Soalan2 boss….

1) All about miscarriages – sila baca protocol mawar in and out dan buku hijau yg harga rm12 tu
a. Definition
b. How do u know it is viable fetus or not by ultrasound. (gestational sac regular, no
endometrial lining distortion) how to calculate gestational sac volume. (AP diameter X
longitudinal diameter X tranverse diameter X 0.532 = gestational sac volume)
c. What is blighted ovum (anembriyonic pregnancy)? How to diagnosed ? kl ikut dkt bilik
scan dkt mawar tu ( gestational sac volume ~ 2.5 and no fetal pole seen = anembryonic
pregnancy)– sila confirmkn dgn MO
d. Management of threaten miscarriage
e. Mx of incomplete miscarriage (when to do ERPOC, when to do explora, when to do
conservative mx)– once diagnosed incomplete miscarriage, subject patient for ERPOC
“without scan”. Explora is a second line for ERPOC. Ideally, we subject patient for
explora when ERPOC not available (such as : no free schedule, patient dah 2 hari kat
hospital) ni jawapan2 dr boss sendiri yg sempat dihafal. Yg lain Tanya MO
i. Indication for conservative mx for incomplete miscarriage : POG < 12 weeks,
min bleeding, os closed, provided no s/sx of infection, patient’s house nearby to
hospital ( patient need to come to mawar regularly as a outpatient to repeat
scan )
ii. For conservative mx : wait for spontaneous abortion . This is when ultrasound
play a role : repeat at day 0 (day of diagnosis)-allow discharged ,ask pt to come
at MAWAR day 3 and day 10 to repeat scan.
2) PAP smear :
a. MOH recommended - women 20 years old who is sexually active
b. Method : currently liquid base (no more conventional method)
c. How to do pap smear : explained to the pt indication for pap smear, comfort patient,
put patient in dorsal position, apply cusco speculum , take pap smear using brush.
d. Where to take sample ? at Transformation zone (TZ)
e. Definition TZ – area between original and new squamouscolumnar epithelial junction.
f. Clinically how to recognized TZ ? (soalan nie x sure jawapan, kita org jawab pelbagai
jawapan tp boss tetap xstuju jwapan kitaorg, tanya MO, MO pun xsure jawapan) – dlm
internet : present of whitish spot at SC epithelial junction (after apply 5% acetic acid) –
sila cari jawapan lain yer..
g. Sila tgk contoh result pap smear. When we want to refer for colposcopy? (sila baca cpg
pap smear yg agak tebal tu , psl negative intra epithelial lesion or no malignanvy,
atypical squamoes with high grade or low grade lesion… bla…bla… yg sgt byk tu.
Memorize that!!!!
h. Pap smear related dgn cervical CA – so kena bc jugaklah cervical CA
3) Molar pregnancy = type, how it occurred ? mx
4) Ectopic pregnancy
5) Ovarian CA – risk factor?
 a. Age – mean age 62-65
b. Anything that can increase ovulation : early menarche, late menapouse, nulliparouse, on
ovulation induction agent (clomid),
c. Fanily hx of ovarian CA –
d. Genetic – BRACA1 BRACA2
e. Perineal talc usage

Protective factor ? – COC, pregnancy, pt already underwent hysterectomy without

oopherectomy

6) Contraception
7) Hormonal therapy ( HRT)

Soalan2 obst dr DR. Nuraini

- Dr Nuraini more on open question –

1. PPH – definition, management
2. Breech delivery – principal hands off .
3. Definition High risk pregnancy
4. Def Eclmapsia and mx
5. Mx of twin pregnancy
6. Definition of labour, stage of labour, phase of labour.
7. Def of normal labour.

Kesimpulan: sila study gynae betul2, obst part, rasanye seme org power, study gynae mcm nk ambik
exam pro deh…. Byk teory ….Good luck!!!!

Dan janganlah kamu iri hati terhadap apa yang dikaruniakan Allah kepada sebahagian kamu
lebih banyak dari sebahagian yang lain. (Karena) bagi orang laki-laki ada bahagian dari pada
apa yang mereka usahakan, dan bagi para wanita (pun) ada bahagian dari apa yang mereka
usahakan, dan mohonlah kepada Allah sebagian dari karunia-Nya. Sesungguhnya Allah Maha
Mengetahui segala sesuatu. (4:32)

-aufa asiah-