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    6th batch OBGYN OSCE _ Group 2

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    usmleusmle86
    The document outlines various oral examination scenarios for a 6th batch OBGYN OSCE, covering topics such as CTG interpretation, ectopic pregnancy, menorrhagia, placental abruption, breech presentation, and complications in pregnant women with type 1 diabetes. Each scenario includes diagnosis, management options, risk factors, and necessary investigations. Additionally, it emphasizes the importance of history taking, physical examination, and interpretation of lab results in the context of obstetrics and gynecology.

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    6th batch OBGYN OSCE _ Group 2

    Uploaded by

    usmleusmle86
    0 views6 pages
    The document outlines various oral examination scenarios for a 6th batch OBGYN OSCE, covering topics such as CTG interpretation, ectopic pregnancy, menorrhagia, placental abruption, breech presentation, and complications in pregnant women with type 1 diabetes. Each scenario includes diagnosis, management options, risk factors, and necessary investigations. Additionally, it emphasizes the importance of history taking, physical examination, and interpretation of lab results in the context of obstetrics and gynecology.

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    The document outlines various oral examination scenarios for a 6th batch OBGYN OSCE, covering topics such as CTG interpretation, ectopic pregnancy, menorrhagia, placental abruption, breech presentation, and complications in pregnant women with type 1 diabetes. Each scenario includes diagnosis, management options, risk factors, and necessary investigations. Additionally, it emphasizes the importance of history taking, physical examination, and interpretation of lab results in the context of obstetrics and gynecology.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    0 views6 pages

    6th batch OBGYN OSCE _ Group 2

    Uploaded by

    usmleusmle86
    The document outlines various oral examination scenarios for a 6th batch OBGYN OSCE, covering topics such as CTG interpretation, ectopic pregnancy, menorrhagia, placental abruption, breech presentation, and complications in pregnant women with type 1 diabetes. Each scenario includes diagnosis, management options, risk factors, and necessary investigations. Additionally, it emphasizes the importance of history taking, physical examination, and interpretation of lab results in the context of obstetrics and gynecology.

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    6th batch OBGYN OSCE – Group 2

    1- Oral: CTG & partogram interpretation.


    CTG:
    Baseline: 130.
    Variability: moderate.
    Accelerations: present.
    Decelerations: absent.
    Contractions: regular.
    Overall impression: Category 1.

    Partogram:
    Comment on the head decent: it plateaus.
    Comment on the cervical dilatation: it plateaus.
    Comment on the contractions: adequate.
    What is your diagnosis? Cephalopelvic disproportion (CPD)
    What are the causes of CPD?
    What are the three important factors in labor? The three: (Ps): power, passenger & passage.
    What is meant by: power, passenger & passage?
    What is the management of this patient? C/S

    2- Oral: A young lady came with iliac fossa pain, vaginal spotting & 6
    weeks history of amenorrhea.
    What is your diagnosis? Ectopic pregnancy.
    What are the risk factors for ectopic pregnancy?
    If a pregnancy occurs with an IUD it is more likely to be an ectopic. Why is that? A Foreign body
    carries the risk of infection.
    What are the sites of ectopic pregnancy?
    What are the physical examination findings in an ectopic pregnancy?
    Mention two investigations to confirm your diagnosis: ultrasound & HCG.
    Mention 3 management options: expectant, medical (methotrexate) & surgical
    What are the perquisites for methotrexate use?
    What are the contraindication for methotrexate use?
    What is the mechanism of action of methotrexate?
    What are the surgical options for this patient?

    3- Oral: 40 year old presents with heavy regular menstrual periods?


    What do we call this? Menorrhagia.
    What physical examination you want to preform? (Don't forget the thyroid).
    What are looking for in the abdominal examination? Pelvi-abdomial masses.
    Mention 5 medical treatments for this patient? COCP, progesterone only pills, NSAIDs
    (mefenamic acid), tranexamic acid & levonorgestrel IUD.

    Interpret these investigations results:


    CBC:
    Hb: low MCV: low WBCs: normal Platelets: normal
    TSH: normal T4: normal
    Ultrasound (picture): thick endometrium.
    Biopsy report: secretory endometrium.

    What are the contraindications for OCP use?


    What are the surgical options for a sub-mucosal fibroid? (Don't forget hysteroscopic
    myomectomy).
    What are the routes of hysterectomy?
    What are the intraoperative, short term & long term complications of hysterectomy?
    Mention three Imaging modalities to investigate abnormal uterine bleeding?
    4- Oral: A pregnant lady in her third trimester with a history of
    hypertension & smoking presents with abdominal pain & vaginal
    bleeding.
    What is your diagnosis? Placental abruption.
    What is the role of ultrasound in this case?
    What is the clinical presentation of placental abruption?
    What are the risk factors for placental abruption?
    What are the maternal & fetal complication of placental abruption?
    How would you manage this patient?
    In which circumstances would you immediately deliver?
    In which circumstances would you admit and observe instead of immediate delivery?
    In which circumstances would you allow her to deliver vaginally?
    In which circumstances would you delver her by C/S?

    5- Oral: 35 weeks pregnant lady with breech presentation.


    What are the questions you would like to ask in the history?
    What are the risk factors for breech?
    What are the management options? ECV or Vaginal delivery or C/S.
    When would you do ECV? 37 weeks.
    When would you do C/S? 39 weeks.
    What are the prerequisites for ECV?
    How would you prepare the patient for ECV?
    How would you monitor the fetus during ECV?
    What are the possible complications of ECV?
    What is the percentage of ECV success?
    What is the percentage of successful ECVs that revert to breech?
    What are the prerequisites for vaginal delivery in breech presentation?
    What is the percentage of fetal anomalies in breech presentation in comparison to cephalic
    presentation?
    What is the percentage of perinatal mortality in breech presentation in comparison to cephalic
    presentation?

    6- History taking: A 10 weeks pregnant lady with type 1 diabetes


    mellitus.
    Take full history - take history for both her current pregnancy & her type 1 DM - (important
    points: retinopathy, nephropathy, vasculopathy, neuropathy, weather her diabetes is
    controlled or not, insulin therapy, her previous pregnancies & about any complications)
    What labs would you order? (Don't order an OGTT for Type 1 DM!).
    What are the fetal complications?
    What are the maternal complications?
    What is your plan for her & what specialties should be involved in her follow up?

    7- History taking: 25 years old lady with postcoital bleeding.


    Full history (important points: OCP, IUD, STI, PID, Pap smear, dysmenorrhea & Dyspareunia).
    What is your differential diagnosis? (Don't forget to mention IUD, OCP & infections).
    Which infections & which medications could cause this?
    What physical examination you want to preform?
    What investigation would you order?

    8- Physical Examination: Preform physical examination on the lady


    mentioned in the station before (postcoital bleeding).
    Introduction (don’t forget a chaperon & to ask if the patient would like to empty her bladder).
    Mention that you would like to do a general examination then the examiner will guide you to
    perform an abdominal exam including inspection & palpation then to move to pelvic
    examination:
    Inspection.
    Speculum examination then obtain a Pap smear & a swab for culture (Use the spatula for the
    ectocerix & the brush for the endocervix).
    Bimanual examination.
    The examiner will show you this picture:

    What is this? A cervical polyp


    Where also can a polyp be? Endometrial polyp
    Mention two management options for an endometrial polyp? Polypectomy or hysteroscopy +
    dilatation & curettage

    9- Physical Examination: Pregnant abdomen.


    Introduction.
    Inspection.
    Palpation.
    Leopold's maneuvers.
    Symphysis fundal height.
    Mention that you want to check the fetal heart sounds.
    Report your findings to the examiner.
    10- Short answer questions:
    Answer the following questions about a pregnant lady using the results of the investigations
    provided below:
    CBC:
    Hb: low MCV: low WBCs: normal Platelets: normal
    Blood group: B negative.
    Antibody screen: negative.
    Rubella antibodies: non-reactive.
    Urine culture: positive for E. coli.

    Form her CBC:


    1- What is your diagnosis?
    2- What tests would you order to confirm it?
    3- What would be your management?

    From her rubella antibodies screen:


    1- What is the importance of her rubella screen result?
    2- What are your recommendations regarding this result?

    From her blood group and antibody screen:


    1- What would you do regarding her Rh blood group?

    From her urine culture results:


    1- What are the complications of asymptomatic bacteriuria?
    2- How would manage asymptomatic bacteriuria?

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