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New: 5th year Course Book/Gynecology

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  • 1. Course Book Contents 1- Course coordinator and list of teachers on this course. 2- Course overview 3- Course objectives. 4- Course Reading list. 5- Course Contents. 6- Syllabus. 7- Exams: Rules and instructions. 8- Samples of expected questions and their answers. 9- External examiners. 10- Student's feedback.
  • 2. Course coordinator and list of teachers on this course 1-Name of the Course: gynecology. 2-lecturer/tutor in charge: Dr Hanaa alani 3-Department Branch and the college: Department of Obstetrics and Gynecology/ College of Medicin 4-Contacts: -Address: University of Sulaimani/ College of Medicine/ Department of Obstetrics and Gynecology. -E-mail:HA_GRD @yahoo.com -Website Link: -Other participant Lecturers: 1-Dr. Sallama Kamel Nasir. 2-Dr. Sundus Yousif Kellow. 3-Dr. Hanaa Abbas Al-ani. 4-Dr. Mahabat Salih Saeed
  • 3. Course Overview The clinical and basic science of gynecology deals with female genital organs (external and internal). This involves the normal development, physiology and functions of the female genital organs, as well as abnormal development. The course deals with all diseases (including infections and malignancies) of the female reproductive organs.It also deals with infertility and contraception. Course objectives The fifth year students usually have about 30 theoretical lectures/ year in gynaecology (2 hours / week), and they have three weeks/ year of clinical session( 3hours/day, 5days/ week ) in suliamani maternity teaching hospital. For theoretical lectures by the end of the year the students should have knowledge about: - Normal and abnormal sexual development and puberty - The normal menstrual cycle -Disorders of the menstrual cycle - Fertility control( contraception). -infertility -Disorders of early pregnancy (abortion, ectopic pregnancy and trophoblastic diseases). -Infections of the female genital organs - Benign and malignant tumours of the female genital organs - Endometriosis and adenomyosis
  • 4. - Urogynaecology - Uterovaginal prolapse - Menopause. Regarding the clinical sessions: The 5th year students will have 3weeks /year of clinical sessions during which the student will learn how to take history from a woman with gynecological problem and how to examine a woman as well as they are going to see instruments, contraceptive methods and x rays used in gynecology.
  • 5. Course Reading list REFRENSES: Gyaenecology by Ten Teachers 18th edition. Further reading: 1 – Essentials of Obstetrics and Genecology 4th edition. 2 – Lecture notes obstetrics and gynaecology 2nd edition. 3- Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds
  • 6. Syllabus No. Title of the Subject Lecturer's/Tutor's Name 1. Developmental &congenital malformation of female genital tract Dr Hanaa Alani 2 Physiology and menstruation Dr Hanaa 3 Vaginal discharle Dr Hanaa 4 Adolescence & puberty Dr Hanaa 5 PID Dr Salama 6 Tuberculosis of the lenital tract Dr Hanaa 7 Infertility & IVF Dr Hanaa 8 Sexually transmitted diseases and AIDS Dr sundus 9 Family planning Dr mahabat 10 Abortions (miscarriages) Dr mahabat 11 Dysmenorrhea & premenstrual syndrome Dr sundus 12 Abnormal uterine bleeding Dr Salama 13 Early pregnancy problems and ectopic pregnancy Dr mahabat
  • 7. 14 Trophoblastic disease Dr mahabat 15 Endometriosis Dr Salama 16 Primary Amenorrhea Dr sundus 17 Secondary amenorrhea &polycystic ovarian syndrome Dr Hanaa
  • 8. 18 Intersexuality Dr Hanaa 19 Genital prolapsed Dr Salama 20 Urine incontinence Dr mahabat 21 Tumours of the vulva(benign &malignant Dr Hanaa 22 Tumours of the vagina (benign &malignant Dr Hanaa 23 Benign tumours of the uterus Dr mahabat 24 Premalignant diseases of the cervix Dr Hanaa 25 Malignant diseases of the cervix Dr Hanaa 26 Carcinoma of the endometrim Dr sundus 27 Menapouse &HRT Dr mahabat 28 Postmenapousal bleeding Dr sundus 29 Operative gynecology Dr mahabat 30 Chronic pelvic pain Dr sundus 31 Ovarian tumours (benign) Dr Salama 32 Malignant ovarian tumours Dr Salama 33 Pre &postoperative evaluation Dr Hanaa
  • 9. First Subject: Family Planning: Lecturer/tutor’s name: Dr. mahabat Salih saeed Learning Objectives: 1) to outline the types of contraception 2) to evaluate the methods of contraception, the advantage and disadvantage of each method. 3) to determine the complications of contraception. Reference: Gynaecology by ten teachers, 18th edition, Chapter 6, fertility control -Obstetric and Gynaecology by Lawrence Impey, Printed in 1999 Chapter 12 Contraception, page 78. -Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds 7th edition 2007, Chapter 32, page 299 Early pregnancy problems: Lecturer/tutor’s name: Dr. Mahabat Salih Saeed 1. Miscarriages
  • 10. Learning objectives: 1) To familiarise the students with the cause of early pregnancy bleeding, 2) To learn about the risks of morbidity and mortality associated with miscarriages 3) To learn the methods of diagnosis References: - Gynaecology by ten teachers, 18th edition, Chapter 8, Disorders of early pregnancy. -Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds 7th edition 2007, Chapter 12 + 13, page 94, 100 -Obstetric and Gynaecology by Lawrence Impey, Printed in 1999 Chapter 14, page 94 2) Ectopic Pregnancy Learning objectives: 1) To learn about risks of Ectopic pregnancy 2) To understand the seriousness of the delayed management 3) To outline the methods of management References: -Gynaecology by ten teachers, 18th edition, Chapter 8, page 97 -Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds
  • 11. 7th edition 2007,Chapter 14, page 106 -Obstetric and Gynaecology by Lawrence Impey, Printed in 1999 Chapter 14, page 97 3) Trophoblastic disease Learning objectives: 1) To determine the types of trophoblastic disease, differentiate between benign and malignant types. 2) To understand the types of management References: Gynaecology by ten teachers, 18th edition, Chapter 8, page 99 Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds 7th edition 2007, Chapter 15, page 117 Obstetric and Gynaecology by Lawrence Impey, Printed in 1999 Chapter 14, page 100 5) Benign tumours of the uterus Learning objectives: 1) to understand the effect of this problem on pregnancy 2) To provide a framework for different ways of managing this problem. 3) To learn about the types and locations of fibroids.
  • 12. References: Gynaecology by ten teachers, 18th edition, Chapter 9, page 103 Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds 7th edition 2007, Chapter 56, page 636 Obstetric and Gynaecology by Lawrence Impey Printed in 1999 Chapter 3, page 18 6)Menopause and HRT Learning objectives: 1) to know the definition of menopause and age of menopause 2) to recognise the psychological and physical signs of menopause 3) to raise awareness about the benefits and risks of HRT References: Gynaecology by ten teachers, by Ash Monga 18th edition Chapter 18, page 207 Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds 7th edition 2007
  • 13. Chapter 47, page 479 Obstetric and Gynaecology by Lawrence Impey Printed in 1999 Chapter 13, page 86 7)Operative Gynaecology Learning objectives: 1) to learn about the technique of laparoscopy and hysteroscopy 2) to understand the risks of laparoscopy and hysteroscopy. 3) to determine the indications for these procedures. References: Gynaecology by ten teachers, by Ash Monga 18th edition Appendix 1, common gynaecological procedures, page 232 Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds 7th edition 2007 Hysteroscopy and laparoscopy, chapter 50, page 560
  • 14. Obstetric and Gynaecology by Lawrence Impey Printed in 1999 Chapter 15, page 103 1-Normal and abnormal sexual development • Genetic sex is determined by the presence of the sex chromosomes X and Y. • The presence of a Y chromosome determines male development; the absence of a Y chromosome leads to a female phenotype. • In Turner's syndrome, the absence of a second X chromosome leads to streak ovaries. • If the testis fails to develop or cannot function, the default state is female. • True hermaphrodites have both ovarian and testicular tissue.The effect is determined by the dominant cell line • Congenital absence of the uterus and vagina is the second most common cause of primary amenorrhoea. • Uterine maldevelopment does not usually result in reproductive failure. • External genitalia in girls may be virilized by excessive androgen exposure in utero. • Puberty is genetically determined and controlled from the hypothalamus. References Gynaecology by Ten Teachers,2006,18th Edition,P21 2-Gynaecological disorders of childhood and adolescence • Gynaecological problems in the prepubertal child and at adolescence create great levels of anxiety in parents • The end result of puberty is the establishment of the fully physically mature adult woman capable of reproductive performance and fully psychologically developed as an adult. • Precocious puberty is defined as the onset of secondary sexual characteristics prior to the age of 8 years. The aetiology of this is varied. • Delayed pubertyis rare with only 1% of females not having had menarche by the age of 18. If there are no secondary sexual
  • 15. characteristics by the age of 14 delay is diagnosed and investigation is appropriae. References • Gynaecology by Ten Teachers,2006,18th Edition, 3-INFERTILITY History, examination, investigations and counselling must include both partners • Treatment should be initiated taking into account the duration of infertility, the female partner's age, previous conception history and success rates. • Men with abnormal sperm analysis should have endocrine assessment; those with low «5 million/mL) or no sperm must be offered chromosomal analyses. • Couples must be given written information regarding the risks of ovarian hyperstimulation syndrome, multiple gestation and ovarian tumours. • FSH and human menopausal gonadotrophin should be used in low dose in clomiphene-resistant women ; clomiphene is an effective treatment in anovulatory women. • All ovulation induction cycles should be monitored References • Gynaecology by Ten Teachers,2006,18th Edition,P30 • Dewhurst’s textbook of obstetrics and gynaecology. / edited by D. Keith Edmonds. –7thed. 2007 4-Genital tuberculosis • Genitourinary TB is almost always secondary to infection elsewhere in the body, usually pulmonary TB, but active pulmonary disease can be documented in only one third of patients • Vascular dissemination is responsible for infection of fallopian tubes in almost all patient with genitalTB, & involvement of endometrium follows in 90% • Most patients are cured by medical management alone , patients who respond poorly or who have other problems( e.g tumer or
  • 16. fistula) may require total hysterectomy & BSO after a trial of chemotherapy. References Current obstetric &gynecologic diagnosis &treatment,fiftht edition,p421-422,2003 5-Premalignant conditions of the cervix. • Dysplasia The process of metaplasia can be disrupted by external influences& can lead to disordered squamous epithelium called dysplastic epithelium ( HPV ,smoking , immune suppression may act as coagent • Observation and repeat Pap smears and biopsies can confirm such spontaneous self-correction. Currently, there is no treatment per se for CIN I, which either resolves or progresses to CIN II, which is treated. • If CIN does not resolve but instead progresses, or is detected at CIN stage II or III, treatment is needed to prevent the development of invasive disease. • CIN lesions may be treated on an outpatient or inpatient basis. References • Current obstetric &gynecologic diagnosis &treatment,fiftht edition,p894-903,2003 • Gynaecology by Ten Teachers,2006,18th Edition 6-cervical cancer
  • 17. • The cervix is made up of two kinds of cells: columnar cells and squamous cells. Columnar cells constantly change into squamous cells in an area of the cervix called the transformation zone. As a result of this natural process of change, some cervical cells can become abnormal. Infection can also cause abnormal cervical cell changes. When abnormal cell changes persist over time (years) and become severe, these cells may develop into cervical cancer • Surgery is generally only employed in early stage cervical cancers. • Higher stage disease is usually treated with radiation and chemotherapy, but sometimes surgery is employed if cervical cancer comes back after it has already been treate References • Current obstetric &gynecologic diagnosis &treatment,fiftht edition,p903,2003 • Gynaecology by Ten Teachers,2006,18th Edition, 7-HYPERANDROGENISM, HIRSUTISM AND POLYCYSTIC OVARY S • The most common clinical presentation of hyperandrogenism in reproductive-aged women is hirsutism or acne with or without evidence of anovulation such as oligoamenorrhea - or amenorrhea or dysfunctional uterine bleeding. • PCOS is the most common cause of hirsutism and the most common endocrinopathy in reproductive aged women. • The etiology of anovulation in PCOS is often explained by high intraovarian androgen levels which induce atresia and prevent the emergence of a dominant follicle
  • 18. • There are many therapies for the induction of ovulation in PCOS patients. The aim of medical therapy in hirsutism is to suppress androgen production, block androgen receptors or decrease the conversion of testosterone to dihydrotestosterone by inhibition of the enzyme 5a-reductase References • Current obstetric &gynecologic diagnosis &treatment,fiftht edition,p1001,2003 • Gynaecology by Ten Teachers,2006,18th Edition, 8-Secondary amenorrhea • the cessation of menstrual flow for a period of 6 months or more in the absence of pregnancy, breastfeeding or menopause. • The problem may lie in the hypothalamus and the pituitary, or the uterus or the ovary. Other endocrine glands like the thyroid, the pancreas and the adrenal cortex also have a role to play in causing amenorrhoea. References • Current obstetric &gynecologic diagnosis &treatment,fiftht edition,p991-1000,2003 • Gynaecology by Ten Teachers,2006,18th Edition
  • 19. 9-Vaginal discharge • In children, vaginitis usually involves infection with GI tract flora (nonspecific vulvovaginitis). • Women of reproductive age: In these women, vaginitis is usually infectious. The most common types are bacterial vaginosis ,candidal vaginitis and trichomonal vaginitis which is sexually transmitted. • Postmenopausal women: Usually, a marked decrease in estrogen causes vaginal thinning, increasing vulnerability to infection and inflammation. • Normal vaginal discharge is white, becoming yellowish on contact with air, due to oxidation. References  Dewhurst’s textbook of obstetrics and gynaecology. / edited by D. Keith Edmonds. –7thed ,2007  Obstetrics and gynaecology an evidence- based text for MRCOG  Gynaecology by Ten Teachers,2006,18th Edition, 10-DISEASES OF THE VULVA and VAGINA •Be familiar with common inflammatory conditions affecting the vulva and vagina. Know which are infectious and which are frequently transmitted sexually. • Understand the relationship between HPV, VIN, VAIN, and squamous cell carcinoma. • Be familiar with “Bowen’s disease” and “extramammary Paget’s disease.” • Understand the relationship between DES, vaginal adenosis and clear cell carcinoma of the vagina.
  • 20. • Know which mesenchymal tumors (benign and malignant) can involve the vagina. References  Dewhurst’s textbook of obstetrics and gynaecology. / edited by D. Keith Edmonds. –7thed ,2007  Obstetrics and gynaecology an evidence- based text for MRCOG  Gynaecology by Ten Teachers,2006,18th Edition, Subject name: pelvic inflammatory disease. This subject is given in two hours. Objectives: this lecture is included in the program so that the student can understand the following 1. The natural defense mechanisms against genital infection. 2. The conditions that predispose to genital infection. 3. What is pelvic inflammatory disease? 4. causes of PID. 5. Pathological changes of PID. 6. Clinical presentation and diagnosis of PID. 7. Complications of PID. 8. Treatment of PID. References Gynecology by ten teachers 18th edition. Current for obstetrics and gynecology. Dweharts for obstetrics and cynecology 7th edition
  • 21. Endometriosis: This lecture is included so that the student will understand the following: 1. The definition of endometriosis. 2. The theories that explain the development of endometriosis. 3. The pathological features of endometriosis. 4. Clinical features and diagnosis of endometriosis. 5. The relationship between endometriosis and infertility and endometriosis. 6. Treatment of endometriosis. References: Gynecology by ten teachers 18th edition. Dwehurts obstetrics and gynecology 7th edition. Ovarian tumours: This subject is given in two hours. Objectives: This subject is included so that the student should understand: 1. The classification and different pathological types of ovarian tumours. 2. What is functional ovarian cysts and how to differentiate between functional ovarian cysts and true ovarian tumours?
  • 22. 3. How to differentiate between benign and malignant ovarian tumor. 4. How to diagnose ovarian tumours. 5. Risk factors of malignant disease of the ovary. 6. Staging of malignant ovarian tumours. 7. Management of ovarian tumours. 8. Prognosis and 5years survival. References: Genital prolapse: Objectives: 1. Defenition of genital prolapse. 2. Classification of genital prolapse. 3. Structures that support the genital organs and prevent prolapse. 4. Factors that predispose to genital prolapse. 5. Clinical presentation of genital prolapse. 6. Treatment of genital prolapse. Reference: Gynecology by ten teachers 18th edition. Dwehurts obstetrics and gynecology 7th edition. NAME OF THE LECTURE: DYSMENORRHOEA Objectives: At the completion of this presentation, the participant should know: 1 – Definition and classification of dysmenorrhoea.
  • 23. 2 – Etiology, diagnosis and management of primary dysmenorrhoea. 3 – Etiology, diagnosis and management of secondary dysmenorrhae 4 – Definition and the various hypothesis behind the etiology of premenstrual syndrome. 5 – Diagnosis and management of premenstrual syndrome. References: 1 –Gynaecology by ten teacher 17th edition. 2 –Current 2003 obstetric and gynaecologic diagnosis and treatment 9th edition. NAME OF THE LECTURE: Sexually transmitted infections (2 hours) Objectives: At the completion of this presentation, the participant should know: 1 – Principles of management of sexually transmitted infections (STDs). 2 – Why STDs are a significant problem, classification of STDs. 3 – Chlamydia trachomatis; prevalence, signs and symptoms, diagnosis and treatment. 4 – Gonorrhea; incidence and epidemiology, diagnosis and treatment. 5 – Classification of genital ulcer diseases. 6 – Herpes simplex virus; epidemiology, primary and recurrent herpes infection, diagnosis, treatment and complications. 7 – Syphilis; epidemiology, clinical features, diagnosis and treatment. 8 – Tropical Genital Ulcer Disease; Lymphogranuloma venereum (LGV) and Chancroid. Their clinical features and treatment.
  • 24. 9 – Human papilloma virus; epidemiology, diagnosis and treatment. 19- HIV infection; virology, diagnosis, transmission, natural history and principles of treatment, gynecological manifestations of HIV, Vertical transmission of HIV and how to minimize it. References: 1 –Gynaecology by ten teacher 17th edition. NAME OF THE LECTURE: PRIMARY AMENORRHOEA Objectives: At the completion of this presentation, the participant should know: 1 – Definition of primary amenorrhoea. 2 – Causes of primary amenorrhoea. 3 – Description of the various causes of primary amenorrhoea. 4 – General investigations of primary amenorrhoea . 5 – Management of the various causes of primary amenorrhoea. References: 1 –Gynaecology by ten teacher 17th edition. 2 – Lecture notes obstetrics and gynaecology 2nd edition. NAME OF THE LECTURE: Disorders of the menstrual cycle// abnormal vaginal bleeding Objectives: At the completion of this presentation, the participant should know: 1 – Classification of menstrual disorders.
  • 25. 2 – Definition of the various terms used in abnormal uterine bleeding. 3 – Causes of abnormal uterine bleeding. 4 – MENORRHAGIA; definition, prevalence, classification and etiology. 5 – Diagnosis; clinical features, Initial investigations, Investigations in women who fail to respond to treatment after 3 months. 6 –Treatment; various medical options and surgical treatment (different types and indications). References: 1 –Gynaecology by ten teacher 18th edition. 2 – Essential of obstetrics and gynecology 4th edition. NAME OF THE LECTURE: Post menopausal bleeding (PMB) Objectives: At the completion of this presentation, the participant should know: 1 – Definition of PMB. 2 – Causes of PMB; gynecologic causes and non gynecologic causes. 3 – Management of PMB including diagnosis, investigations and treatment options. References: 1 –Gynaecology by ten teacher 18th edition. 2 – Essential of obstetrics and gynecology 4th edition.
  • 26. NAME OF THE LECTURE: Operative gyneacology/ laparoscopy Objectives: At the completion of this presentation, the participant should know: 1 – What is pelvic endoscopy. 2 – What is laparoscopy; indications and contraindications of the procedure. 3 – Equipment for laparoscopy. 4 – Technique of laparoscopy. 5 – Complications of the procedure. References: 1 – Dewhursts textbook of obstetrics and gynaecology 7th edition. 2 – Lecture notes obstetrics and gynaecology 2nd edition. NAME OF THE LECTURE: Premalignant and malignant disorders of the uterine corpus Objectives: At the completion of this presentation, the participant should know: 1 – Epidemiology and incidence. 2 – Etiology and risks factors for endometrial hyperplasia and cancer. 3 – Classification; endometrial hyperplasia and malignant endometrial cancer. 4 – Pathology, spread, and FIGO staging of endometrial cancer. 5 – Clinical presentation and diagnosis. 6 – Differential diagnosis and prognosis.
  • 27. 7 – Treatment of the different stages of endometrial cancer. References: 1 –Gynaecology by ten teacher 18th edition. 2 – Essential of obstetrics and gynecology 4th edition. :
  • 28. Student's feedback on the subject Date: Course: Year: Lecturer/ tutor: No. Evaluation Questions Subject's Level 1-5 Subjective Remarks 1 The objectives and key messages of the subject were clear 2 The contents of the subject were useful and related to the main objectives of the course 3 The materials were prepared carefully as needed 4 The lecturer/ tutor while lecturing tried to analyze the principles, contents and the important points of the subject simply and properly. 5 The lecturer/ tutor while lecturing kept my attention. 6 The lecturer/ tutor came into the classroom on time and was committed to the duration of the lecture. 7 The lecturer's behavior in the classroom was calm and respectful. 8 The slides used in the lecture were clear and attractive. 9 At the end of the lecture, the lecturer gave the students a chance for questions and comments. His/ her answers were complete. 10 The reading sources are new and compatible with the subject. Total of the levels
  • 29. Exams The fifth year students will have one clinical exams and one written final exam. The clinical exams is at the end of the course & it includes all the gynecological cases that have been discussed in an out patient clinic in maternity hospital ,the student is asked about history, examination,investigation& how to manage these cases including medical & surgical management. For the written exam, it is only one exam at the end of the year lasts for 3 hours and includes the following types of questions: 1. An essays questions (there will be long and short essays): For long essays the student will asked the following: Discuss, write in details about, how you manage, mention the causes, presentation and management, ect. For such type of question the student should write in details about the subject. Standards to evaluate the level of the contents 1 2 3 4 5 Very bad Bad Mediu m Good Very good
  • 30. For short essays, the student will asked to enumerate, write briefly, and Mention the causes, ect. For such question the student should answer briefly according to the question. We advice the students to do the following in order to have proper answer: -To read the questions twice. -Think carefully before answering. -Plan the answer on a separate paper. -The answer should contain preface, main contents and conclusion. 2.Multiple choice questions: For such questions, there will be a statement and below it four different answers. For each answer the student should write true or false. 3.Single choice questions: For such question there will be a statement, and below it four different answers, the student should select one answer only which is the right answer.
  • 31. Samples of the expected questions and their answers Long essay question: A 32- year- old lady with 8 weeks amenorrhea came to outpatient clinic with mild vaginal bleeding and she feels no more pregnant and ultrasound result showed no fetal heart. What is your management plan: To answer such question, the student should analyze its component: 1. Woman with 8weeks amenorrhea and she feel no more pregnant, this means that she is pregnant 8weeks. 2. Clinically she feels disappearance of symptoms of pregnancy and her ultrasound showed no fetal heart sound so the pregnancy is not viable, so the diagnosis is missed abortion. 3.Treatment of such woman will be treatment of missed abortion at 1st trimester and the student should write about treatment in details. Short essays questions: 1. What are the complications of fibroid on pregnancy? 2. Enumerate the types of urinary incontinence. To answer such questions is only by mentioning the complications and enumerating the types.
  • 32. Multiple choice questions In the presence of a positive pregnancy test and vaginal bleeding, the following are possible differential diagnoses if the CERVIX is closed: (T ) a – Ectopic pregnancy. (F ) b – Incomplete miscarriage. ( T) c – Threatened miscarriage. ( F) d – Inevitable miscarriage. (T ) e – Complete miscarriage. – Regarding the pathophysiology of pelvic organ prolapsed: ( F) a – Pelvic organ prolapse is commoner in nulliparous than in multiparous women. ( F) b – Pelvic organ prolapsed is never seen in nulliparous women. (T) c –Prolapse is commoner after the menopause partly due to oestrogen deficiency ( F) d – Epidural in labour is a risk factor for subsequent development of prolapse. ( T) e – Forceps delivery is a risk factor for the development of prolapse. The main tissues which provide support to the uterus include: (T)a- uterosacral ligaments (F)b-perineal body (F)c- round ligament (T) d-cardinal ligaments (F) e-broad ligaments
  • 33. Single choice questions: Select the ONE lettered answer or completion that is BEST in each statement below. 1–The most common symptom of endometrial hyperplasia is: a –Vaginal discharge. T (b) –Vaginal bleeding. c –Amenorrhoea. d –Pelvic pain. e –Abdominal distensions. 2 –Hirsutisim is associated with all the following EXCEPT: a – Polycystic ovary syndrome. b – Congenital adrenal hyperplasia. c – Cushing syndrome. d – Increased androgen utilization by skin. (T) e – Hyperprolactinemia. For each description below, choose the SINGLE most appropriate answer from the above list of options. Each option may be used once, more than once, or not at all.
  • 34. 1 –Gynaecological investigation: a –colostomy. b –laparoscopy. c –hysteroscopy. d –hysterosalpingography. e –ultrasound. F –more than one of the above. G – None of the above. D 1- A procedure that assesses both the uterine cavity and tubal lumen. B 2- A procedure that visualizes pelvic endometriosis. C 3- A procedure that visualizes the endometrial cavity. F 4-A procedure that assesses the tubal patency.
  • 35. External Examiner From now on every course should have its own external examiner with identified roles. The one who can play the role of an external examiner should: • Have an academic post with the scientific rank of assistant Professor and higher. • He/she should be an active, reputable and experienced academic staff in his field or a related field to the course. • He/she should have not participated in lecturing or administering of the course. The roles of the external examiner are: • Evaluating the contents and the program of the course. • Prior to the exam, he/she should contribute to choosing the questions and looking at the ideal answers. • Evaluating the process of the examinations: he/she should see all the marked exam papers, then choose randomly nine marked papers: three with high marks, three with medium and three with low marks.
  • 36. • Evaluating the students' feedbacks • He/she should participate in the final meeting of the first round examinations committee and give his assessment on the entire course and the examination process, then to give his opinion about the final results. • He/she should participate in the final meeting of the second round examinations committee and should have a main vote on those problems that may face them. • Then the lecturer/ tutor in charge will respond to the external examiner's questions and will reply officially to all the questions and clarify the reasons.
  • 37. Student's Feedback on the Course Date: Course: Year: Lecturer/ tutor: Evaluation Questions Subject's Level 1-5 Subjective Remarks 1 The objectives and key messages of the subject were clear 2 The contents of the subject were useful and were related to the main objectives of the course 3 The coordinator teacher had worked hard to prepare the materials 4 The coordinator teacher had worked hard to cooperate and prepare the course 5 The lecturers were carefully selected and were expert in their fields 6 The coordinator teacher gave a good attention to the students' criticisms and claims 7 Information on the Examination process was well provided 8 The questions of the exams were related to the contents of the course.
  • 38. 9 Total of the levels 10 There is a potential to promote and develop the course in the following areas: Standards to evaluate the level of the contents 1 2 3 4 5 Very bad Bad Medium Good Very good