Gynea&obstetric osce

1. 425 OSCE
slide show
By: 425 people =D

2. *

3. Qs:
Identify the defect in arrow 1.
Identify the anatomic structure in: (1, 2, 3, 4 ).
Name 3 risk factors for this condition.

4. • Cystocele.
• 1= urinary bladder wall, anterior vaginal
wall.
2=rectum
3=uterus
4=urinarry bladder
3. multiparty, old age, genetic connective tissue
weakness, previous injury

5. *

6. Qs:
What is the defect in arrow 3?
What is the position of this uterus?
Identify instruments in arrow (1, 2).
How can you prevent this condition.

7. • Perforated uterus.
• Sharply anteflexed uterus.
• (1=Sim’s uterine sound, 2=metallic vaginal
speculum ).
• 1.US-guided procedure
2.Gentle and gradual insertion.

8. Slide 5

9. *

10. Qs:
• Name this organism.
• How would it present clinically?
• What is the treatment?
• Would you treat the partner? Why?

11. • Trichomonus vaginalis.
• It could present with itching and discharge.
• Treat with metronidazole.
• Yes treat the husband, because it is
infectious sexually transmitted disease.

12. Slide 6

14. Qs:
Identify
Name three indications.
Name three complications

15. • Plastic ventous suction cup
• Indications:
 Prolonged labour
 maternal exhaustion
 Fetal distress
 Maternal medical illness.

16. 3. Complications:
Epidural , cephalic haematoma.
Hyperbilirobinemia
Birth canal injury due to tissue entrapment.
Prolonged suction causes fetal distress.

17. *

18. Qs:
• Name the 4 hormones in menstrual cycle
and from where are they secreted?
• Name the two phases and their
predominant hormone.

19. • FSH……………..from anterior pituitary
LH ………………from anterior pituitary
Oestrogen………from granulosa cells
Progesterone….. from corpus luteum
2. Proliferative phase (by estrogen)
secretary phase-luteal- (by progesterone)

20. Slide 9

22. Qs:
• What is shown in the picture?
• Name 4 common sites for this lesions.
• What are the two main ways of treatment?
mention an example for each.

23. 1.Endometriosis (shown by laproscope)
2.Common sites:
Ovaries
Peritoneum
Ovarian/uterine ligaments
Pelvic wall
cervical

24. 3.treatment
1.Medical:
Pseudopregnency: progesterone pills, OCPs.
Pseudomenopause: danazole, GnRH
agonists.
2.Surgical:
Partial or radical either by :Laproscopy or
laprotomy

25. Slide 10

26. Slide 1

28. Qs
 What do you see?
 Give two DDx.
 What would you ask in Hx. (give 3)
 What would you order for investigation.
(give 3)

29.  What do you see?
 Breast budding.
 Give 2 DDx.
• Complete precocious puberty.
• Incomplete precocious puberty

30.  What would you ask in Hx?
• Ask if she has any pubic or axillary hair?
• Ask if she had any vaginal bleeding or
menses.
• Ask if she has been taking any medications
• Ask for any family Hx in this condition.

31.  What would you order for investigation?
• Check hormonal level of estrogen.
• Check her FSH, LH levels.
• Take radio-images of her brain to rule out
any secretery tumors (sp: pituitary)
• Do an US for her ovaries to rule out any
estrogen secreting tumors (ex: granulosal
cells tumor)

32. Slide 2

33. *

34. Qs
 What is this condition?
 Caused by which hormone?
 What could cause it elevation?
 What other posible symptoms could it
present with?
 How would you treat it?

35. What is it?
Galactorrhea
By which hormone?
Prolactin

36. What could cause its elevation? (give 4)
Physiological (lactating breast-feeding
mother)
Pituitary adenoma
Drug-induced.
Other prolactin-secretory tumors.
Idiopathic elevation.

37. Possible other symptoms: give 2
Infertility
Amenorrhea

38. How would you treat?
Medically: bromocreptine (for decreasing
prolactin secretion and reducing adenomas
size),
clomid (to restore fertility)
Surgical: remove the tumor

40. Qs
 What is your Dx?
 What symptoms would present (give 2)
 What hormones would be elevated?
 How would you treat?

41. What is the Dx?
Polycystic ovarian syndrome (PCOs)
Symptoms:
Acne
Hiristisum
Infertility
Irregular menses

42.  What hormones would be elevated?
(Give2)
• LH
• Androgens
• Insulin

43. How would you treat?
Give combined OCPs (for hiristisum and
prevention of endometrial cancer due to
elevated unopposed estrogen
Or give progestrone to prevent endometrial
cancer
Give metformin for insulin resistance.
Remove ovary surgically if associated with
neoplasm or unreasoning to medications.