Osce revision in obstetrics and gynecology

transcript

Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1

Dr Manal BeheryZagazig University

OSCE OSCE Revision in Revision in

Obstetrics&Gynecology Obstetrics&Gynecology

1-What this photo show?2-What is the indication name 2?3-What is the complication ?name 3 4-Name 3 prerequisite •

1-What is the Malpresention in this photo? 2Name 3possible cause?

3-Describe briefly how to manage during labor ?

1-Determine fetal head position in this photo?2-What is the attitude of this fetus?3- What Is The Engaging Diameter 4-What is the mechanism by which head is delivered?

What is the curve ABC refere to?What is the curve EFG refere to ?Which one has obstetric importance

1-What is this procedure ?2-Name 3 indication to do this procedure? 3-What is the right time to do this procedure? 4-Name 2 possible complication ?

• What is name of A

• What is the name of B

• What is the obstetric importance of A and B?

• What is the position of fetal head in C

• What does this photo show?• What is the cause of this malpresention

name 2 • What is the possible complication at vaginal

delivery mention 3?

Prolapsed Umbilical Cord

• What this photo show?• What is the cause of this abnormality?• What is the preferred maternal position to

decrease complication ?• Mention 3 factors affecting the prognosis ?

Prolapsed Umbilical Cord

• What is the name of these 4 manouvers ?

• What each one detectA,B,C, D?

• What this photo show?• What is meant by 0 station • What is the obstetric importance of level

of iscial spine mention 3 ?

1-What is the name of this procedure?2-What is the indication 3-Give 2 precaution before performing it?4-Name 2 possible complication

1-What Does This Photo Show ?2-What is the complication of this abnormality

during pregnancy and in labor ? mention 3 3-Give the name of drug used in prophylaxis ?

1- Congenital anomalies ( 25%)

1-What is the name of this manouver ?

2-What is the indication?

3-How does it act

4-Name 2 alternative methods one medical and one

surgical

1-What is 1 and 2 refer to ? 1-What is 1 and 2 refer to ? 2-What 3 refer to?2-What 3 refer to?3- What is the name of segment between 1&2 ?3- What is the name of segment between 1&2 ?

1-What is the name of these 2 maternal changes with

pregnancy ?

2-What is the possible cause ?

3-Mention another 2 cuteneous changes with

pregnancy ?

1-What is the name of this abnormality? 1-What is the name of this abnormality? 2-Mention 2 possible causes ?2-Mention 2 possible causes ?3-How it is diagnosed by US3-How it is diagnosed by US4- Mention 2 complications 4- Mention 2 complications

1-What is the name of this condition ?

2-What is the possible cause name 3 ?

3-Mention 3 complication during pregnancy ?

4-Mention 2 complication during labor ?

1-What is the name of this machine ?2- What is the difference between A and B ?3- Give 4 criteria to consider the trace normal

1-What is the name of these 2 fetal head diameterA,B? 2-What is the importance of A ,B?

1-What is the name of this procedure? 2-Mention 2 indication ?3-Mention 2 complication 4-Give alternative method for prenatal diagnosis

1-What is the most probable diagnosis ?2- Mention two risk factors?3- Mention two symptoms ?4- Two methods of investigations?

vesicles

uterus

• What is the name of this operation ?• What is the indication ?• What is the best time to perform this

operation ?

• A patient presented with Unilateral pelvic pain and tenderness, + HCG ,palpable adnexal mass on PV,Exploration reveal this photo,

• 1-what is the most likely diagnosis ?

• 2-Give 2 differential diagnosis

• What Does This Photo Show?• What Is The cause of this abnormality • How to diagnose antenatally?• Mention 2 line of treatment

• What is the cause of this abnormality?• Mention 3 risk factors for this condition ?• Mention 2 maneuver to solve this condition?• Give 2 possible complication ?

What is the name of this manouver ?What is the indication Name 2 precaution Name 2 complication

• What is the name of this operation • What is the type of incision • What is the indication of this operation in the photo • What is the incidence and cause of this

malpresention name 2

• Name the placental abnormality in A ,B ,and C• Give 2 main cause for this condition • Name 2 indication for C.S in this condition • Name 3 complication

1-What is the patient position in A and B2-What is the name of the syndrome in photo A3-Which position is preferred during pregnancy

and why

• What is the name of these instruments?• Give 2 indication for its use• Mention 2 complication if used improbably

• Describe the abnormality you see in this image• Give 2 causes • Name 2 complication• Name the characteristic US appearance of this

condition •

• What this photo show?• What is the commenst site in the tube for

this condition occurs • Name 2 fate of this condition from the photo • Give 2 surgical lines of treatment

• Give the name of this operation• Name 2 indication • Name 3 complication

• What this image show • What is the cause of this condition• How to avoid this complication • How to suspect this complication antenatally

• 1-What is the name of maneuver• 2-Give to prerequisite • 3-Name 2 indication • 4-Name 2 complication • 5-Name 2 precaution

1-Describe what you see in image A 2-Describe what you see in image B3-What is the common site in uterus for this

complication to occur4-Name 2 common causes for this condition in labor

• What is the name of this placenta abnormality • What is A in photo refer to • What B in photo refer to • Name 2 complication for this abnormality

during and after labor

1-What is the name of this maneuver ?2- Give 2 complication for this maneuver 3- Name 2 alternative methods for delivery of

after coming fetal head

• What is the name of this condition• What is the commonest presentation ?• How to diagnose name 2 ?• What is the differntial diagnosis name 2 ?

1-What `this photo show ?2- What is the name of diameter red arrow ?3- Give 3 risk factor for this condition 4- Name 2 maneuver to solve this problem

• What this US image show ?• What is the type of zygosity ?and

choronicity• Name 3complication

• What is the name of this syndrome ?describe briefly ?

• How to avoid it during pregnancy (what is the preferred maternal position to avoid it ?

inferior vena cava

• This is a case of shoulder dystocia • What is the name of this maneuver? • Briefly define how does it work• Name 2 alternative maneuvers

• What is the name of this manouver ?• What is the aim of this maneuver • How to avoid perineal laceration in labor –

name 2 ?

1-What This Photo Show? ?2-How to diagnose direction of fetal back by PV

examination ?3-What is the best line to manage this condition ?

1-What this photo show?2-What is the type of this incision ?3-Give 3 indication for recurrent operation 4-Name 4 complication 2 intra operative ,2 post

operative

1-What image A and B show2-Which type has a better prognosis and why?

1-What you see in photo A 2- What photo B show 3-What is the site of cord insertion in photo A 4-Name 2 abnormal sites for cord insertion

• What photo A show?What does it detect• What photo B show? What does it detect • What is the direction of examiner head in A

and B A B

1-Name of this maneuver?2 -What is the examiner’s hand assessing?3-If the hand can not catch the presenting

part the; presenting part is engaged (Right or wrong)

• 1-Describe the placental abnormality in photo A

• 2- Describe the placental abnormality in photo B

• 3- Name 2 complication for these abnormalities

• What photo A show ?What is the significance of this maneuver

• When maneuverB is considered inaccurate • A B

• 1-What is the name of pelvic outlet diameter in photo A

• 2- What Is The Significance Of This Test• What is thom’s dictum • 3- according to photo B is this diameter normal or

• What is the name of this malpresention ?• What is the diameter of engagment in this case • What is the movement by which head is delivered

• What is the presentation of these fetuses • What is the safest mode of delivery • How you manage if 1st twin delivered

vaginally and 2nd twin retained

• 1-Describe what you see in photo A • 2-What is the name and aim of this maneuver • what you see in photo B,• what is the risk if maneuver A is not done

• 1-What THIS photo show?• 2-What does this manouver detect

• Is fetal head engaged or not?• What is the station the photo show • What is the position of fetal head • Name 3 causes for non engagement of head

in prior TO LABOR

• 1- what is the attitude of fetal head in A,B ,and C• 2-What is the presenting part of fetal head in

A ,B, and C? • 3- What is the denominator in A,B, and C?

• 1-What this photo show ?• 2-What is the name of this instrument • 3-What is the advantage of using this instrument • 4-Name one alternative method to deliver the head

• 1-What is the degree of pernieal laceration in photo A

• 2-What is the degree of pernieal laceration in photo B

• 3-How to prevent perneal laceration in labor? name 2

• What photo A show?• Name 2 diagnostic test for this condition • What is the complication seen in photo B• Name 4 clinical signs for this complication

Amniotic fluid

1-what photo A and B show 2- give 2 complication for this condition 3- Name 3 indication for C.s in this condition 4- name 3 differential diagnosis

Placenta

2- what is the diameter passing through vulval ring (red arrow)?

3- Why is this called ?4- what is meant by crowning ?5- What is the expected next movement of the

fetal head

Occiput

• What this photo show? • which is more common A or B • How many chorion ,amnion in photo A • How many chorion ,amnion in photo B• Name 3 complication for this condition

1-Describe the condition of cervix in photo A,B,C, and D

2-What is the cause of cervical effacement3- what cause cervical dilation name 2 3-In primigravida which occurs first dilation or effacement ? A B C D

• 1-what this image shows • 2-what is the 3 main

item of this graph ?• what is the cause of C.S

as The Graph show?

• What is the name of this cervicogaph? • What does it shows ?• Give the name labor pattern in of A .B .And

1-What is the name of these 3 cardinal movement of labor ?

2-What is the cause of B 3-What is the cause of C

• what is the prerequisite after delivery of 1st twin in photo A?

• What is the preferred mode of delivery in photo B? and why ?

• 1-What this photo show?• 2-What is the comment site for this complication

to occurs • 3-give 3 causes for this complication in labor• 4- Name 2 lines of management

• What is the name of this manouver? • Give 2 indication • Name 3 prerequisite • 2 complications

1- give the name of these 2 cord abnormalities 2- Name 2 complication for these anomalies 3-How to diagnose B antanally ?

• Cesarean hysterectomy ,what this photo show?• Name 2 clinical signs for diagnosis of this

condition at operation • Give the histopathology finding in this case • Name 2 risk factors for this case

Placenta

• What is the name of this placental abnormality?• What is the cause of this abnormality • Name the commonest complication for this

abnormality

• Describe what this photo show? • At what stage in labor this condition occurs ?• Name 3 risk factors for this condition • Name 2 symptoms if this condition occur in

• What is the name of this operation ?• What is the indication of this operation as appear

in the photo ?• What other types of this malpresention • Name 4 indication of this operation in this

malpresention

• What image A shows?What image B show • What is the structure hold by Allis forceps in

red arrow? • What is the structure hold by Allis forceps in

red arrow ?A B

• What is the name of this test? what is the prerequisites for this test ?

• What is the name of instrument A, and B? • What is the indication of this test ?• Name 2 ominous signs requiring interference in

this test

• Name the three component of this graph

• Describe what you see in this cevicograph

• What TR mean • Is this course of labor

normal? and why

• What is the name and length of the pelvic diameter in green arrow ?

• When we considered pelvic contracted according to this diameter

• What is the name of ligament in red arrow(1)?

• 1-Describe what photo A,and B show? • 2-What is the 2 cardinal movement of labor in photo

B• 3-What is the cause of cervical change in photo B

• 1- What the examiner assess in this photo?• What is the value of this examination ?• Which angle is considered normal and why

• What is the name of pelvic type in A,B,and C• Which pelvic type is considered normal,name 3

characters • Which type favors occipto posterior position • Which type favors transverse fetal head position

• 1-What is the name of this patient position • 2-What is the name of this examination ?• 3-What is the information gained by this

exam as photo b shows ? name 2

• What does this photo show • Describe brifely how to deliver both fetuses• Name 3 factors affecting the prognosis of

this condition

1-what is the difference between a ,b, and c 2-which one has the worst prognosis 3-give 2 other factors affecting the prognosis

of the condition 4-name 2 diagnostic signs

• What is the abnormality in this partograph

• What is the cause of C.S as the graph show

• 1-Describe what this graph show

• 2-What is the type of abnormality in this graph

• 3- This case delivered vaginally after correction of which item in the graph

• 1-what this image show • 2-what is the name of this operation • 3-what is the risk of this operation • 4-name 2 alternative methods

• 1- What this graph show?• 2-What is your comment on this CTG trace • 3-What is the degree of this abnormality as the

graph show• 4- at what stage in labor this abnormality occur ? • 5- briefly what is your next step in management

• 1-What is the name of this decleration • 2-Describe its onset and offset in relation to 3-

uterine contraction• 3- What Is The Cause ?

• 1-What this photo show • 2- What is meant by engagment • 2-What is the station of fetal head in A and

B • 3- name 3 importance for the level of ischial

spineA B

• Define the three cardinal movement in labor illustrated in this photo

• What is the cause of internal rotation• What is the station of fetal head in photo B

• What is the name of this operation• What is the indication • What is the next step if this operation failed• Name 3 risk factor for this condition

Uterine artery

• What this image show ?• Name 4 risk factors for this condition• What is the first line of treatment of this case

GYNECOLOGY

• What is the name of this investigation • What is the patient postion for this

examination • What is the abnormality shown in this photo

ovaryULTRASOUND PROBE

• Infertile women taking ovulation induction presented with abdominal pain and enlargement

• What is the name of this syndrome• What is the risk factors • What is the treatment

• A case presented with uterine myoma• 1-What is the name of this operation • 2-What is types of this operation • 2-Name 3 contraindication• 4- name 2 complication

• What is the name of this operation• What is the indication • What is the contraindication • Name 2 complications

• What this slide show • What is the commonest presentation of this lesion• What is the diagnostic method in this photo

• 1-What is the name of this examination?• 2-What is the patient position for this

examination?• 3- Name 3 indication for this examination ?

• What this image show• What is the degree of this condition • Name 3 risk factors • What is the differential diagnosis of this case

• 1- What this photo show• 2- What is the risk factors for this condition • 3- What is signs of malignancy in this case• 4-what is the stage of this lesion

• What is the name of this operation • What is the indication • Name 2 diagnostic test for this condition to be

treated by this operation• Name 3 different types for this condition

• Describe what you see in the photo • What is the types of this condition • What is the most probable type of this

condition as photo illustrate • How to diagnose it clinically

1-Describe what you see in the photo ?

2-What is the different types of this condition? 3- What is the type of this condition as photo illustrate 4-How to diagnose it clinically?

• 1-What is the name of this operation • 2-What is the indication • 3-What is the predisposing factors for this

condition

• 1-What this photo show?• 2-What is the degree of this condition • 3-How to differentiate between A and B

• What this photo show?• What is the pathology in this photo • Name 3 clincal presention for this condition • Name 2 investigation

1- Describe what you see in this photo? 2- Name another 2 investigation to confirm the

diagnosis ?3-What is the differential diagnosis name 3

1-What is the name of this operation2-What are types of this operation2-give 3 gynecological indication 3-Name 3 complications

• What is the name of this test? • What is the indication ?• Name 2 precaution before the test • Name 2 disadvantage for this test

• 1-Describe what this photo show • 2- What is the name of this instrument • 3- What is the indication of this examination • What is the finding in A and B

• 1-What is the type of this uterine anomaly • 2- What is the cause of this anomaly • 3- What is the commonest clinical presentation

• What this photo shows ?• What is the cause of this anomaly • What is the possible complication of this

condition ?

A patient with throbbing pain and swelling in the right side of the vulva

1)which structure is involved 2)What is the diagnosis3)What is the name of the operation for this

condition as photo B shows

1)What is 1 in this photo refere to2- Name 2 differential diagnosis for this condition 2) 3 predisposing factor4) Mention two complications

6) Mention two lines of treatment1

• 1 1 what this photo show what this photo show • What is the site of this complication as the What is the site of this complication as the

photo show photo show 3 - What is the position of this uterus?3 - What is the position of this uterus?5- Identify instrument in arrow (1).5- Identify instrument in arrow (1).6 - Identify instrument in arrow (2).6 - Identify instrument in arrow (2).

• What is the name of this investigation • What is the indication name 2• Name 2 abnormal finding by this examination• Name 2 contraindication

• 1-Describe the character of vaginal discharge in this photo

• What is the name of this characteristic cervical appearance B

• What is the name of the organism in C• What is the specific treatement •

1-What is the name of pathology in this photo 2-What is the presentation of this patient 3-What is the name of investigation in B4- Name 2 alternative investigations 5-What is the best treatment if condition is bilateral

• 1-What is the name of this uterine abnormality • 2-What is the investigation used in this photo• 3-Name 2 clinical presentation• 4-Name 2 obstetrical complication

• What is the name of this operation• What is the indication • Name 2 complications • Name 2 contraindications

1-Describe what image A show ?2-What is the name and cause of this condition ?3-How to confirm the presence of this lesion4-What is the treatment as image B shows •

• A patient with chronic pelvic pain and infertility ,laproscopy revealed this photo

• 1-What is the provisional diagnosis • 2-What is the comment organism responsible for

lesion • 3- What is the specific medical therapy for this

condition

1-Name the type of this intrauterine contraceptive device?

2-List 3 contraindications to the use of this form of contraception

3-Name 2 complications4- Name 3 non contraceptive benefits for this method

1. What this photo show 2. What is the responsible hormone 3. Name 3 possible causes 4. Name 2 drugs used to treat this case ?5. How would you treat it?

1-What is the name of this lesion 2-What is the commenst clinical presentation name 3 3-What is the comment site in pelvis this lesion

occurs 4-Name 2 diagnostic tests and 2 surgical lines for

treatment

A 19years old girl presents with 1ry amenorrhea . She is 141cm.

1) What is the most likely diagnosis

3)What hormone test would you request4) What IS her uterus looks like5) What IS her gonads looks like6) Name two other associated anomalies

1-What is the type of this lesion in A ,and B2-What is the commonest presentation? 3-Name 2 complications? 4-What is best line of treatment in A ,and B

Bladder

Rectum

uterus

Cervix

This is a case of cancer cervix ,From the photo 1-What is the staging of this patient 2-What is the commonest clinical presentation3-Name 2 complication4-What is the best line of treatment (in one word)

Osce revision in obstetrics and gynecology

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