustion
• Fetal distress
• Maternal medical illness.

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• 3. Complications
• Epidural , cephalic haematoma.
• Hyperbilirobinemia
• Birth canal injury due to tissue entrapment.
• Prolonged suction causes fetal distress.

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Slide 7
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Qs

• Identify the abnormality.
• What is the normal range?
• Name 4 causes.

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• Fetal tachycardia. (gt180 beats/mint)
• 2.120-160 beats/mint

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3.CAUSES of fetal tachycardia

• Maternal
• Fever, Anxiety, medications (ex terbutaline)
• Fetal
• Infection, excitation and movement, early
  hypoxia, infection, fetal heart arrhythmia and
  prematurity.

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Slide 8
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Qs

1. Name the 4 hormones in menstrual cycle and from
   where are they secreted?
2. Name the two phases and their predominant
   hormone.

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• FSH..from anterior pituitary
• LH from anterior pituitary
• Oestrogenfrom granulosa cells
• Progesterone.. from corpus luteum
• 2. Proliferative phase (by estrogen)
• secretary phase-luteal- (by progesterone)

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Slide 9
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Qs

1. What is shown in the picture?
2. Name 4 common sites for this lesions.
3. What are the two main ways of treatment? mention
   an example for each.

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• 1.Endometriosis (shown by laproscope)
• 2.Common sites
• Ovaries
• Peritoneum
• Ovarian/uterine ligaments
• Pelvic wall
• cervical

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3.treatment

• 1.Medical
• Pseudopregnency progesterone pills, OCPs.
• Pseudomenopause danazole, GnRH agonists.
• 2.Surgical
• Partial or radical either by Laproscopy or
  laprotomy

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Slide 10
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Qs

• What is the lie and presentation?
• Name two diagnostic signs.
• Name two complications.
• What is the management
• Before delivery?
• During labour?

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• 1.Transverse lie, shoulder presentation.
• 2.Signs low fundal hight to date, feel the head
  on abdominal lateral sides, feel the back of the
  fetus running transverse lie, transverse lie by
  US.
• 3.Complications cord prolapse (Most common),
  cord compression, shoulder dystocia, prolonged
  labour, fetal distress, maternal exhaustion,
  fetal injury, bone fracture, maternal injury and
  obstructed labour.

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4. management

• 1.Before delivery
• External cephalic version.
• 2.Intra labour
• C/S

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• Special thanx to
• Addana alsaad
• Aljowhara alameer
• For squeezing their brains to remember Qs D
• hearts

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425 Female Final Slide Show Exam
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Slide 1
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Qs

1. What do you see?
2. Give two DDx.
3. What would you ask in Hx. (give 3)
4. What would you order for investigation. (give 3)

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• What do you see?
• Breast budding.
• Give 2 DDx.
• Complete precocious puberty.
• Incomplete precocious puberty

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• What would you ask in Hx?
• Ask if she has any pubic or axillary hair?
• Ask if she had any vaginal bleeding or menses.
• Ask if she has been taking any medications
• Ask for any family Hx in this condition.

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• What would you order for investigation?
• Check hormonal level of estrogen.
• Check her FSH, LH levels.
• Take radio-images of her brain to rule out any
  secretery tumors (sp pituitary)
• Do an US for her ovaries to rule out any estrogen
  secreting tumors (ex granulosal cells tumor)

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Slide 2
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Qs

1. What is this condition?
2. Caused by which hormone?
3. What could cause it elevation?
4. What other posible symptoms could it present
   with?
5. How would you treat it?

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• What is it?
• Galactorrhea
• By which hormone?
• Prolactin

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• What could cause its elevation? (give 4)
• Physiological (lactating breast-feeding mother)
• Pituitary adenoma
• Drug-induced.
• Other prolactin-secretory tumors.
• Idiopathic elevation.

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• Possible other symptoms give 2
• Infertility
• Amenorrhea

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• How would you treat?
• Medically bromocreptine (for decreasing
  prolactin secretion and reducing adenomas size),
• clomid (to restore fertility)
• Surgical remove the tumor

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Slide 3
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Qs

1. What is it?
2. Used for what?
3. What are the indications for its job?
4. Who uses it?
5. Name to complication.

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• What?
• An amniotic hook (or an amniohook)
• Used for what?
• For artificial rupture of membranes (or amniotomy)

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• What are the indication?
• Used in induction of labor (to fasten baby birth
  due to any reason)
• Used to see muconium-stained amniotic fluid to
  confirm fetal distress (in an external fetal
  monitor)
• Used to put on fetal scalp heart monitor to
  confirm fetal distress in an external monitor.

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• Who uses it?
• An obstetrician and a midwife.
• Name 3 complications
• Bleeding.
• Injury to the babys presenting part.
• Infection.

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Slide 4
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Pt presents with 6 week of amenorrhea and lower
abdominal pain (look at picture)
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Qs

• What is the Dx?
• What possible other symptoms?
• Give 4 risk factors.
• How would you treat?

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• What is the Dx?
• Ectopic pregnancy.
• What possible other symptoms?
• PV bleeding, lower abdominal pain and amenorrhea

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• Give 4 risk factors.
• Previous Ectopic pregnancy
• Tubal disease
• Chronic PID and adhesions.
• Adhesions from endometriosis
• IUCD
• Tubal ligation

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• How would you manage?
• Medical methotrexate if it fits the recommended
  criteria.
• Surgical salpingostomy (if in ampulla and
  uncomplicated) salpingectomy if otherwise with
  checking the patency and health of the other tube.

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Slide 5
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Qs

1. What are 1, 2 ,3 ?
2. Which one is the most important obstetrically and
   whats its length?
3. What are 4 and 5?

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• What are 1, 2 and 3?
• 1 True (anatomic) diameter.
• 2obstetric diameter.
• 3diagonal diameter.
• Which is obs. Imp and whats its length?
• Obstetric diameter and its about 11.5 cm

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• What are 4 and 5?
• 4pubic bone (symphesis pubis)
• 5sacral promontory.

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Slide 6
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Qs

1. What is your Dx?
2. What symptoms would present (give 2)
3. What hormones would be elevated?
4. How would you treat?

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• What is the Dx?
• Polycystic ovarian syndrome (PCOs)
• Symptoms
• Acne
• Hiristisum
• Infertility
• Irregular menses

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• What hormones would be elevated? (Give2)
• LH
• Androgens
• Insulin

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• How would you treat?
• Give combined OCPs (for hiristisum and prevention
  of endometrial cancer due to elevated unopposed
  estrogen
• Or give progestrone to prevent endometrial cancer
• Give metformin for insulin resistance.
• Remove ovary surgically if associated with
  neoplasm or unreasoning to medications.

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Slide 7
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Qs

• What is this condition?
• How to detect it antenatally?
• Name 3 complications.
• How would you prevent it?

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• What?
• Anencephaly
• How would you prevent it?
• By folic acid supplementation in diet.

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• Name 3 complications
• 1.malpresenation
• 2.post date
• 3.polyhydrominous.
• 4.postpartum haemorrhage (uterine atony)
• 5.baby loss (depression)

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• How to detect?
• 1.US absent brain and skull bones.
• 2 triple marker test elevated
  alpha-fetoprotein.
• 3.by physical exam cant palpate the fetal head.

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Slide 8
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Qs

• What is this condition?
• What could cause this condition?
• Name 3 complications of forceps delivery.

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• What?
• Facial palsy.
• What could cause it?
• Operative delivery by forceps.

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• Name 3 other obstetric and 3 fetal complications
  of forceps
• Fetal
• Fetal skull bone fractures.
• Intracranial hematomas.
• Intracranial haemorrhage.
• Low apgar score
• Fetal distress.

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• Maternal
• Birth canal injury.
• Post partum haemorrhage.
• Fistulae formation.
• Bladder, urethral and perineal body injury
• Urine incontinence.

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Slide 9
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Qs

• What are 1 and 2?
• Name 4 indications for C/S.
• Name 4 complications for C/S.

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• What are 1 and 2?
• 1 vertical (longtudinal) section (classic)
• 2 low transverse section.

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• Name 4 indications.
• Placenta prevea.
• Preveious myomectomy
• Previous C/S
• Previous uterine rupture
• Conditions need to deliver baby as fast as
  possible with the cervix is unfavourable like
• A-Severe pre-eclampsia
• B-Eclampsia.
• C-Severe fetal distress.

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• Name 4 complications
• Heavy bleeding.
• risk of uterine rupture in a subsequent
  pregnancy.
• Higher risk for infections and puerperal sepses.
• Urine overflow incontinence (from anaesthetics)
• Risk of fetal injury (from cutting the uterus)
• Injury of other pelvic organ tissues.

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Slide 10
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Missing picture D

• In last Q (Q10), we had a case and a picture
• The case was postpartum patient, in day 4 with
  tender well contracted uterus.
• BUT unfortunately we dont have the picture of
  it , It was a nurse chart S
• It was so easy , so no need to freak out D
• It clearly showed a temp of 38.5, HR 120 and the
  word Heavy in the lochia column of the chart, and
  the Qs were as follows

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Qs

• What do you see in the patients chart?
• What is the possible Dx?
• What investigations would you do?
• What general management would you do?

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• What do you see in chart?
• Chart shows fever, tachycardia and persisting
  heavy lochia (bleeding)

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• What is the possible Dx?
• Secondary postpartum hemorrahge from retaind
  tissue and puerperal fever.
• What is most probably caused fever?
• Endometritis.

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• What investigations would you do? (give3)
• US to rule out retained placental tissue.
• CBC for dropping Hb and leukocytosis.
• Culture of endometrial tissue and lochia to
  identify the causing organism. (not routinely
  done).

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• General management? (give3)
• IV fluids (dehydration from fever).
• Antipyretics.
• Broad spectrum Abx.
• Analgesics.
• DC to clear from retained tissue.

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The End

• Good luck
• Allergy D