1. This document contains questions and answers about various medical conditions and procedures. 2. Topics covered include cystocele, perforated uterus, Trichomonas vaginalis infection, ventouse delivery, the menstrual cycle, endometriosis, precocious puberty, galactorrhea, and polycystic ovarian syndrome. 3. For each topic, the document provides definitions, descriptions, risk factors, treatments, and other relevant clinical information.

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.