OSPE EXAM

OF
OBSTETRICS
AND
GYNAECOLOGY

(AFMG 2017/2018)
1. Identify the instrument :
- Sim's speculum/Post. Vaginal retractor
2. Mention 2 indications
- D+C
- Any gynaecology operation
3. Complications :
- Injury/Perforation
- Infection
- Hemorrhage
1. Identify : Conjoint twins (Thoracophagus)
2. Causes : Delayed timing of division
3. Mode of delivery : CS
4. Incidence : 18.5 %
5. Prognosis : Depend on vital organs they share
1. Identify :
- placenta succenturiata
- Battledore placenta
- Vellamentous insertion of cord
2. Complications
- Post partum hemorrhage
- Avulsion of cord during separation
- If Vasa previa = Antepartum hemorrhage (fetal
origin)
3. How to diagnose: by US
4. Management:
- Manage PPH (PS)
- Manual evacuation of placenta (BP)
- Depend on the gestational age (VP)
1. Identify : True knot of cord
2. Effect : Fetal asphyxia
3. Causes : Long cord, and fetal passed through it
4. Diagnose : by US
5. Management : Immediate delivery of the baby
1. Identify : Chorionicvillous sampling
2. Indications :
- detect of congenital disease
- detect of metabolic error disease
3. Timing : Early (10-13 week)
4. Precautions :
- Complete aseptic technique
- Guides by US
5. Complications:
- Abortion
- Hemorrhage
- Infection
1. Identify : Adenaxial mass with increasing blood supply (Ring
of fire) -- pictures of Doppler US)
2. Diagnosis : Ectopic pregnancy
3. Causes :
- previous ectopic
- IUD uses
- Tubal pregnancy for any causes
4. C/P :
- short period of amenorrhea
- abdominal pain
- vaginal bleeding
5. Diagnostic tool :
- US with measure of BHCG
- Laparoscopy
6. Treatment :
- Salphyngectomy (if pt is old and has enough child)
1. Hystosalphyngography (HSG)
2. Pathology :
- Hydrosalphynx
- Pyosalphyx
3. Treatment :
- Excision of the lesion
1. Procedure : Pap smear
2. Precautions :
- Must not do intercourses by 3 days
- 3 days without vaginal douching
- post menstrual period
3. Pathology : Cervical erosion
1. Identify : Uterus and cervix
2. Pathology : Submucous fibroids
3. Operation : Total hysterectomy
1. Anomaly of first picture : Uterus didelphas
2. C/P :
- Menorrhagia
- Recurrent abortion
3. Treatment : If there's present of cavity just
leave it
1. Name : Cleft palate with cleft palate
2. Other fetal anomaly :
- Hydrocephalus
- Spina befida
3. Treatment : Surgical correction
1. Define the site :
- Fundal
- Lower down
- Marginalia
- Centralised
2. Dx : by US
3. CP of type D (Centralised) :
- Painless, causeless, recurrent vaginal bleeding
1. Identify : Cervix
2. Define : Ulcer with malignant criteria (protruding mass,
hemorrhagic, barrel shape cx, area of necrosis)
3. CP :
- Contact bleeding
- Offensive discharge
4. Method of early detection
- Pap smear
- Punch biopsy
- Colposcopy
5. TTT :
- TTT of CIN (ablation / excision)
- Active : Surgery + radiotherapy
- Palliative : pain killers
1. Modality : Vaginal US
2. Define : PCOS
3. CP :
- Anovulation/Amenorrhea
- Hirsutism
- Masculinization
4. TTT :
- Decrease weight
- Induction of ovulation (Clomid)
- Surgical : wedge resection/ovarian drilling
1. Procedure : Abdominal Laparoscopy
2. Indications :
- Removal of any pelvic lesion
- Ovarian drilling
- Dx of infertility.
3. Complications :
- Hemorrhage
- Pelvic adhesion
- Gases embolization
- Complications of anaesthesia
1. Define : Patches of endometriosis (black patches)
2. Symptoms :
-- Infertility
- bleading
- dysmenorrhoea
- irregular menses.
3. TTT :
- Medical : NSAID, Progesterone, Anti estrogen
- Surgical cauterisation/laser
- Excision
1. Modality : US
2. Diagnosis : Multiple pregnancy
3. Complications:
- Increase incidence of CS
- Preterm labor
- IUGR
1. Define : Uterus full with vesicular mole
2. CP :
- Bleeding
- Pain
- Period of amenorrhe
3. TTT : Suction and curettage
4. Follow up : Beta HCG
1. Identify : Cusco speculum
2. Uses :
- Routine vaginal examination
- Cx smear
- Insertion of IUD
- Taking of swab
1. Dilator
2. Use :
- 4 : uterine sounds
- 8 : incompetent Cx (use without pain)
- 10 : D+C
- 12 : Fathergill operations
- 14 : treatment of Spasmodic dysmenorrhoea
1. Identify : Uterine sounds
2. Use :
- Dx RVF uterus
- Measure the uterus before insertion of IUD
- Measure the supravagina elongation in prolapse
3. Complications :
- Perforation
- Ascending infection
- Bleeding
1. Name the test : Contraction Stress
Test
2. Pathology : Late deceleration
3. Immediate delivery (if fully dilated
Cx)
1. Identify : Cuppor IUCD / Multiload
IUCD
2. Contraindications :
- Bleeding
- Sepsis
3. Complications :
- Ectopic pregnancy
- Expulsion of IUCD / Perforation
- Missed treat
1. Name device : Merena (hormonal IUCD)
2. Use :
- Contraception
- Dx uterine bleeding
- TTT of endometriosis
3. S/E : Perforation
1. Test : Contraction Stress Test
2. Normal or not? : No (lost of
variability)
1. Name :
- Fundal grip
- Umbilical grip
- 1st pelvic grip
- 2nd pelvic grip
1. Identify : Ventose cup
2. Indications :
- Fetal distressed
- To shorten the 2nd stage of labour
3. Precautions:
- Aseptic conditions
- General or local anesthesia
- Empty the bladder and rectum
- Cephalic presentation
4. Complications:
- Cephalic hematoma
- ICH
- Laceration
- Tear
- Rupture uterus
1. Identify : Spina bifida
2. TTT : Surgical correction
3. Prognosis : Patient will be handicap
4. how to prevent : Take folic acid at 1st
trimester of pregnancy
1. Identify : Frank breech
2. Incidence : no need to mention
3. Best mode of delivery : CS
1. Identify : Hysteroscopy picture of
uterus
2. Pathology : Endometrial polyp
3. TTT : Polypectomy
1. Procedure : Abdominal Laparoscopy
2. Anomaly : Bicornuate uterus
3. CP :
- Menorrhagia
- Preterm labor
- Recurrent abortion
1. Name suture: B lynch suture
2. Indications : PPH
3. Other TTT :
- Hysterectomy
- Uterine artery embolization/ligation
- Economic
- Internal iliac artery ligation
1. Identify : Dermoid cyst
2. Diagnose : by US
3. TTT : Surgical excision
1. Diagnosis : Acute Inversion of uterus
2. Causes :
- Placenta accreta
- Short cord
- Seperation of placenta before sign of Seperation
- Fundal placenta
3. TTT :
- Immediate reduction
- Abdominal exploration
- Pull from abdomen
1. Non Stress Test
2. Normal.
3. Precautions before the test :
- patient must eat
- patient must in semi sitting
position or left lateral position