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Osce picture test in obstetrics and gynaecology

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osce picture test with DR ADEGBENGA AJEPE

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Osce picture test in obstetrics and gynaecology

  1. 1. OSCE Picture test in Obstetrics and Gynaecology Dr. Okechukwu A. Ugwu
  2. 2. . About this instrument a) It can be used for hindwater rupture of membrane F b) Its use is associated with cord prolapse T c) Its use is associated with foetal injury T d) It can cause uterine hyperstimulation F e) Its use is contraindicated in retroviral positive patients F
  3. 3. Prevention of ureteric injury 1. Generous surgical exposure T 2. Meticulous surgical technique T 3. IdentifIcation of Risk factors T 4. Ureteric stenting T 5. Pre operative IVU not necessary F
  4. 4. About this instrument a) It is a high cavity forceps F b) It is a non-rotational forceps and so can be used in the correction of asynclitism F c) It has a sliding lock T d) The cervix should be at least 8cm dilated for its use F e) It causes more maternal injury compared to the vacuum extractor T
  5. 5. Concerning this a) It is a permanent measure of management F b) Pregnancy is a contraindication F c) It should be changed every 6 months F d) It can be complicated by vaginal infection T e) If it fails, surgery is indicated T
  6. 6. About the condition depicted below a) It is common in postmenopausal women F b) Cystic degeneration usually precedes hyaline degeneration F c) The intraligamentary form can cause polycythaemia T d) GnRH antagonists are useful in its management T e) Iron deficiency anaemia secondary to chronic blood loss is an indication for surgical management. **T
  7. 7. Features of delayed ureteric injury Prolonged ileus T Watery vaginal discharge T Prolonged high output from drains T Fever/sepsis. T Persistent flank/ abdominal pain T Flank mass T Elevated creatinine or BUN T
  8. 8. About the Instrument 1. They are indicated in maternal exhaustion. -T 2. Bladder must be empty but the catheter bulb need not deflated-F 3. Associated with more maternal worries about the baby compared to Vacuum. -F 4. Associated with lower APGAR scores compared to vacuum.-F 5. Ideal traction of 30-45 lb.-T
  9. 9. 6. Cervarix offers protection-F 7. May contain oncogenic subtypes of HPV-T 8. Contraception is mandatory while using podophyllin-T 9. Neonatal laryngeal papilomatosis is a recognized potential problem.-T 10. Histology is necessary for diagnosis- F
  10. 10. Concerning this instrument, a. It is used in fistula repair T b. Cusco’s speculum can be used in its place F c. Its use requires one assistant T d. Its use requires more than one assistant F e. Autoclaving is contraindicated F
  11. 11. About this instrument a) A tourniquet can be used in its place. T b) It is useful in vaginal hysterectomy F c) It is used in clamping the isthmus of the fallopian tubes F d) It helps reduce blood loss during surgery T e) It can be left in place for at least 2 hours F
  12. 12. Concerning the use of this instrument: a. It is used to reduce the bisacromial diameter and allow for vaginal delivery F b. Cervix need not be fully dilated in experienced hands T c. It is employed in the commonest type of destructive surgery. T d. Continuous bladder drainage is essential after its use T e. At least 2/5th of the fetal head must have gone into the maternal pelvis if its use is indicated F
  13. 13. Concerning the picture shown and intrapartum monitoring a. The duration between two vertical lines on a partograph is half hour. T b. In the primigravida, the cervix dilates at a rate of at least 1 cm/hr in the active phase T c. The alert line is parallel and 4hours to the right of the action line F d. Vaginal examination is done four hourly. T e. Plastic Pinnard stethoscope is better than the metallic one in monitoring fetal heart rate. T
  14. 14. Concerning the picture shown a. Birth weight of 1400gram is an indication for Caeserian delivery. T b. Engagement of the presenting part in the pelvis is not a contraindication for external cephalic version. F c. High parity is a predisposing factor T d. Lovset manouvre is used to deliver the head F e. Kielland’s forceps can be used in the delivery of the aftercoming head F
  15. 15. Concerning uterine incisions during Caesarean delivery a. A is associated with less likelihood of adhesion formation to bowel or omentum T b. A is more commonly used than B T c. B allows for easy entry into the uterus when there is fibroid in the lower segment T d. B is associated with less likelihood of subsequent uterine rupture during pregnancy F e. A is indicated in the presence of carcinoma of the cervix F A B
  16. 16. Multiple gestation a. Cleavage of zygote on day 9 after fertilization produces the picture shown F b. The intertwin membrane is made up of 2 layers of amnion with no chorionic layer F c. Inheritance as autosomal recessive trait is recognised F d. There is a risk of twin to twin transfusion F e. Caeserian delivery is indicated if the presentation of the first twin is vertex and the second twin non-vertex F
  17. 17. Concerning this picture a. This is a complication of external cephalic version T b. Coagulation failure is a complication T c. Foetal parts will be easily outlined on palpation.F d. The uterus will have a hard wooden consistency on palpation T e. Caeserian section should be performed if the fetus is dead on presentation. F
  18. 18. 11. Used by 2% of Nigerian women.-T 12. Failure rate of ideal use is 2%.-F 13. Use associated with deep vein thrombosis but not myocardial infarction in obese women.-F 14. Increased risk of rheumatoid arthritis.-F 15. Risk of Stroke is increased in women with migraine but lower in those with aura.-F
  19. 19. 16. Outer ring needs to be held prior to penetration.-T 17. Can be noisy and cumbersome-T 18. More likely to rupture than male condom.-F 19. Contains spermicide-F 20. Failure rate of 5% with ideal use.-T
  20. 20. 21. Sensitivity of 96%-F 22. Liquid based type make diagnosis of HPV and Chlamydia possible-T 23. Abnormality found in 10% of all samples-T 24. False negative result may be up to 70%-F 25. Nationwide programme has reduced incidence of Ca. Cervix by 95%- F
  21. 21. 26. This is a Karman syringe- F 27. Volume of syringe is 50cc- F 60CC 28. 5-10mm cannula for 9-12weeks-F 29. Provides sunction pressure of about 640mmHg-T 30. Can be used for menstrual regulation.-T
  22. 22. 31. Size and rate of growth influenced by sexual stimulation.- T 32. N. gonorrhoeae and Chlamydia Trachomatis are most often isolated in the abscesses-F -E.coli 33. Word Catheter has a role in management.-T 34. Silver Nitrate ablation may be used in treatment. -T 35. Biopsy is mandatory in patients under 40years-F
  23. 23. 36. Postdatism and malpresentation may be complication-T 37. Oligohydramnios often associated-F 38. Defect results from malformation around day 35 of embryonic life.-F 25 39. Late neonatal death is common.-F EARLY 40. Folic acid supplementation may reduce incidence.-T
  24. 24. 41. Monoclonal in origin-T 42. Red degeneration is the commonest form of degeneration-F 43. Only submucous type has been shown to be linked with infertility-F 44. Uterine artery embolization not recommended for women who wish to preserve fertility. -T 45. Recurrence after myomectomy is about 20%.-F 10-15
  25. 25. 46. About 80% of patients are above 55years –F 65 47. Commonest site is labia minor-F 48. Two-thirds occur in women with Lichen sclerosis-T 49. 4-8% of squamous cell type linked with Paget disease.-F <1% 50. Stage 3 has 5-year survival rate of about 75%.-T
  26. 26. 51. Bilateral in about 25%-F 52. Stroma ovarii if parathyroid tissue is demonstrated.-F 53. Immature variant accounts for 20% of all ovarian malignancy in females less than 20 years-T 54. Immature variant are commonly bilateral-F 55. Squamous cell carcinoma is the most common histology of malignant transformation in mature variant.-T
  27. 27. 56. Flexion point is 3cm from anterior fontanelle-F 57. Negative pressure of 600mmHg is recommended-T 58. Use associated with increase risk of shoulder dystocia-T 59. Retinal haemorrhage commoner in forceps than in this instrument.-F 60. May be used during Caesarean section.-T
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osce picture test with DR ADEGBENGA AJEPE

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