Mini-OSCE OBS & GYN.pptx

Q1)
‫صورة‬
‫بارتوجرام‬
‫عليها‬ ‫نعبي‬ ‫واحنا‬
‫خالل‬ ‫من‬ ‫المعلومات‬
‫الهيستوري‬
…
‫السؤال‬
‫وسهل‬ ‫واضح‬ ‫لكنه‬ ‫شوي‬ ‫طويل‬
*

Q2) a-what is the name of this
device?
b-name of the procedure?
C-4 advantage for this
procedure?
d)if the amniotic index was 29
and on rule of 5 was 5/5 what
well happen if you use this
instrument?
E)if the patient had previous
one C/S can you use this
instrument and why?

•
Q3)19 years old female complaining of
hairsutism,acne:
a-give 2 questions you will ask her in history
b-give to finding you will see in P/E
C-investigation to this patient
d-if there is ultrasound findings of 12 follicles
with normal total testosterone level what is
you’re diagnosis?
e- If it PCOS what is you’re management?
**

Q4)a 70 years old female patient
complaining of mass protrusion from
her vagina with cytometry image:
a- what are the findings in cystometry?
b-what is the probable diagnosis and
what the cause of it
c-what is the pelvic floor problem in
this patient?
d- give other symptoms the patient
may complain
e) fill this table

Q5)female patient came with
abdominal contractions pain, GA
32,
a-what is the name of this test?
b-reflect for what?
c-if the reading was 22.000 what is
the name of the result
d-what is the next step?
e-if there is gush of fluid what is
youre probable diagnosis?
f-how you will diagnose PPROM
clinically?
g-what is you’re management?

•
Q6) a 7 years old female patient came for vaginal bleeding for 4days,
no acne or hairsutism image with secondary sexual finding)
•
a-what is the diagnosis (precocious puberty)
•
b-investigation
•
c-what is the most common type of this diagnosis
•
d-suppose all investigations are normal what is the probable
diagnosis?
•
E)what is you’re management

Gynecology & Obstetric
29/8/2023

Station 1
1. What is the procedure and type ?
2. Instruments used
3. If she complain after 3 hours of
perineal pain what do u think the
cause?
4. How to confirm?
5. Mangment

Station 2
1.what is this, indication?
2. Complication?
3.the patient come after 3
days, complaining from fever
what do you think the most
common cause of her
complaint?
4.Managment

Station 3
33 female, para 1 by ovarian stimulation,( cs before 5 years) ,
infrequent cycle, hairstusim, DM
1. What are the cause of infrequent cycle in general?
2. What is the diagnosis in this case?
3. Investigation?
4. Mangment?
5. If she came with vaginal sottig what is the mangment?

57 female, menopause 2 years,
complain of vaginal spotting
1. What will you ask in histroy?
2.examination?
3. If tests unmarkable what is the
most cause?
4.How to confirm your diagnosis?
Station 4
Thickness <2mm

1. What is this
2. Prequset
3. Complication
4. If she get
pregnant with iucd
what is the
mangment?
Station5

1. What is the presentation?
2.Diameter and it's name
3.finding in examination
4. If she is -2 station with 5cm dilatation
and after 6hours she still like that what
do you think the cause is ?
5. How would you deliver her?
Station 6

Osce
27 year old married woman G4P0+4 come to clinic my to explore
the cause in US the uterus is normal
What is the name of this case ?
What is the possible causes?
What are the relevant questions in history?
“”””””””””””””in examination?
What is the investigation if the cause is antiphospholiped
syndrom ?
What are the treatments?

37 year old married woman G4P2+1 the GA37 week
CC decrase fetal movement
In US absent fetal heart
In examination fundal high is 32
What the relevant question in history
“””””””””in examination ?
Most common causes?
Investigation ?
Management? (Medical and surgical)

37years old
recurrent miscarrage para zero +4
1.cause of miscarrage in general?
2.most common cause with this case?
3.management
4.investigation

RTA, Admitted via ER, 26 Years old, GA34 week, abdominal pain.
1.what the relevant question in history?
2.physical examination finding?
3.CTG For fetus»* baseline heart rate
*variability
4. managment?

2 previous second trimester miscarrage. one
preterm labor
1.what is the most likely cause?
2.what is the relievant point in history and
examination
3.investigation
4.managment

Mini-OSCE Archive
Eslam Al-Tarawneh
Walid Azayzeh
Laith Najada

Station 1
1- What is the name of the test?
2
How to define the abnormal
lesions? (Mention 2)
3
What is the indications for this test?
(Mention 3)
4
What is the next step and what is the
name of the tool that used for it?
5
If its CIN 2, what is the management?

1
5% Acetic acid
2
a) Acetowhite lesion
b) Abnormal atypical blood vessels 3- a) Any
abnormal results from cytology
(b
persistent (two consecutive years) positive testing for high-risk human
papillomavirus and normal cytology
(c
Evaluation of a palpably or visually abnormal cervix, vagina, or vulva
4
Cervical biopsy using cervical punch biopsy forceps
5
Ablative therapy (e.g. cryotherapy) / Excisional treatment (e.g. LEEP or cold
knife conization) / Hysterectomy if completed her family
Answers

Station 2
49 year old women para 5 complain of a mass
protruding from her genital opening, there is no
significant thing from the history except that she
had a bilateral tubal ligation 5 years ago
1- What is your diagnosis?
2- What is the stage according to POP-Q?
3- What is the level of support and what is the
structures at this level?
+
+
+
+ +

Station 2
4- What is the urinary symptoms associated
with this case? (Mention 5)
5- If it's associated with postcoital and
intermenstrual bleeding, you should rule out
what?
6- what is the best management for this patient? +
+
+
+ +

Answers
1- Procidentia
2
Stage 4
3
Level one of support (Suspension)
(a
Uterosacral ligament
b) Cardinal ligament
4
urinary frequency, urgency, voiding difficulty, urinary tract infections, stress
incontinence, Incomplete emptying of bladder, and splinting
5
I think its either fibroid & decubitus ulcer or large uterine polyp
6- Vaginal hysterectomy with SSLF

Station 3
1- What is the signs shown in the picture?
(Mention 2)
2
What is the maternal complications from
PET? (Mention 5)
3
What is the fetal complications?
(Mention 5)

Station 3
4- Mention another methods for screening?
(Mention 4)
5- If she came at 12th week of gestation,
what will you give her as prophylaxis?
(Mention 2)

Answers
1- a) Early diastolic notch b) low end-diastolic flow
2
Eclampsia / Brain hemorrhage or stroke / Disseminated intravascular
coagulation (DIC) / HELLP syndrome /
Blindness / Renal failure
3
a) Reduced blood supply to the placenta
(b
Impairment in fetal growth oxygenation and increased risk of stillbirth
(c
Premature delivery for maternal and / or fetal indications
(d
Babies are subjected to the additional risks arising from prematurity: -
brain hemorrhage / seizures / respiratory and feeding difficulties
(e
neonatal death

Answers
4- MAP / PlGF / sFlt-1 / PAPP-A
5- a) low-dose Aspirin (75-150 mg)
b) calcium
supplement / statin

Station 4
29 year old married women complain of
infertility for 3 years.
1
What is the name of the test?
2
Identify the findings in the picture. 3-
What is your advice to her and why?
4- Breast tenderness and midcycle pain
indicates what?

Answers
1- Hysterosalpingogram (HSG)
2
HSG showing :
(a
speculum
(b
patent cervix
(c
normal uterine cavity with no filling defect
(d
bilateral dilated tubes with no free spillage
3
Bilateral salpingectomy followed by IVF because the tubes are blocked by
fluid and swelling
4
Indicates ovulation (ovaries are intact)

Station 5
35 year old female G4P3 came to you as
regular visit on 18th week of gestation.
1
What is the relevant history about the
previous pregnancies ? (Mention 3)
2
What is the relevant history about the
current pregnancy? (Mention 2)
3
What is your next step?
4
If she came at 22nd week, and the antibody titer
is 1:64 what is the next step?
Husband blood
group
A+
Indirect coombs
test
Positive
1.5 MOM
0.75 MOM

Station 5
5
According to the shown diagram, what is
your management at:
(a
28th week of gestation
(b
32nd week of gestation
(c
35th week of gestation
Husband blood
group
A+
Indirect coombs
test
Positive
1.5 MOM
0.75 MOM

1
a) Are they born alive?
(b
Did you have any complications during pregnancy?
(c
Did you deliver them at term or not?
2- a) What is your blood group? (
‫الؤسالب‬
‫ةروكذم‬
‫تناك‬
‫ام‬
‫ركذتب‬
(
(b
Did you feel the movement of the baby or not?
(c
Did you have any vaginal bleeding during pregnancy?
3- Indirect Coombs test and antibody titer
4- Follow up until titer reach 1:32
Answers

5
a) Anti-D and follow up
(b
Intra-uterine transfusion
(c
Deliver the baby
Answers

Station 1
29 year old female para 4
1
What is relevant point about
menstrual cycle you would ask?
2
What is your diagnosis?
3
What is protective factor in her
history?
4- You will be worried about what if she
has the same way of treatment?
5- What is the best method to diagnose it?
‫ة‬
‫ر‬
‫و‬
‫ص‬
‫ال‬
‫س‬
‫ف‬
‫ن‬
‫ش‬
‫م‬

Answers
1- Regularity / Frequency / Duration / Amount / Associated symptoms / AUB?
2
Fibroid
3
Multiparity
4
Infertility
5
MRI

OSCE Archive

Case of polyhydramnios at 32nd week of gestation
1
Diagnosis?
2
Causes?
3
Investigations?
4
What will you find on U/S?

Case of oligohydramnios at 32nd week of gestation
1
Diagnosis?
2
Causes?
3
Investigations?
4
What will you find on U/S?

Case of heavy menstrualbleedingfor the last 3 periods
1
Diagnosis?
2
Other DDx?
3
Relevant physical examination?
4- Management?
5- what the name of drug use for acute
management to stop bleeding?

Case of postmenopausal woman complain of vaginal
spotting, U/S show endometrial thickness of 10 mm
1- Relevant history?
2-4 DDx?
3- What is your next step?
4- Management?

Obs & Gyne Mini-OSCE
5th year
27/12/2022
Group 5
By: Ahmad Abu-Morad
Osamah Alawneh
Mahmoud darwish

Station 1
1.name of this procudure?
2.Indication?
.3
Causes of this
problem? 1. 2. 3. 4.
.4
At what gestational age this procedure is done
and why?
1. 2. 3.
.5
When to
remove? 1. 2. 3.

Station 1 ansewers
1.Cervical cerculage
2.Cervical incompetence
3.1.Previous kone biopsy or LEEP
2.Cervical trauma in previous deliveries
3.Short cervix <2.5 cm
4.Previous termination of pregnancy
.4
14 weeks , to bypass the high risk of miscarriage and to make sure that the fetus is
healthy
.5
1)In case of preterm labor
2)At 37 weeks
3)Miscarriage

Station 2
27 year old lady married complaining of primary infertility?
1.Describe the U/S finding ?
1. 2. 3. 4.
2.mangementat this time?
3.Complications ?
1. 2. 3. 4.
.4
if patient present with acute pain, management?
1. 2. 3.
.5
Complications of recurrent ovarian cystectomy?
1. 2.

Station 2 answers
(1
unilocular
2)Thin wall
(3
No solid component
(4
5 cm in diameter
.2
follow up for 3 cycles
.3
1) Torsion
2)Haemorrhage
3)Rupture
4)Infection
.4
Emergent laparoscopic left ovarian cystectomy
5.1.decrease ovarian reserve
2.Pelvic adhesion

Station 3
Partogram
1.Cervical dilatation and head decent at admission?
2.membrane intact or ruptured?
.3
Uterine contractions after 3 hr of admission?
.4
How to asses the progress of labor regarding what points?
1. 2. 3. 4.
.5
what is the name of this problem in the partogram? And what is the most
common cause?
.6
what is the management in this situation?

Station 3 answers
.1
4 cm Dilatation
5 cm descent
.2
Clear rupture
.3
3 strong contractions per 10 min
.4
1)Head descent
2)Cervical Dilatation
3)Moulding
4)Contraction
.5
secondary arrest ,Cephalopelvic disproportion
.6
C/S Delivery

Station 4
.1
what is the presentationand position?
Incidence?
.2
Head attitude?
.3
presenting diameter and its length?
.4
method of delivery?
.5
if there is prolonged 2nd stage of labor
how to deliver?

Station 4 answers
.1
Face presentation, mentoanterior
Incidence: 2%
.2
Hyperextended
3.Submentobregmatic 9.5 cm
4.Vaginal delivery
5. Instrumental vaginal delivery by foreceps only

Station 5
44 year old female,pelvic floor disorder ,
done for her this procedure
.1
Dx?
.2
Clinical Presentation / CC regarding
your dx?
.3
relevent points in hx?
.4
physical examination?
.5
if the patient refuse surgery, your
management?

Station 5 answers
.1
Urine incontinence
.2
Urine leakage with increased intraabdominal
pressure
.3
1)Sudden onset of incontinence
2)the presence of abdominal or pelvic pain
3)Haematuria
4)changes in gait or new lower extremity weakness,
5)cardiopulmonaryor neurologicsymptoms
(6
mental status changes
(7
Drugs intake,caffeine
4.1)Inspect the vaginal mucosa for signs of atrophy
(thinning, pallor, loss of rugae), and inflammation
2)Palpate bimanually to evaluate for masses or
tenderness.
(3
Assessfor pelvic organprolapse:hold the blade
firmly against the posterior vaginal wall. Ask the
woman to cough once, looking for urethral leakage
&/or cystocele.
(4
Bladder stresstest: is performedby asking the
patient, with a fullbladder, to stand, relax, and
give a singlevigorous cough
5. 1)Reduce factors that worsenthe problem → obesity,smoking, medication, excessive fluid intake
2)Pelvic floor exercise & biofeedback, Electrical stimulationof pelvic floor muscle
3)Estrogen therapy (in postmenopausalwomen with urogenital atrophy).
(4
Vaginal Pessaries.
(5
Medication:Duloxetine, Impiramine.

Station 6
49 year old female, multiparous, heavy period, cyclic pain
The patient underwent TAH with BSO
.1
your dx
.2
points from hx supportyour dx
1. 2. 3. 4.
3 complications may happen during this surgery?
1. 2. 3. 4. 5.
4. Risk sites for ureter injury in this surgery?
1. 2. 3.

Station 6 answers
1. Adenomyosis
2.1)Heavy menstural bleeding
2) Advanced maternal age
3)Multiparous
.3
• general anaesthetic complications.
•
bleeding.
•
ureter damage.
•
bladder or bowel damage.
4.

Osce stations
Station 1
history taking on booking visit GA 6weeks patient with chronic
hypertension
Station 2
Heavy menstrual bleeding since the last 3 months with known case of
breast cancer
**history taking relavent point?
**physical examination ?
**investigations?
**cause of her bleeding? Drug use (tamoxifine)

Obs & Gyne Mini-OSCE
5th year
1/11/2022
6 stations, 10 marks each, 40 minutes 
By: Osama Al-Lahham & Ebaa Al-Khattab

Q1: a female that her last menstrual period was 8 weeks ago,
presented with bleeding and passage of the structures in
figure A
1
describe what you see in figures
A-
Hydropic vesicles
B-
snowstormappearance
2
Complete Molar Pregnancy
3
Mention 6 relevant questions in the history that you’ll ask?
figure B
4
Mention 4 lab investigations to do?
5
Mention 4 steps in management.
figure A
Station 1

a 17 years old female that never had her period comes to
the clinic, blood pressure normal, thyroid normal, height is
163, all othertests are normal.
1- What is your provisional diagnosis?
2- what does her Tanner stage tell you?
3- mention 2 differentialdiagnosis
4
Mention 2 investigationsto do
5
regarding presence of pubic and axillary hair, what is
your diagnosis and why?
Station 2

1
what is the name of the procedure? Tubal ligation
2
What time of the patient’s cycle is the best to do this procedure?
3
mention 2 other contraceptive surgical procedures that could be
done
4
what advices will you give the patient?
5- failure rate of this method?
Station 3

A female in her 11th week of gestation
1
Mention the abnormalities in the ultrasound
1-
2-
2
Mention the abnormalities seen in the combined
test?
3
name the procedure to be done at this gestational
age.
4
mention 2 complications of the procedure done in
the previous question?
5
what is your diagnosis? Down syndrome
Station 4

A G4P3 female, previous 2 vaginal and 1
cesarean deliveries, she is in her 30th week of
gestation, she came to the hospital due to
leakage of fluid and fetal distress.
1
Relevant history?
2
what investigations should be done
3
your diagnosis?
4
if you find fluid in the posterior fornix with closed cervix what is the
diagnosis and management?
5
the most serious complication?
Station 5

OSCE: 2 stations
•
Station 1
•
History for a female in the booking visit
•
At 11 weeks what investigations you should do
•
Which patients are at high risk for Pre-Eclampsia?
•
What is the drug given for prophylaxis of Pre-Eclampsia?
•
Station 2
-
History for a 30 years old female with Abnormal Uterine Bleeding.
-
what investigations and
physical exam you should do?
-
according to this picture, what is your diagnosis and management.
Polyp, treated by excision

OSCE
•
Station1
•
History for a female in the booking visit
•
At 11 weeks what investigations you should do
•
How do you screen for patients at high risk for Gestational DM?
•
Station 2
•
History for patient with Abnormal Uterine Bleeding
•
Physical exam and Investigations?
•
According to this picture, whats your diagnosis and management.
Ectropion,treated by ablation

Mini-osce exam group A
4TH YEAR
30/8/2022
Done by :
Mohammad Banibaker
Sulaf al Maaitah

Station one :
1- what’s yourdx :
2-according to pop_Q staging systemwhat's the
grade? And why ? Providing that gh=4.5,pb=1,tvl=8
3- if she was able to reduce it
what are the findings on :
A- cystometre :
B- uroflowmetry :
4- after the treatment of this prolapse
what is the type of prolapse that youexpect the
patient to come with ?
5 – according to Delancy's levels of support at what
level the defect is ?

Station two :
33 years old , primiparous , GA 41 months ,
planned for induction of labor ?
1
what are the relevant points in hx you
want to ask about :
2
name the maneuvers inA,B,C
3
what are the finding on physical exam
on b,c ?
4
what are the relevant physical exam
findings in this patient ?
5
ctg pic ??
It was Reactive
6 – before proceeding
into iol what do you
want to make sure of ?

Station three :
1
Name the two epi.
A-
b-
2
the most likely dx ?
3
mention Two risk factors for this condition
?
4
before starting the treatment what do you
want to assess ?
5
mention two treatment options

Station four :
30 years old female presented to you two weeks after
delivery complaining of increased lochia for tow days
duration , on examinationher temp was 38.5 c
(the picture was cbc result showing just leukocytosis,
otherwise normal)
1
What’s the most likely dx ?
2
What other symptoms the patient may complainof ?
3
what other signs you want to assess on physical
exam ?
5
mention two risk factors forthis condition ?
6
what other investigations you want to do to confirm
yourdiagnosis
(puerperal sepsis endometritis )

Station five :
1
What's the Stage ?
2
Why is it important to stage endometriosis ?
3
what are the laparoscopic findings in this
condition ?
4
what’re the tx options ?
5
what is the feared outcome following tx of
these patient ?

Station six
( Portogram picture showing features of secondary arrest )
the patient was para 1 , no rupture of membrane
1
Dilatation on admission ?
It was 3 diagnosis
2
What’s your diagnosis ?
Secondary arrest
3
what are the causes ?
Cpd
malposition , malpresentation
insufficient uterine contractions
4
if you came to examine this patient at 6 hours what do you want to
assess ?
Assess the adequacy of the pelvis via clinical pelvimetry , assess for any
signs of obstruction likeexcessive molding and caput , and assess uterine
contractions along withposition and the presentation of the baby
5
if there was infrequent uterine contraction what do you want to do ?
augmentationof labor via amniotomy and oxytocin

•
OBS
& GYN MINI
OSCE
•
6TH YEAR
•
10/6/2022
DONE BY:
Abdelrahman bdeir

Picture 1
This radiology taken in the 20 weeks gestation of
pregnant women show periventricularcalcification
Picture 2
This radiologytaken in the 23 weeks gestation of
pregnant women & her 3 year child complainof
slapped cheek rash

Picture 1
Q1 what is the diagnosis?
Congenital cytomegalovirus infection
Q2 mention 2 intrauterine finding other than that mention in the
question?
1
microcephaly
2
hydrops fetalis (accumulation of fluid in two cavities)
Q3 mention 2 clinical finding after delivery?
1
microcephaly
2
skin changes (blueberry muffin rash)
3- chorioretinitis

Picture 2
Q1
what is the interpretation of the picture?
The middle cerebral artery Doppler showing that its above the normal
around 1.30 mom indicate that the baby has a mild to moderate
intrauterine growth restriction
Q2 what is the intrauterine complication?
Fetal hydrops (accumulation of fluid in two cavities)
Q3 what is the cause?
Parvovirus b19
Q4 what is the management?
Follow up and intrauterine blood infusion if it become severe

Q1 what is the active gradient in this device?
Etonogestrel & ethenyl estradiol
Q2 mechanism of action?
1
Inhibit ovulation
2
thickening mucus
Q3 pearl index with typical use and perfect use?
Typical use …. 8
Perfect use …. 1
Q4 how many used per cycle?
1 ring (not 3 its not a skin patch)

Q5 when its insert and why?
In the first day of cycle (day 1), because it needs 5 days to produce the
effect, and so we can be confident that there is no pregnancy will
occur
Q6 mention 3 types of malignancies that can be decreased with this
device?
1
ovarian ca
2
endometrium ca
3
colon ca

A pregnant women came with uterine contraction , had
a history of elevatedblood pressure during pregnancy

Q1 what is the type of analgesia used?
Neuraxial (epidural)
Q2 what are the indicationof this type of analgesia?
1
patient request
2
normal vaginal delivery
3
no hypovolemia or ongoing blood loss
Q3 mention 2 consideration?
1- platelet count it must be more than 70000-80000
2- the site is clear no abscess or cellulitis
Q4 what are the concern of using this type of analgesia?
The epidural analgesia decrease the mean blood pressureso it will benefit
from using this type of analgesia

Q5 what are the complication of using this type of anesthesia?
1
hematoma
2
severe hypotension if piercing an artery
3- abcess
Q6 what is the CTG finding?
Prolong deceleration, some students say bradycardia

A 45 years old female multiparouscomplaining of heavy menstrual bleeding

Q1 what is the name of the procedure?
hysteroscopic examination
Q2 mention 2 things from the history suggest a cause of adenomyosis?
1
multiparous
2
heavy menstrual bleeding
Q3 mention 2 other procedures can be done?
1
saline hysterosonogram
2
Hysterosalpingography (HSG)
Q4 indication of this procedure?
1- no obvious finding on ultrasound
2- biopsy taken
3
remove polyp or submucosal fibroid

Q5 what findings can be seen using this procedure?
1
polyps
2
submucosal fibroids
3
congenital anomalies
Q6 if every things was normal what method of treatment can be
used?
Endometrial ablation

fasting 105
1 hour 180
2 hour 155
3 hour 150
A case of dm

Q1 what are the interpretation of those pictures?
picture 1 …. The fasting was abnormal (above 95) & 3 hour was
abnormal (normal below 140) so 2 reading were abnormal so its
diagnosed gestational DM
Picture 2 …. Large for gestational age (its over the 90%)
Q2
what is the management?
Insulin & dietary changes
Q3 mention 2 obstetric complication?
1
shoulder dystocia
2
post partum hemorrhage

Q4 intrapartum management ?
1- withhold morning insulin
2- Glucose infusion
3
Insulin infusion
4
Monitor maternal glucose level
5- CTG
Q5 what can you advise this patient after the delivery ?
1
to monitor her glucose after delivery and post puerperium
2
to tell her doctor in the next pregnancy that she was previous
gestational DM

The same partogram was in the exam and unfortunately the
picture was not clear as this

Q1 what are the dilatation and descent at admission?
4cm & -1
Q2 what is the dilatation in the 2nd vaginal exam?
6 cm
Q3 what are the physical findings in vaginal exam at 4pm that
indicate obstructed labor?
1
molding become 3
2
there is meconium liquor
3-there is no dilatation
Q4 how many contraction in 2nd vaginal exam and what is the
intensity?
3 contraction per 10 minutes, with mild intensity

Q5 What is the type of anesthesia that is used in this patient?
according to the picture the drug is not clear maybe pethidine
or
paracetamol
Q6 what are the action that should be taken to enhance the
progress of labor in 2nd vaginal exam?
1-rupture the membrane
2-oxytocin

OBS & GYN MINI
OSCE
3/11/2021
DONE BY:
Asma’a Ghanem
Razan Al-tarawneh

A B C
•
1-In picture a write what represent a,b,c,d?
•
2-what type of prolapse patient b suffer from? Vault prolapse
•
3-when patient c reduce the mass back to the vagina then start voiding , what
we call that? Splinting
•
4-patient b did hysterectomy and she is diabetic (uncontrolled) what is your
management? First thing she has to control here dm to be fit for surgery, the
surgery will be Sacrocolpopexy , Sacrospinous ligament fixation
(SSLF),
Uteroscaral ligament suspension, ileococcygeous
suspension, Vaginal
mesh kits

Write down steps of long protocol in ART
chronologically after the down regulation till the
retrieval of embryo and the goal for each step
•
After 1 week ( on day28) period will occur , on 2nd day of period we must check if the down regulation was successful ornot by 2 ways :
•
Vaginal US to see if there are follicles or not (if no follicles this means successful downregulation, Endometrium 8-9mm good )
•
Estrogen (17 beta-estradiol) level must be low, if both conditions are present continue to next step.
•
On 3rd day of period Give injectable ovulation induction agents (menopausal or recombinant FSH ) daily .
•
After 1 week check if she is responding or not (normal responding  continue same dose , over responding  decrease dose or under responding increase dose )
to avoid ovarian hyperstimulation syndrome.
•
Continue dose and repeat US dayafter day to measure size of follicles , until we have at least 3 follicles measuring at least 17 mm in size.
•
Give HCG to trigger ovulation and release of the egg (release of egg should occur 40 hours afterHCG is given) .
•
Oocyte retrieval should be done at day 13 of cycle, 36 hours afterHCG (not beyond to avoidrupture and release of egg) , under sedation or GA by vaginal approach
under US guidance ,All follicles >10mm aspirated
•
Eggs arepicked fromthe specimen that was drawn .
•
give progesterone at day of Oocyteretrieval to maintain lueteal phase to support implantation .
•
Insemination by 2 methods :
•
Conventional IVF :
•
If husband has good number of sperms , wash and clean them then put 50,000-100,000 motilesperms in each test tube , and
put one egg (after removing cumulus oophorus) in each , then wait for spontaneous fertilizationto occur
•
ICSI (intra-cytoplasmic sperminjection ) :
•
If failed IVF , Teratospermia , Asthenospermia , severe oligo or azospermia we inject one sperm in the cytoplasm of the egg and
wait for fertilization.
•
Fertilization normally takes 12 hours to occur
•
5-6 days after fertilization the blastocystwill form, so wedo embryo transfer by transvaginal approach (same as in IUI) , embryo transfer can also
be done at day 3 after fertilization at this stage wecall it 8 cell stage not blastocyst, maximum 2 embryos transferred

25 years old leady complaining from menstrual irregularity
U/S done for her:
.1
Descripe U/S findings?
Cystic mass ,thin wall ,no solid component.
.2
What is your management plan?
Follow up for 3 cycles.
.3
What are the complicationsmay occurs for this mass?
1. Infection 2. torsion 3.rupture 4. hemorrhage
.4
If the patientcome with severe right iliac
fossa pain whal would you do for her?
cystectomy
.5
If the patient had recurrent cystectomy how can this
affect her?
Decrease her ovarianreserve

This CBC for pregnant previously healthy leady (92 gestational age) , she said that she has
no symptoms:
1.What is the abnormalityin this CBC?
Low plateletcount
2.Most likely diagnosis?
Gestational thrombocytopenia
3.What support your diagnosis?
1.Previously healthy
2.asymptomatic 3.platelet> 70,000 4. late
gestational age
.4
What would confirme your diagnosis?
After delivery plateletcount will improve
.5
Mention other obstetric complicationsresult in this abnormality?
1. HELLP syndrome 2. Amniotic fluid embolism 3.abroptio placenta
CBC ALL READINGS
WERE NORMAL
EXCEPT PLATLET
COUNTE
77,000

Pregnant lady comes to the hospital with sudden gush of fluid , she
denays presence of abdominal pain (36 weeks gestational age) she
admittedto the hospitalfor induction:
1.Take relevant history from the patient?
- Amount , color , odder of fluid - abnormalvaginaldischarge – abdominal
pain -Vaginalbleeding- Dysuria -Cord prolapse
.2
Physicalexamination?
Vitalsigns : temperature and PR
Abdominal exam : tender
Sterile speculum: cough or pooling signs
.3
What is the type of method of induction used for her?
Slow release pessary
.4
During induction , CTG shows decelerations, what is the
type of these decelerations?
Late decelerations

.5
What cause of this type of decelerations ?
Uteroplacental insufficiency
.6
Whats your management?
-Left lateral position
-
IV hydration
-
Oxygen
-Stop induction

35 years old female comes with hemoptysis after complete molar evacuation ,
B-HCG done for her was 100,000.
.1
Most likely diagnosis?
Choriocarcinoma
.2
Other investigationsyou would do for her?
-
Pelvis U/S
-
-chest x-ray
-
CT for abdomen and brain
.3
Relevantgynecological symptomsmay present with it?
vaginalbleeding Uterine rupture
.4
What is your management plan?
Treatment with chemotherapy methotrexate or dactinomycin &monitored with weekly serial
measurements of serum beta-hCG during therapy. Remission is defined as three consecutive
normal hCG values over 14 to 21 days.

OBS & GYN Mini OSCE
Archive
1/9/2021
Done By : Noor
Al-Huda Al-Karaki

Station ONE
1-What is the name of this examination ?
2-what is the position of patient during it ?
3-what are the structures and related findings during it ?
4-your findings with :
A- Acute pelvic inflammatorydisorder
B-10 Weeks Incomplete miscarriage
C- Adenomyosis
-
Your Answer :
1-BimanualPelvic Examination
2- Lithotomyposition
3-Uterus : Size , shape , direction and position , Tenderness
Ovaries and Fallopian Tube( Adnexa ) : Masses ( cyst ) , Size , shape , Tenderness .
Uterosacral ligament Nodularity
Cervix Masses , Polyp , motion Tenderness .
After that inspect your gloves .
4-A :purulent endocervical discharge and/or acute cervical motion and adnexal
tenderness, Adnexalmasses
B-dilatedcervix , small uterus not well contracted , conception tissues .
C- Regular enlarged uterus , boggy tender uterus , Mobile .

Station TWO
1-What is the name of this procedure ?
2-What is the mechanism ?
3
How long we use it ?
4
If it failed , what are other options ?
-
Your Answer :
1-Bakri Balloon
2- 1.
2.
3
The Bakri balloon is left in the uterus for a maximum of 24
hours
4
UterinearteryLigation
Hysterectomy
Uterotonic agent
Internal iliac artery embolization

Station THREE
Couple came to your clinical , and the husband is
diagnosed with Azospermia :
1-What is the name of this procedure ?
2- What is the Source of Sperms ?
3- In long protocol ,What is the medication that you ‘ll
give it to your patient before the start of cycle and why ?
4-When to retrieval the zygote ?
5- Luteal phase support ?
Your Answer :
1
Assissted reproductive technologies , Intra
Cytoplasmic sperm injection ( ICSI)
2
Donor or Freezing sperm from husband
3
GnRH agonist, to Down regulate the LH surge to
inhibit ovulation
4
in 3 days ( Morula phase ) 6-8 cells phase and at 5
days ( blastocysts ) which is better
5
can be done by : Progesterone which is better , and
injection of HMG (FSH)

Station FOUR
1-Which type of the contraception ? Support your answer ?
2-Other modalities
3
How it works ?
4
The effectiveness with typicaluse and perfect use ?
5
mention liver enzyme inducers which are contraindicated
with them ?
6
in case of severe bleeding during the course , what is your
management ?
Your Answer :
1- Combined oral contraceptive pills , number of tablets .
2- Transdermal patch , Vaginal ring , Monthly injection .
3
Inhibit ovulation
4
Typical 92% , Perfect 99%
5
antibiotic as Rifampicin , antiepileptic as Na valporate , Phenytoin 6-
continue with this course and add extra exogenous estrogen dose

Station FIVE
A
B
1
A, B ?
2
most common clinical
presentationwith A?
3
antenataldiagnostictest for A ?
4-most importantDifferential
diagnosisshould be excluded when
you diagnosed A ?
5-in the absence of prenatal
diagnosis, what is the presentation
6-Mode of delivery ?
-
Your Answer :
1- A : Vasa Previa
B- velamentous umbilical cord
2
Antepartum Hemorrhage
3
by Doppler velocemetry at 16 Weeks
4-cord presenting part
5-vaginal bleeding that occurs upon rupture of membranes and is accompanied
by fetal heart rate abnormalities : bradycardia or sinusoidal pattern
6- By cesarean section

Station SIX
32 Weeks , A
B C
Primigravida , 36 weeks of gestation , came to ER with seizure (15
min in duration ):
1- What are A, B, C ?
2- B use for what ?
3-What is your diagnosis ?
4-Your Management?
5-By A , what is your comment ?
6-conclude the findings by A,B,C ?
Your Answer :
1- A. Symphysis Fundal Height
stethoscope
B. First pelvic grip
C. Intermittentauscultationby pinard
2-identyfying what fetal part in the pelvic inlet and it confirms the first pelvic grip
3- Severe Preeclampsia complicated by eclampisa
4
Mg Sulphate 4-6 Mg within 2 Hours IV infusion ( loadingdose ) and maintenancedose 1-2
gram /Hour
5
Small for that gestationalage
6
By A the fetus was small for gestational age , by B
By c , it was above the umblicus level , so breech presentation

Station SEVEN
-38 years female with twins pregnancy 32 weeks
,
came with abdominal pain , and this CTG :
1
Question relevant to history?
2
she came with 2cm dilation , Long cervix and
intact membrane ,Your Diagnosis ?
3
Your management ?
Your answer :
1
Fetal movement , pelvic and abdominal pain ,
vaginal discharge , spotting , rupture of membrane,
uterine contractions , frequency and amplitude,
urgency , dysuria , blurred vision , epigastric pain ,
headache , fever .
2
Pre term labor
3
Admission , IV fluid , Prophylacticantibiotic,
antenatal corticosteroid, tocolysis .

Station Eight
52 Years Female with post
menopausalbleeding , and this
US
Arrows : Endometrium
1-What does the US measure?
2-What is Your Deferential
diagnosis?
3
How much the probabilityfor
this female to have endometrial
cancer ?
4
Your next step and why ?
5
If she has endometrial cancer
what is your management ?
Your Answer :
1-Endometrial thickness
2-1-Endometrial hyperplasia
2 – Endometrialcancer
3
Adenomyosis
4
Fibroid
3-10%
4-Hystroscopic guided endometrial biopsy, to
assess the stage of hyperplasia and management?
5-Total hysterectomyand chemotherapy

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Done By : Mahmoud younes
Mini-OSCE
6th year 1st form
27-5-2021

•
findind in picture
•
Dx
•
mention tow dyes used
•
next step
•
your management

palm coein
•
E represent …….
•
initial managment
•
L represent ………
•
mention 2 method for management
•
what relative history before surgery

•
Hystrescope of normal uterus
•
findings maybe found in hystescope

•
mention these structure
•
Name the stuctures support the urethra
•
mention three obstetric imortance of ischial spine
•
mention urinary findings in epidural anathesia

OGTT : 190/140/180
•
your Dx
•
management
•
mention 6 relative history question
•
if patient come at 43 week ,baby is well, no labor
•
your next step ( induction of labor)

•
your interpretation about picture
•
findings in abd/vaginal examination
•
engagement
diameter
•
if this patient come at 37 week ,station -3 , no cervical changes ..your
next step
•
if this patient deliver vaginally ,mention complication
•
mention four things you should follow up

Mini-OSCE
6th year 2nd form
27-5-2021
Done by: Abdullah Gumander,
Abdulrahman Alwardat

Case 1
•
33 GA G3P2 (all by cs)
•
Diagnosis:
-placenta previa
•
Mother is Rh –ve, Father is Rh +ve, Hb 8.5, What essential lab test you must
do?
-anti-D-antibodytiterorindirect coombstest ??
•
What associatedconditionyou mustcheck?
-Morbidlyadherentplacenta (accrete)
•
If the bleeding have stopped, and the patientis stable, what’s your
management?
1
Symptomatic women often remain hospitalized from their initial bleeding episode
until delivery.
2
Correction of anemia.
3
4 unites of PRBCs should be available.
4
Anti-D immune globulin for Rh(D)-negative women.
5- Schedule cesarean section at 37 weeks.
•
What are thecomplication in thiscase?
-primaryPPH, pretermlabor
•
Patient refused admissionwhat shouldyou advise?
Avoid sexual intercourse,to comeagain if bleeding recurrent, Follow-up TVSis
performed at 36 weeks , Single course of antenatal corticosteroid should be
administered

Case 2
•
Nulligravid patient complain of
•
What’s your diagnosis?
-endometriosis
•
Gynecological symptoms tosupport your diagnosis?
dysmenorrhea, deep dyspareunia, menstrual irregularities,
pelvic pain
•
What finding expected on physical exam?
-fixed retroverted uterus, fixed immobile cervix, pouch of
douglas nodularity, pelvic tenderness
•
What do you expect to find on biopsy of the lesion?
-endometrial stroma and gland
•
Mention a drug that’s given IM monthly, what’s the duration
of the treatment, give a side effect?
-GnRH agonist
-6 month
-osteoporosis

Case 3
•
Identify the letters:
A:Ayer spatula
b:endocervical brus
c:transformational zone
d:endocervix
•
Define C anatomically?
area between old and new squamocolumnar
junction
•
Mention bethsda finding by a+b?
HSIL, LSIL
•
Cytology screening and method of preparing?
Pap smear, conventional and liquid based
•
CIN II patient without visible lesion next step?
-colposcopy
•
Confined cervical lesion management?
-excisional therapy (conization, LEEP)
A b
c
d

Case 4
•
G1p0 8 weeks –Rh with +Rh father (on exam pictures left embryo
larger than right)
•
Type of placentation?
-Monochorionicmonoamniotic
•
Vaginal spotting and active fetal heart by us, Diagnosis?
-threatened miscarriage
•
Give two investigationfor her?
-cbc, klehur test, Not coombs test ( first bleeding episode, first
time pregnancy)
•
What is the best delivery date for this patient and why?
-32 weeks risk of fetal loss and cord entaglement
•
True or false
•
This type of chorionicityoccursif division after 12 days(F) (after 8 days)
•
Should take low dose aspirin in the beginningof 2nd trimester (T)
•
In this case IVF is a risk factor (F) (ART is a risk factorfor dizygotictwins)
•
singleton samerisk for previa like multiplegestation (F)

Case 5
•
occipitolateral at level of ischial spine
•
Mention what you should find in examination?
-engaged head , vertex presentation, occipitolateral
position,
•
What is the next mechanism of labor at this level?
-internal rotation at level of pelvic muscle
•
Does epidural prolong delivery and how?
-yes, in the 2nd stage of labor for a primigravid patient the
normal duration is 1 hour, with epidural it’s 2 hours
•
If after 1 hour CTG shows reccurent late decelerations,
what’s your management?
-IV fluids, O2 by mask, left lateral position, stop oxytocin,
CS if persistent
•
If the patient has same findings after 2 hours what’s your
next step?
-instrumental delivery

Case 6 ???????
•
G5P5 obstructed 2nd stage, vaginal deliver, normal blood loss, during
delivery collapsed few minutes after delivery.
•
Give 3 deferential diagnoses?
-Amniotic fluid embolism
-Uterine inversion
-Uterine rupture??
•
Give 3 possible findings on physical exam?
-Vaginal mass
-non contracted uterus
-incomplete placenta
•
What’s your management?
-Stabilize (IV fluid, oxygen, ABC)
-Call for help

Obs and gyn mini osce
17/5/2021
group 3
Omyma faqeeh

Q1 pregnant women 8 w
known case of sickle cell anemia
planned pregnancy
in pic the result of urine culture
*the interpretation of the result
*drugs used to treat the condition above …………
*most common obstetric complication in this
case …………
*how to manage this case at 12 w….
* If she came with seizure ,cause ,management

Q2 pic for CVS and NT
*name of structure at arrow in first pic
*absence of this structure indicate
*what is the abnormality in the pic
*name of procedure in second pic
*when you should do
*after this procedure

Q3 pic for depo provera
*rout of administration and duration between doses IM every 3 m
*side effect
*pearl index
*when we give the first dose
*

Q4 pic for partogram
•
Name of this paper
•
Interpretation
•
Causes of this condition according to progression of labour ……………..
•
If she delivered without intervention what is the most common cause………
•
If she cant deliver you shuold …..

Q5 pregnant women 33w came to emergency
with watery vaginal discharge
•
imoprtant point you should ask about in history ……….
•
findings in examination………….
•
management …………
•
if she complain from fever ,most common cause …………..
•
other symptoms for the condition above ……

Q6 8 weeks came to ER with vaginal bleeding
•
Diagnosis
•
Things support it
•
Risk factors
•
If she came after two months pregnant
with HbA1c =8 what you should advice
her

Q7women with recurrent loss of pregnancy
first loss at 8w second 12w third 26w
•
Name of this procedure
•
Name of abnormality
•
‫د‬
‫ا‬
‫د‬
‫ز‬
‫ي‬
‫ل‬
‫م‬
‫ح‬
‫ال‬
‫ر‬
‫م‬
‫ع‬
‫ن‬
‫ا‬
‫ك‬
‫ة‬
‫ر‬
‫م‬
‫ل‬
‫ك‬
‫ا‬
‫ذ‬
‫ا‬
‫م‬
‫ل‬
‫ر‬
‫س‬
‫ف‬

•
According the first pic the interpretation is
•
DDX of this abnormality
•
Interpretation of CTG
Q8 35 w pregnant women
31 Cm
Pic for CTG

Mini osce gyne
Sarah khirfan
Group 2

Labor station
•
What is the the diameter of pelvis that the baby’s head enter through
and why? Pelvic inlet (transverse diameter)
•
Level station the baby do internal rotation and why? At the level of
the pelvic floor station 0 and more
•
What is the diameter of? Transverse of inlet? 13, interischial 9.5, AP
of outlet 13
•
How do we assess the pelvic outlet clinically (this qs was from the
record) (1) diagonal conjugate, pubic arch, intertuberoischial diamet,

Station ectopic us picture
•
What is the following finding? Pseudosac
•
How to differentiate it from gestational sac? Points in slide
•
Diagnosis? Ectopic
•
2 additional investigation?
B HCG, progesterone, Doppler
•
all questions from slide

Adenomyosis MRI
•
What’s the diagnosis?
•
Another name for this variant? Endometriosis
•
Definitive treatment? Hysterectomy
•
Possible drug? GnRH agonist
•
Differential diagnosis? Fibroid
•
How to differentiate it from fibroid? The uterus is soft boggy and
tender unlike fibroids they are firm non tender.

Station 4 picture from genital tract infection
•
Whats the organism and way of transmission? Trichomnalis vaginalis
and STD
•
Findings on examination? Copious purulent greenish discharge,
colpitis macularis (strawberry cervix) and angry looking vagina?
•
4 ways of management (from the slide)
•
Complication after hystectomy? Cuff cellulitis
•
Complications during pregnancy? Preterm delivery and rupture of
membrane, miscarriage

Station 5 is induction of labor with pic of
tachysystole
•
Bishop score? It was 4 (cervix closed, firm, anterior, primigravida,
•
Woman was in her 40 weeks of gestation what would u recommend
her?
•
Way of induction and why? Dinopristone due to unfavorable cervix
•
What is the complication in the picture above? Uterine
hyperstimulation
with fetal distress
(uterine hypertonus and
increased contraction)

Station 6 is concealed abruption with US
image
•
The questions were logical and easy but no definite way to write or
answer them

Station 7 is woman sitting in hospital after cs with
monitor showing her BP 140/90 and lab finding of
elevated liver enzyme
•
Diagnosis? Severe preeclampsia complicated with HELLP syndrome
•
Summarize the clinical picture using the findings above
•
What is the drug given to her and why? MgSO4 to manage eclampsia
•
When to stop the drug? 24 hours after labour or from last seizure
•
How to monitor the drug? Points mentioned in slide (patellar reflex..)

Station 8 was open question with multiple
possible answers (57 years woman on us with
increased endometrial thickness
•
Possible question on history?
•
DDX? Endometrial cancer, ovarian cancer, endometrial hyperplasia
•
Things to check on physical examination? Lymph node, abdominal
masses, pelvic examination
•
What ovarian cancer do the following picture? Sex cord stromal
tumors.
•
And thank you

Obstetric and gynecology
group 1
23/12/2020
Done by : dana alabadi

Station 1
33 week pregnant female came with vaginal discharge
1- what relevent points on history ?
2
whats impotant points on examination ?
3
if you found on examination pooling sign and closed cervix what is
your dignosis?
4
what is your management ?
5- what is the complication ?

1
onset , amount , coulor
, bloody
2
cervix (open or closed ) pooling sign on posterior
fornix
3
premature rupture of membrane
4
admition , prophylaxis antibiotic , hydration ,
dexamethazone , ctg
5
chorioaminionitis

Station 2
50 year old patient came with
irregular bleeding and pelvic
pain
On the examit was intramural

1
what is yur dignosis and what type ? Uterine leiomyoma , intramural
1- what other symptoms according to her case ?secondary
dysmenorrhea ,deep dysparunia
2
what you will find on bimanual examination ?firm non tender
irrelgular enlarged uterus
3
what the dignostic image ? (size and location )
mri
4
what is the defenitive treatment ? hysterctomy

1
what is the labeled structure on photo a ?
1-
2-
3-
4-
5-
2
what are the symptoms according to a ?anterior
vaginal wall prolapse
Urinary symptoms (frequency urgeny uti voiding
disability stress incontinence
3
which pop-q on b according to the patient a ?b
4 – what is the treatment ?anterior colporrhaphy
5 –what symptoms according to pop-q b? gi symptoms
(not the same pop-q here but it was about gi
symptoms
6- what is the tratment for patient pop-q
a if she is 60
years (in pop-q it was procedentia ) ?

Station 4
++2 picture shows HC and AC
39 year old patient , on antnatal
visit BP 130/85

1
what is your dignosis according to the chart ?IUGR
2
what other parameters you will look for on us ?growth velocity
,amniotic fluid
, body proportion ,
3
if she cames later with bp 140/100 what is you
dignosis ?
Preeclampsia
4
what points on examination whill support your dignosis on q 3 ?
5- what is you management ?

1- on admittion :
Dilation ?
Head desent ?
Amniotic fluid ?according to partogram
Describe uterine contarction after 2 hours of admition ?
2- when the rupture happens ?
3 – what is you interpretaion for labour progress ?primary dysfunction of
labour
4- whats points on partogram suuport you answer on q3
?no head desend ,
fetal bradycardia , cervical dilation less then 1 cm per hour
5- what are
the causes ?CPD , malpresentation

1- what is the labeld diameter and it’s lenght ?
a
b
c
d
2- which diameter in normal vaginal delivery
?suboccipitobregmetic
Smallest diameter on flexion
and why
3- which diameter
will cause CPD ?mentovertical
4 – what is the denominator for ?
A
b
c
d

Station 7
1- what you see ?
2 –mechanism of action
3- when it inserted and why ?
4- what is the pearl index with
typical use ?
5- whats the complication
?
Back to the slide

Station 8
39 year old patient , g2p1 she is epileptic and she use carbamezapine , previous cs ?
What points on the case above
support the dignosis ?
2- the yellow arrow is ? Nuchal
translucency
3
what is the name of this test
?combined test
according to the table
4
at which gestation age we do it
?11-15 week
5
if she cames in preconception
what you will advice her ?
6
what is your management
?
a table which shows
High hcg
Low ppapA
Absent nasal bone

OBS and GYN
group 5
Done by : Saja saraireh
Thanksto: fatima emad
shatha al adam

1
what you see and diagnosis ?
Single deepest pocket less than 2 ,
oligohydramnios
2
one single important
finding
during
abdominal examination ?
decrease fetal movment or small uterus
??
3
4 causes for this condition ?
RENAL AGENESIS
URETHRAL OBESTRACTION
IUGR
ACEI
4
clinical importance for amniotic fluid ?
Screening of fetal malformation
genetic testing
Assessment of fetal well-being .
Diagnosis of PROM (fern test )
Assessment of fetal lung maturity
1.2
Station 1

•
CBC with HB = 6 , MCV = 70 , MCHC = 30
•
1- your interpretation ? Microcytic hypochromic
anemia
•
2- DDx ? Iron defeciancy , thalassemia
•
3- if women are financially able what test you ask to
differentiate ? HB electrophoresis , others answer
ferrittin test !!
•
4- if the woman not take medication , write three
complication ? Miscarriage , low birth weight ,
prematurity , Intrauterine fetal death
•
5- management If woman enter labour room with
this HB level ? Blood transfusion , fetal
monitoring , o2 , IV fluid
Station 2

Station 3
•
ultrasound for 55 years old post-menopausal female complaining of right ovarian
mass
?
1- Describe the findings in the ultrasound ?
Solid component with thick wall
2- What is your diagnosis ?
epithelial ovrian cancer
3
Mention 3 finding on examination ?
adnexal mass , cervical lymphadenopathy , ascitis
4
Calculate the risk malignancy index if CA125 is 150 ?
5- management ?? cytoreductive surgery

1- procedure ? colposcopy
2- name of this site ? Transformation zone
3- name of lesion ? Acetowhite lesion
4
name of substance used ? 5% acetic acid
5
if this is CIN3 what the management ? loop
electrosurgical
excision
procedure
(LEEP)
Station 4

•
The question mentions that her menstrual cycle
is normal .
•
1 – procedure ? Hysteroscopy
•
2 – test use with it ? Biopsy
•
3- complications ? Perforation , infection …..
•
4- if it was totally normal what you ask to do ?
Coagulation study
•
5 – you think that there ovulation is normal ?
Why ? Yes because of regular cycle
Station 5

Station 6
•
27 woman G0P0 married 3 years ago her BMI 30
•
1 – cause of there infertility ? Anovulation
•
2- condition ? PCOOS
•
3- criteria ?? Menstrual irregularity due to anovulation or oligo-ovulation
•
Evidence of clinical or biochemical hyperandrogenism
•
Hirsutism, acne, male pattern baldness
•
High serum androgen levels
•
Exclusion of other causes (CAH, tumors, hyperprolactinemia)
•
4 – your advice and why
?? Weight loss to improve ovulation , improve their
response to ovulation induction agents
•
5 – other modality of treatment if want to become pregnant ?
•
Clomifene Citrate
•
Metformin
•
Laparoscopic Ovarian drilling

1
findings ? Congested enlarged left tube with
free peritonealfluid
2
diagnosis ? Ectopicpregnancy
3 – examination ? adnexal, cervical motion, and/or
abdominal tenderness, an adnexal mass, and mild
uterine enlargement.
4
ultrasound finding ? Pseudosac , tubal ring or a
non cystic adnexal mas , peritonealfree fluid ,
cardiac activity in tube
5
surgical management ? In the presence of a
healthy contralateral tube, salpingectomy , In
women with a history of fertility-reducingfactors
(previousectopic pregnancy, contralateraltubal
damage, previous abdominal surgery, previous
pelvic inflammatory disease), salpingotomy
Station 7

•
Partogram ?? Primary dysfunctional labour
•
Describe CTG with explanation ?? Write the normal description
•
Any stage according to pic ??
Extention , Second stage
•
Question about muscle contraction in partogam ??
•
Management ?? Oxytocin …

•
Instrument station from the instrument file

OB.GYN mini OSCE
2020/2021
Group 4
Prepared by :
Abdelrahman bdeir
Mohammad rabai
Lina alhawadi

Station 1
(1
what's this instrument? Amnio hook
(2
name of procedure? Amniotomy, artificial rupture of membrane
(3
4 advantages of this procedure?
Enhance uterine contraction
Shorten active phase of first stage
Assess fetal well being from liquor state
To check if there's cord prolapse
(4
if pt. pregnant with 24w , length of fundal pubic height
29cm, what's the
sequence if this procedure make to she?( polyhydramnios)
1
abruptio placenta
2
cord prolapse
3
fetal bradycardia

•
Name of the Method : implanon
•
Active gradient :
etonogestrel
•
Mechanism of action : Inhibits Ovulation
•
Complication : Weight gain, Acne, Amenorrhea, Bleeding irregularity .
•
Site of insertion : above the medial epicondyle of the non dependent
hand
•
Duration of action: 3 years
•
Pearl index : is<0.05%
Station 2

Station 3
•
GDM
OGTT 1h =195
2h =140
Fasting =105
.1
Interpretation ?
Elevated fasting glucose and 1 h OGTT – GDM
.2
Immediate management ? Diet , hypoglycemic agent , insulin
.3
Antenatal OBS complication? Polyhydramnios , macrosomia , preeclampsia
.4
Management if she will deliver vaginally :
No morning insulin ( 6hr before delivery )
Glucose infusion
Insuline infusion
Monitor maternal glucose level
CTG

Station 4
Partial molar3d
ultrasound
.1
Dx
: partial haydatidiform mole
.2
Karyotyping : 69XXX, 69XYY ,69XXY
.3
The pt didn’t accept the treatment and
she came after 2 month with seizure
and no fetal cardiac activity, what is
the cause of seaizure ?
preeclampsia
.1
Mangement : Suction curettage
.2
How to confirm dx : histology
.3
Other investigation : HCG
,
karyotyping , chest X-ray
.4
How do you follow up her : beta-HCG
level weekly

Q1 write what represented in each line ?
a: normal labor b : secondary arrest c : latentphase d: primary dysfunction
Q2 what is the mangment of line c ?
discharge from the labor room , analgesics, mobilization,reassurance.
Q3 what is the causes of line b ?
Cephalopelvic dis (most common) , inefficient uterine contraction , malpostionpresentation
Q4 what is the most important things u should looking in partogram in line b ?
Molding amniotic membrane ( liquor) uterine contraction
Station 5

34 y old female P3G2+0 , 29W , came to the hospital with gush of fluid :
answer the followings : ( exam pic. differ )
Q1- Name of this method/procedure
Speculum cervical examination
Q2- describe the findings in the image
Dilated/Closed cervix
? .. Absence/prescience of pooling sign ?
Q3- Other investigations to your diagnosis
Nitrazine test – CBC – Urinalysis – CRP – U/S – vaginal swab for infection
Q4- Your management
Admission - Detect chorioamnionitis – corticosteroids – Antibiotics ..
( Erythromycin 250 mg *4 for 10 days ) – Timing of delivery ...
Q5- At any week you want to deliver her , and the method ? 34 W , vaginal delivery
Station 6

OSCEstation
‫هنع‬
ً
‫اضوعو‬
,
‫انوروك‬
‫ةحئاج‬
‫ب‬
‫س‬
‫ب‬
‫ب‬
OSCE
‫ال‬
‫ناحتما‬
‫ءاغال‬
‫ت‬
‫م‬

.mini osce
‫ال‬
‫ن‬
‫ا‬
‫ح‬
‫ت‬
‫مإل‬
‫ن‬
‫ي‬
‫ال‬
‫ؤ‬
‫س‬
‫ف‬
‫ي‬
‫ض‬
‫أ‬

A 30 year old pregnant female in 34 weeks gestation come to emergency
department with abdominal pain radiating to back with minimal vaginal bleeding .
Q1 what is the most common cause for her condition ?
Abrubtio placenta
Q2 what is the maternal obstetric complication in such case ?
DIC ,shock, death , renal failure , adult respiratory distress syndrome
Q3 what is the appropriate management in such stable case ?
Inpatient monitoring ,Corticosteroid ,Anti d , monitor the fetus status , delivery at
37
Q4 what we called the condition when we do cesarean section to case presented
like this (extravasation)?
Couvelaire uterus

( Female came to emergency after 2 week of 40w vaginal delivery
with Fever 38.5 …. ) :
Q1- Ask relevant questions about the History : ( 6 Marks )
Abdominal pain – delivery complications – lochia & discharge -
.…. ?
Q2- Investigation guide to diagnosis : ( 2 Marks )
CBC – CRP – Vitals – pelvic U/S – Urinalysis – Blood culture … ?
Q3- If she had a retained placental parts .. What is
your
management : ( 2 Marks )
Stabilization – analgesia – Uterotonic agents – prophylactic antibiotics – D&C -
… ?

OBS & GYN
Mini-OSCE - 6th year
16/6/2020
Done by:
Ibrahim Ghayyadah
Tariq abu-lebdeh

1. A 30-year-old primigavida, at gestational age of 32 weeks, presented to the ER
complaining of uterine contractions every 15 min. After assessment and admission,
the fibronectintestwas positive.Her cervix is 60% effaced and1-2 cm dilated. The
CTG was normalon admission.A Tocolytic agent wasstarted.After 24 hours, the CTG
was repeatedand it canbe seen in the image.
Based On that, whichof thefollowingtocolytichas mostlybeen used?
.a
Terbutaline
.b
Ritodrine
.c
Magnesium sulphate
.d
Nifedipne
.e
Indomethacin

2. A primigravida, presents to the antenatal clinic,
at 9 weeks of gestation for booking visit.
Which of the following statements is correct?
.a
Her ultrasound scan in front of you shows
lambda sign that is suggestive of monochorionicity.
.b
Her pregnancy arises from the split off the
fertilised ovum that occurred within 3 days after
fertilisation.
.c
This patient should have an antenatal visit every
4 weeks after the first trimester.
.d
Discordant fetal gender confirms this type of
gestation.
.e
Death of one of the fetuses in this case may
result in immediate complications in the survivor
co-twin (i.e brain damage).

3. A 45-year-old woman who was found to have a highgrade squamous
intraepithelial lesion in her pap smear result. The patient underwent
colposcopic examination and a cervical biopsy was taken. Check the
histologicalappearanceof the biopsyshownin the image in front of you.
Whatis the diagnosis?
.a
CIN1
.b
CIN2
.c
CIN3
.d
Carcinoma in situ
.e
Cervical cancer

4. A 40-year-old, G4P1+2, presented to the antenatal clinic at 14 weeks of gestation for
booking.She claimed thatthispregnancy wasunplanned. In front of you,an imagefromthe
ultrasoundscan (U/S)that was doneat thisvisit.Whichof thefollowingstatementsis correct
regardingthe finding in the U/S:
a. Microcytic hypochromic anemia can be
found in Complete blood count (CBC)for this
patient.
.b
According to her age the risk for
developing such abnormality is 1: 100.
.c
A 75 g glucose tolerance test results few
days ago: fasting 105 mg/dl, 1st hour 175
mg/dl, 2nd hour 160 mg/dl.
.d
First trimester ultrasound is not accurate in
diagnosing this condition.
.e
It is sporadic, no chance for recurrence in
subsequent pregnancies

5. A 19-year-old patient attends the gynaecology clinic complaining of
heavy painful periods for the last2 years.The pain usuallystarts 4-5 days
before the onset of blood flow. Back at the age of 16, and due to primary
amenorrhea, she had underwent the procedure that is shown in the
image. According to her new complaint, and given that no significant
findings on exam, the essential investigation for the most probable
diagnosisis:
.a
Karyotyping
.b
Ultrasound scan
.c
Diagnostic laparoscopy
.d
Urogram
.e
Hysteroscopy

GYN & OBS Mini-OSCE Exam
2019/2020
group c
7/6/2020
Done By : Rayan Nihad

Q1 : A 33 years old primgravida at 33 w gestation
headache since 2 days
her investigations , choose the correct statement
complaining of a
HB 12
PCV 37%
PLATELETS 85*10^9/L
ALT 98
AST 120
Urine analysis +2 protein
Na+ 140
LDH 800
Creatinine .9

.a
this patient has mild pre-eclampsia
.b
Methyldopa should be started to control her BP
.c
Blood film has no role in diagnosis
.d
MgSO4 is not indicated as her risk of eclampsia is low
.e
Acute control of BP and procced into urgent CS is the management of choice

Q2 what is in the pic
answer : levonogesrel

Q3 what is this pic
.a
Shoulder dystocia
.b
Abruptio placental
.c
Patrial uterine rupture
.d
Sound dehiscence
E. Uterine rupture

‫ن‬
‫ي‬
‫و‬
‫د‬
‫د‬
‫حم‬
‫نا‬
‫ك‬ head/ placenta/ cervix Q4
choose the correct statement
a.Age isn't a risk factor for her condition
.b
Postpartum hemorrhage is an expected condition
.c
Painful vaginal bleeding is the usual presentation
.d
Elective CS should be scheduled at 39 weeks

Q5 colposcopic views where are the normal
areas
Asnwer : B AND E

Q6 which part of the mechanism of labor
Answer : restitution ( external rotation ) to
deliver the anterior shoulder

Q7 regarding this procedure select one
.a
It is performed at 13 W of gestation
.b
It is used as a screening test for chromosomal abnormality
.c
The risk of miscarriage is 0.5%
.d
Placental mosaicism is more common compared to other method
.e
anti-d prophylaxisis considered after doing this procedure in a woman with rh negativeblood group and indirect
coombs test of 1:8

Q8 this method is used for?
Answer : deep endometriosis

Q9 regarding this photo choose the correct
answer
Answer : the patient is definitely had a total hysterectomybefore

Q10 a 33 y old G4P2+1 presents at 7 weeks of amenorrhea complaining
of vaginal spotting check her transvaginal IS image , what is your next
step of management ( given that both adenxia are free )
a.Do urine pregnancy test
.b
Do beta HCG-titer
.c
Discharge home after reassurance
.d
Immediate admission
.e
Give her misoprostol

Q11 what is true regarding this picture
Answer : This pregnancy is
due to division of an ovum that occurs 12 days post
fertilization

Q12 : what causes maternal mortality in this
case
Answer : acute renal failure

Q13 : 39 weeks primgravida , who has been in
labour for 8 hours , next step?
C B A
Answer : operative delivery using forceps C

Q14 causative organism of this lesion is
Answer : pox virus

Q15 regarding this photo what is your
interpretation
Answer : primary dysfunctional labour

Q16 after hysteroscopy , atypical endometrial hyperplasia
found choose the most likable PALM-COEIN terminlogy
description
answer

Q17 your managment
Answer : suction and evacuation

Q18 : what is the patient excepted karyotype ( normal
pelvis anatomy on US)
Answer : XX

Q19 growth parameters showing
low weight / small abdomen / normal head
what is the most probable cause
Answer : SLE

Q20 A 29 year old G2P1 (previous cesarean section) admitted at 38 weeks
of gestation with Labor pain , check her CTG on admission and during the
second stage of labor and choose the correct answer
First pic was variable decelerations
Second pic was late decelerations
ANSWER :patients history necessitates continuous fetal heart monitoring
during labor

Done by ;
Mahmoud M.
younis
2019/2020
Group B 19/2/2020

Q1
•
Hx of heavy period , ………
1
mention two things from Hx require patient to do hysteroscpe
biopsy
:
Failed medication/ heavy menstrual period /may be the age if>45y
2
(( E )) indicate for what , according to picture:
Endometrial causes

3
Fist line in management :
I think
mirena , …….
4
If your plan to manage in previous Q fail ,
Mention three other modalities for management
1-hystrectomy
2-conservative surgery
3-endometrial ablation

Q2
1
your diagnosis :
IUGR
2
mention two obstetric complication
In this case :
Intrauterine death
increase CS rate
oligohydrominus

3
Fetus GA =30 weeks , what you do for this pregnant women :
Delivery plan according to doppler U/S 
Normal (36 W)/absence (34 W) /reversed(32W)
-
4
If this pregnant come with abd pain and heavy bleeding , fetus show
bradycardia on doppler
(A
your DX : I think placenta abrubtio
(B
your definitive management : Deliver the baby

Q3
1
Dx :
condylomata acuminata
2
what organism casue This lesion :
HPV
3
mention three modalities for treatment :
cryotherapy, trichloroacetic acid, surgical
excision, electrosurgery, and laser therapy

4
how to reduce prevalence of it :
HPV vaccination
5
If a pregnant has this lesion ,mention one specific complication in
fetus
Sepsis

Q4
^^
‫ة‬
‫ح‬
‫ض‬
‫او‬
‫ت‬
‫ن‬
‫ا‬
‫ك‬
‫ن‬
‫ا‬
‫ح‬
‫ت‬
‫م‬
‫ال‬
‫ا‬
‫ب‬
‫ة‬
‫ر‬
‫و‬
‫ص‬
‫ال‬
1-On admission :Mention
(A
cervical dilatation : 4 cm
(B
Descent: 4
(C
FH according o picture
2
your interpretation about
Progress of labor :
Primary dysfunction
3
mention 3 findings from
Partogram support your
answer :
No descent
cervical dilatation Less than 1 cm/h
FHR wosening

4
mention two possible causes :
CVP/malposition
5
after 4 H from admission .comment on uterine contraction
Five strong contraction not four
6- what your management :
After exclude CVP/malposition  Go to CS

Q5 :cases scenario
CASE 1 :
Pregnant with Hemoglobin = 8
1-M.C.C in pregnancy
Iron deficiency anemia
2-Treatment :
Oral iron supplement

Case 2 : pregnant in GA =13 weeks
,
her blood pr =160/100 :
1
mention four points in management :
Stabilize blood pr by mythele dopa/ follow up for end-organ
damage/avoid ACE inhibitors and ARBs/ monthly U/S for fetal
growth/ deliver at term
2
mention 2 obstetric complication :
IUGR / prematurity / preeclampsia

OSCE stations
2019/2020
Group B
•
Station1: Primary amenorrhea
•
Station2: Gestational DM
•
Station3: Induction of labor

OSCE stations1
primary amenorrhea /normal FSh :
1
DX : Müllerian agenesis
2
Mention Ddx
Genito-urinary malformation, e.g. imperforate
hymen, transverse vaginal septum
drug use, an eating disorder anorexia nervosa,
athleticism, or psychosocial stress

3-findind on examination
Normal breasts and Sexual Hair Normal looking external female genitalia
4-U/S
findings/
^^
‫د‬
‫ي‬
‫ال‬
‫س‬
‫ال‬
‫ب‬
‫د‬
‫و‬
‫ج‬
‫و‬
‫م‬
‫ش‬
‫م‬
Initial radiologic evaluation includes transabdominal, translabial, or transrectal
two-dimensional or three-dimensional ultra-sonography to assess for the
presence of a midline uterus. Rudimentary müllerian structures are found in
).90% of patients with müllerian agenesis by (MRI
5-Your plan for management
Treatment :
Vaginal creation (Dilatation VS
Vaginoplasty

pregnant women suspect for DM :
1-Mention risk factor
.1
A family history of diabetes, especiallyin first degree relatives
.2
BMI >30 kg/m 2
.3
Age >25 years
.4
Previous delivery of a macrosomic baby (4 kg)
.5
Personal history of impairedglucose tolerance
.6
Previous unexplained perinatal lossor birth of a malformed infant
.7
Glycosuria at the first prenatalvisit
.8
Polycystic ovary syndrome
.9
Current use of glucocorticoids
.10
Essential hypertension or pregnancy-related hypertension
2-U/S findings
.1
Polyhydramnios
.2
congenitalmalformation (cardiac and NTD)
.3
Macrosomia
3- your interpretationfor giver OGTT
A 2-hr plasma glucose measurement ≥200 mg/dL (11.1 mmol/L) during an OGTT.
OSCE Station 2

OSCE Station 3
Induction of labor for post-term pregnancy :
1-Relative Q in Hx
Assessment of gestational age & EDD
•
The EDD is most accurately determined early in pregnancy on the basis of the known LMP in a women
with regular,normal menstrual cycles.
•
Unfortunately, this method is not entirely reliable in assessing the GA due to:
.1
Wrong recall .
.2
Lactation & post COC
.3
Irregular cycles .
•
Therefore, Accurate pregnancy dating is important for minimizing the false diagnosis of PT. , fetal
movement , risk factors as primi…..
2- findings on examination fundal height, engagment, presentation…..
3-Bishop score/ how to induce labor


A high score ( 8 to 13)
(a ‘favourable’ cervix) are associated with an easier, shorter
induction that is less likely to fail
no need for cervical ripeninig by PG.

A low score < 8
(an ‘unfavourable’ cervix) point to a longer IOL that is more likely to
fail and result in Caesarean section
cervical ripeninig is necessary.
Bishop score

Method for induction
Pharmacological:
.1
Prostaglandins
.2
Oxytocin
Non-pharmacological methods include:
.1
Membrane sweeping
.2
Mechanicalmethods
.3
Amniotomy

2019/2020
Group A
25/12/2019 Prepared by :
Amr Mohammad Al-Khattab
Taimaa Rwashdeh

Q1
ultrasound for 50 years old post-menopausalfemale complaining of right
ovarian mass :
( I thinkUS>> contain solid component, multi-
locular)
1- Describe the findings in the ultrasound ?
there is multilocular cyst ,with solid areas and thick wall .
2- What is your provisional diagnosis ?
epithelial ovrian cancer (m.c. Is serous carcinoma )

3
Mention 3 finding on examination ?
adnexal mass , palpable inguinal or cervical lymphadenopathy
, acanthosis
,ascitis…
4
Calculate the risk malignancy index if CA125 is 100 ?
•
RMI =U *M*CA125
•
U=multilocular/solid
Soo give U ...3
•
M= she is menopaused Soo give M..3
•
CA125 from the question...100
•
RMI =900
•
5- What is your plan for management ?
it's high risk Soo
cytoreductive surgery

Q2
•
ultrasoundfor9 weeks pregnant
women
1- What are the findings in the
ultrasound ?
2 gestational sacs with thin intertwin membrane
2-what is your diagnosis
monochorionic diamniotic twins
3- When the next visit should be and why ?
Bec it's monochorionic diamniotic the next visit will be within 2 weeks (11 week) this true
but startedat 16w so the next visit will be in 11 w but not because it monochoroinic but
to confirim vaiablity …..
‫ةرضاحمال‬
‫نم‬
4-If the pt. reach 32 weeks without complications at which GA you will deliver and by
what
at 36-37 weeks by CS delivery
‫اذا‬
‫بوتكم‬
‫ةرضاحمالب‬
‫ب‬
‫س‬
‫نرومب‬‫ن‬‫غ‬
‫اهتكح‬
‫مالحأ‬
.
‫د‬
monoaminoitic even
the answer is vaginal according to presentation…

5
What is the name of the complication
that is shown in the picture ?
twin to twin transfusion
6
What are the finding on ultrasound for this complication ?
b) sex concordance
d) discrepancy in amniotic fluid
•
a) single placenta
•
c) growth discordance
will be hydropic
e)one fetus
•
f) abnormal umbalical artery Doppler

Q3
infertility ( Azosperima
in male )
1- The name of this procedure ?
intracytoplasmic sperm injection
2- Mention 4 indications ?
oligospermia ,,asthenospermia ,,teratospermia ,,failed IVF
3- Mention 3 complication ?
multiple pregnancy .. ectopic pregnancy... Ohss

4
Drugs used in preparing for this procedure ?
GnRH agonist or antagonist according to protocol
Hmg
Hcg
5
From where you can get the sperms ?
testis or epididymis

Q4
Pregnant women complaining of itching
‫ة‬
‫رو‬
‫ص‬
‫ي‬
‫ف‬
‫ن‬
‫ا‬
‫ك‬
‫ن‬
‫ا‬
‫ح‬
‫ت‬
‫مال‬
‫ا‬
‫ي‬
‫ف‬
LAB
-
Normal Hb, normal Platelets
, normal PCV
-
ElevatedAST&AL
T
1
What is your diagnosis ?
intrahepatic cholestasis
of pregnancy
2
Point in history you should ask to confirm Dx ?
loss of appetite
dark colored urine
steatorrhea

3
Additional investigation to confirm Dx ?
total serum bile acid
4
Your plan for management ?
symptomatic include ,: ursodeoxycholic acid .. antihistamine
.dexamethasone
.. vitamin k .. delivery at 37weeks
5
What are the complications
meconium stained amniotic fluid ,, fetal demise

Q5
pregnantwoman complaining of erythema, pain and
hotnessin herrightleg
1
What is your diagnosis
deep vein thrombosis
2
Mention 3 diagnostic tests?
venous duplex imaging
,,MRI ,, d dimer
3
Management during
pregnancy?
low molecular waight heparin

4
The most common complication if she came in labor
?
bleeding (not sure about it )may be pulmonary embolism
5
What is post partum management and the type of contraceptive you
should offer for her?
•
Warfarin or continu LMWH , 6mon from inatation, or 6 w post partum
which is longer
•
Mirina ..pops

OSCE stations
2019/2020
Group A

For each one >> relevant point in history , examination , investigation , management
and may ask about complications or give a specific dx and ask about it ^_^
(1
34 wks pregnant woman with road traffic accident is presented to you in ER with
vaginal bleeding?
( antepartum hemorrhage >> placental abruption
)
(2
49 years old female p3 , sterilized 3 yrs age , complaining of abnormal uterine
bleeding of 4 months duration ?
( AUB >> fibroid )
(3
Female with 8 wks amenorrhea presented with vaginal bleeding and passage of
tissue ?
( early pregnancy bleeding )

‫م‬
‫ي‬
‫ح‬
‫ر‬
‫ال‬
‫ن‬
‫م‬
‫ح‬
‫ر‬
‫ال‬
‫هللا‬
‫م‬
‫س‬
‫ب‬
Mini-OSCE
6/8/2019
Done by : AYMAN AL-MANASRAH

Q1
1-What's the name of this
contraceptive method
It is an injectable contraceptive (IM)
2-What the scientific name?
Depot medroxyprogesterone acetate (DMPA,Depo-Provera
‫ناك‬
‫ام‬
‫بط‬‫ع‬‫ا‬
‫ق‬
‫و‬
‫ف‬
‫ي‬
‫لال‬
‫ي‬
‫ز‬
‫ة‬
‫ر‬
‫و‬
‫ص‬
‫ال‬
‫ب‬
‫ه‬
‫م‬
‫س‬
‫ا‬
‫د‬
‫و‬
‫ج‬
‫وم‬
3-What route of administratin ?
Deep intramascular

4-Name 3 benefits of this?
•
It's not affected by other medicines.
•
Doesn't require daily action.
Decreases menstrual cramps and pain.
5-How to tell patient how to use it? and what time to take it ?
The 1st injection should be administered within five days after ‘ onset of
menses . ---
Injections should be repeated every 3 months .

6-Whats the MECHANISM of action
•
thickening the cervical mucus, thereby presenting a barrier for sperm
penetration.
•
changes to the endometrium make it an unfavourable environment for
implantation
•
prevent pregnancy by the inhibition
of ovulation week effect
7-If women want to get pregnant can she ? Why?
After stopping Delayed return to fertility: 6-18 months. By 18 months, 90% will have ovulated.

Q2
1
What is
the difinition of
:
Lie :The relationship of the long axis
of the fetus to the long axis
of the mother
Denominator: arbitrary part of the presentation
2
Whats the presentation?
A)Frank
breech
b)Footling breech
c) Complete breech
3-What are findings by abdominal examination for this presentation?
•
1_Ballotable head at fundus
•
2_Soft presenting part
•
3_Fetal heart auscultatedmore commonlyabove umbilicus

4
Whats the dominator for this presentation?
Sacrum
5
Engagement
diameter?
10 cm
6
What is the risk found in (b) more than other ?
I think>>> cord prolapse
7
Pregnant women comes to obstetric room by examination she
has presentation in picture (c) and she want to deliver vaginally>>>
**Can you deliver it vaginally and how ?
Yes, by external cephallic version

Q3
1
WHATS the abnormality in
picture 2?
Dawn syndrome, increase NT,depressed
Nasal bone
2
What's the structure
pointed?
by arrow?
•
Tip of the nose
3-What the procedure done ?
Amniocentesis
4-and what the benefit of this procedure?
Prenatal
genetic diagnosis (PGD) and assessment of fetal lung maturity.
Phosphatadyl glycerol, Evaluation
of the fetus for infection, degree of
hemolytic
anemia,
blood or platelet
type, hemoglobinopathy, and NTDs.

5-What the risk of it when its done
.1
Leakage of amniotic fluid.
.2
Direct fetal needle injury.
.3
Vertical transmission
.4
Innoculation by bowel flora.
.5
Fetal loss.
.6
Cell culture failure:
6-at which gestational week you can do it?
optimally to be done at 15-17 weeks
> 15w of
gestation.
7-What are screening test used for diagnosis of this conginital
anomaly ,, and when
it done??
First trimestercombined test 11-13w
Second trimesterquadruble test 15-18w
fetal "cell-free (cf)" nucleic acids
as early as the fifth postmenstrual
week, and almost always by the ninth postmenstrual week

Q4
1-Whats the Name of this two
devices?
(1)
Support Pessary: Ring Pessary
(2)
Space- Filling Pessary: Donut
2-Write 3 indications to use them
.1
As a therapeutic test.
.2
Medically unfit for surgery or refused surgery.
.3
During and after pregnancy.
.4
While awaiting for surgery.
3-What the advantages of type A over type B
1)Easy to insert , can be inserted by patient her self
2) Can have intercourse during use it
4-Which one you chose for 70 years old female complaining of organ prolapse??
Type b

Q5
1-What do you see in image?
6-8 cell stageempryo
2
What technique used ??
In vetro fertalization
3
When you transfer it to be implanted ?
Can transfer at Day 3 cleavage embryo
Or at Day 5 blastocyst
4
Why YOU CHOOSE this technique in this case?
……………..
5
Three medication used in this technique?
Gonadotrophic releasing hormone analogue or agonist(GnRHa) Deycapeptyl
HMG
HCG
6
What Percentage of ectopic pregnancy in this technique?
5%
7
What Percentage of miscarriage?

OSCE stations
6/8/2019
•
Pre term
•
Small for gestational age
•
PCOS
•
‫ةمهم‬
‫يالسال‬‫د‬
‫ت‬
‫ف‬
‫ا‬
‫ص‬
‫ي‬
‫ل‬
‫لك‬
ً
‫اعبط‬

Obs & Gyne mini-OSCE
sixth year 2019
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4
0
( ‫ق‬
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‫ب‬ :P

Q 1
39 weeks gestation came with ROM 4 hours ago .
•
What do you see on CTG ?
Abnormal CTG , fetal tachycardia
•
What is the underlying cause ?
Chorioamnionitis
•
What other clinical findings might support your diagnosis ?
Fever , abnormal vaginal discharge ?
•
How to manage ?
Antibiotic and deliver vaginally
•
Mention 2 complications ?
Post partum hemorrhage , neonatal sepsis

Q 2
This lady came with history of 8 week amenorrhea ,vaginal bleeding and lower abdominal discomfort .
•
What is the diagnosis ? And why ?
Missed miscarriage , because no fetal heart activity on doppler US
•
Mention 3 bimanual examination findings ?
Small uterus for gestational age , closed cervix , ?
•
Serious complication you should avoid ?
DIC
•
What lab investigations you should order ?
PT , PTT , fibrinogen , platelet count

Q 3
•
What is the diagnosis ? And what is the organism ?
Bacterial vaginosis , Gardnella Vaginitis
•
Mention4 other tests for diagnosis?
Whiff test , culture , PH , gram stain
•
What is significantfeature this patienthave?
Fishy odor vaginaldischarge
•
What is the treatment ?
Metronidazole500 mg orallytwice a day for 7 days
•
What hygiene advice you should give this patient ?
Don’t do vaginaldouching
•
If this patientcame with 19 weeks gestation , what are most common complicationsthat might happen ?
Preterm labour , neonatalsepsis
‫ن‬
‫ا‬
‫ك‬
‫و‬
‫ر‬
‫ي‬
‫ث‬
‫ك‬
‫ة‬
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‫ض‬
‫ا‬
‫و‬
‫ت‬
‫ن‬
‫ا‬
‫ك‬
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‫ت‬
‫ج‬
‫ا‬
‫ي‬
‫لال‬
‫ة‬
‫ر‬
‫و‬
‫ص‬
‫ال‬
‫ا‬
‫ه‬
‫ي‬
‫ل‬
‫ع‬
‫ب‬
‫و‬
‫ت‬
‫ك‬
‫م‬
(clue
cells)

Q 4
No pic in this question
36 year-old patient came with severe chronic lower abdominal pain and menorrhagia since 2 years , on
examination the uterus size was normal , on pelvic examination there were painful nodules in posterior fornix
•
What is your diagnosis ?
Endometriosis
•
How to confirm it ?
Laparoscope
•
Give another gyne presentation this patient may suffer from ?
Deep dysparuenia , dysmenorrhea
•
Another finding on examination ?
Lower abdominal tenderness , fixed retroverted uterus
•
What is the surgical treatment ?
Hysterectomy

Q 5
Lady who is 8 weeks gestation came to you complaining of vaginal bleeding .
•
What do you see ?
Snow storm appearance
•
Complete hydatiform molarpregnancy
•
What other findingyou might see on US ?
Theca lutien cyst
•
Suction curretage
•
What would you advise her after she has completed treatment and before discharge from hospital?
Follow up with B-HCG every week , and use doublecontraception method

Q 6
This female is 8 years old , came with her mother due to vaginal discharge .
•
What is the diagnosis ?
precocious puberty
•
Mention 2 features in this picture that confirm your diagnosis ?
Thelarche (breast budding )
Pubarche (pubic hair)
•
What's your concern and why ?
Short stature due to premature closure of metaphysis ?
•
6 investigations you should order to confirm ?
FSH , LH , testesterone , pituitary MRI …??
•
GnRH agonist

Q 7
No pic in this question
Pregnant 24 weeks gestation came to your clinic , her booking investigations :
Hb 11
WBCs 5.6
Plt 294
FBG 190
Urine analysis+2 glucose
Urine culture negative
•
What is the abnormalityin her test ?
High fasting blood glucose FBG , glucosuria
•
Mention other investigations you need to support diagnosis ?
OGTT , HBA1C
•
Mention 5 fetal assessment you need to look for in this pregnancy ?
Detailed anomalyscan , AFI , estimated fetal weight .. ??
•
Mention 3 obstetric complicationsassociatedwith this abnormality ?
Preterm birth , CS , obstructed labor
•
What's your management goal ?
HBA1C < 6 …???

Q 8
•
What is the name of the sign ( arrow)
T sign
•
What is the type of this pregnancy ?
Monochorionic diamniotic
•
On 12 weeks gestation what are you should look for on US ?
Viability , chorionicity , fetal survey , nuchal transluscency
•
On 18 weeks , you find one baby with polyhydramnios and the other with oligo , what is the name of this
presentation ?
Twin-twin transfusion syndrome
•
Mention 4 US findings to confirm diagnosis ?
Growth discordancy > 20% , same sex , monochorionicity ,
•
On 22 weeks , if you see one fetus dead , what serious complication associated with it ?and how to confirm it ?
DIC , by PT , PTT , fibrinogen , plt count

Mini-OSCE Obs & Gyn
14/4/2019
1 - Face presentation
2 - Hyper emesis gravi
3 - ectopic pregnancy
4 - Poly cystic ovarian syndrome
5 - Prolapse

Q1
•
1 _ Whats the lie of this presentation?
Face presentationwith Vertical lie
•
2_ Whats the presenting diameter? And its length?
•
Submento-bregmatic in mento-anterior 9.5 cm
•
•Face mento posteriorbregma-sternal diameter 18 cm
•
3_mention 4 causes of this presentation?
•
Pelvic block (pelvic tumer,fibroid,pelvic shape)
•
decreased uterine polarity ( Grand multiparty,Uterine malformation)
•
altred fetal mobility (•IUGR •Prematurity •Macrosomia •Polyhydramnios or oligohydramnios
•
Multiply gestation •Fetal abnormality)

4_ how can You deliver this patient vaginaly?
•
Vaginal delivery allowed only for face mento anterior
5_ If you deliver this pt vaginaly Whats the Instrumentyou want to use?
(can used forceps only)
6_ Whats the causes that lead to deliver her CS ?
Mento-posterior only by cs

Q2
1 _Whats your diagnosis?
PCOS
2_ mention 6 result of hormonal abnormalities?
Serum luteinizing hormone (LH) elevated
Serum estrone elevated
Fasting insulin: elevated
Free testosterone: elevated
elevated serum androgen level
high LH/FSH ratio >2

3-how can You manage the infertility in this pt?
•
Life style management of Weight Reduction (Clomiphene Citrate or
Metformin)
•
Laparoscopic Ovarian drilling
•
Gonadotrophines
4
mention 4 long term complication
. Insulin Resistance, Obesity, Endometrial Cancer , Sleep Apnea ,Dyslipidaemia,
Hypertension and Endothelial Dysfunction, Depression, Cardiovascular Disease
5
_mention 2 complication if it become pregnant (I dont remember the Q
exactly)
•
Spontaneous Abortions Increasedin high BMI/PCOSpatients,
•
Impaired Glucose Tolerance Gestational Diabetes,
•
Hypertension,
•
Small for GestationalAge

Q3
22 years old female p2+ come with vaginal bleeding abd lower abdominal pain and amenorrhea 8 w :
1_Describe what can You see?
a small fluid collection that is centrally located
within the
endometrial cavity psudosac
2_whats the diagnosis?
ectopic pregnancy
3_mention another differantial diagnosis?
Ectopic pregnancy, missedmiscarriage,blightedovum.
4_ mention another abnormality on US adenexial mass
Peritoneal fluid
5_whats your managmentif this pt come with sever abdominal pain to ER?
Signs of impending or ongoing ectopic mass rupture (ie, severe or persistent abdominal pain or >300 mL of free
peritoneal fluid outside the pelvic cavity)
A laparoscopicsurgical approach

Q4
30 years old woman with amenorrhea 8 W duration, come with sever vomiting ( I
dont remember the details in Q) and the investigations was done & the result
shown below :
Hb :11.5
,
K:3.1
,
Keton in urine : ++ (normal :Nill)
1_ Whats your diagnosis? Hyperemesis Gravidarum
2_write another 6 Investigations you want to order them?
BUN & electrolytes
LFT
Urinalysis
Thyroidfunction test
Hematocrit
U/S
3_ write 2 obstetric condition you should exclude them
molar, multiple.

4_Whats your managment?
•
Depends on the severity of symptoms.
•
Two types :
Non- pharmacological
1. Dietary measures
Pharmacological
.1
Pyridoxine (Vitamin B6) and
Doxylamine.
.2
Antiemetics 2. Emotional support
3. Antihistamines and Anticholinergics 3. Acupressure
4. Motility Drugs 4. Ginger
5. Corticosteroids.
229

‫ركذأ‬
‫ام‬
‫لع‬‫ى‬
1
- Anterior vaginal wall prolapse
2
- Urinary symptoms mainly ( frequency, retention , incontenance…)
3
- Hystrectomy
4
- Anterior colporhaphy
5 –
Gh : the area between urthra and posterior forchetee
C: cervix
TVL : the total destant between posterior fornix and gh. measured at rest

OSCE
15/4/2019
1st case:
Pre term labour
2nd case:
CTG
3ed case:
Endometrial cancer

Q1
U/S pic with12 cm deepest
verticalpocket
1
) what is the Dx?
Polyhydramnios
2
) 4 complications?
a. Premature rupture of membranes .

b. Preterm labor and Premature birth .

c. Placental abruption

d. Umbilical cord prolapse .

e. Stillbirth

f. Heavy bleeding (lack of uterine muscle tone after delivery)

g. Maternal respiratory compromise .

h. Fetal malposition & malpresentaion

i. Excess fetal growth -Macrosomia

j. Cesarean delivery & NICU

k. Perinatal mortality (two- to five-folds)

3) 2 maternal causes 2 fetal causes?
1 - Maternal : Maternal diabetes
2 - Materno-Fetal :
Multiple gestation
Chorioangiomas
Erythroblastosis Fetalis
3 - Fetal :
Chromosomal Disorders :
Trisomy 18 ( Difficulty swallowing, intestinal abnormalities)
Trisomy 21 (Duodenal Artesia )
Respiratory
(Cystic adenomatoid malformed lung)
CNS
(anencephaly, hydrocephalus, meningocele)
GI
( Primary : duodenal, esophageal, or intestinal atresia)
( Secondary : massive unilateral dysplastic kidneys)

4 ) 2 treatment?

Amnioreduction .

Prostaglandin synthetase inhibitor .
.1
Indomethacin.
.2
Sulindac .

Q2
Partogram
1
) Vaginal examination finding on admission?
2
) The abnormal findings at 5 pm?
3
) The action you would do to the pt now?

Q3
50 years old postmenapoasel patient with abnormal uterine bleeding and US of
increase endometrial thickness
1-What's the most commoncause?
Atrophic vaginitis
2-Whats the important question in the history you should ask about it?...................
.................3-Investigation?hystroscopy +biopsy
What's your management if the result of biopsy is hyperplasia
with atopy?
•
hystrectomy

Q4
Picture of CTG
1-Whats the name of these test?
2-Whats the finding?
3-Whats the cause of these finding?
4-Whats your management?

Q5
A case about family planning
•
37
years old female
need a
method of conception for long period(I
cant remember the question exactly
-_-)
1-quation on history you should ask about it?
2-Whats the best method to choose?
3-Why you use these method?
4-Whats the side effect?

•
Side effect of medroxyprogesterone
.1
Irregular bleeding
70% in the first year; 10% thereafter , and it is the most common reason for
discontinuation (Up to 25% in the first year of use)
.2
Amenorrhea: 55% at one year, 70% at 2 years, 80% at 5 years
.3
Weight Gain, Adult women: 4.3 kg increase over 5 years
.4
Use of DMPA is associated with loss of BMD.
After stopping, recovery of BMD is seen
&
return to baseline in 1-4 years.

•
Side effect of implanon
.1
Amenorrhea ~20% in 1st year, Increases to 30-
40% after 1st year
.2
Acne: 17% reported acne. 1.3% of women discontinued for acne
.3
Weight gain: Overall increase in BMI 0.7kg/m2 , 12.7% of women reported weight gain, 3.3%
of women discontinued for weight gain
.4
Bleeding irregularity is the most common reason for discontinuation , U.S. studies: 13-14%
Overall U.S. Implanon continuation rate: 75%-84%

OSCE Obs & Gyn
20/2/2019
•
Recurrent miscarriage
•
premature rupture of membrane
•
secondary amenorrhea

Mini-OSCE OBS & GYN.pptx

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