OSCE PICTURE TEST IN OBSTETRICS AND GYNAECOLOGY

1. OBSTERICS AND GYNAECOLOGY PICTURE TEST OSCE 2
Dr OkechukwuA. Ugwu
5/2/2018 1Okechukwu A. Ugwu

2. DERMOID CYST
• Most common benign
tumour of the ovary T
• Most common
neoplasm diagnosed
during pregnancy T
• Most common germ cell
tumour T
• Commonest tumour to
undergo torsion T
5/2/2018 Okechukwu A. Ugwu 2

3. Ovarian Tumours
• Call Exner Bodies-
Granulosa cell tumour T
• Walthard Cell nest-
Brenner Tumour T
• Signet Ring-Krukuberg
tumour T
• Hobnail Cell- Clear cell
tumour T
• Schiller Duval Bodies-
Endodermal sinus tumour
T
5/2/2018 Okechukwu A. Ugwu 3

4. CONCERNING OVARIAN TUMOURS
• Skin, Teeth and
cartillage- Teratoma T
• Psammoma bodies-
Serous epithelial
Tumours T
• Pseudomyxoma
peritonei- Mucinous
tumours T
• Rienke’s Crystal- Hilus
cell tumour T
5/2/2018 Okechukwu A. Ugwu 4

5. • BILATERAL in 10-15% of
cases T
• Malignant change occurs
in 0.5-2% of cases T
• Most common malignant
transformation is
squamous cell tumour
• Lining epithelium is
columnar epithelium F
5/2/2018 Okechukwu A. Ugwu 5

6. About the procedure shown
a) It is an endoscopic
procedure T
b) It facilitates directed
biopsy T
c) Areas of CIN appear white
when the cervix is painted
with Lugol’s iodine during
this procedure F
d) It can be used to assess
vascular patterns on the
cervix T
e) The instrument used is a
monocular microscope F
5/2/2018 6Okechukwu A. Ugwu

7. Concerning this picture
a) It is used for emergency
contraception F
b) The duration of use is 10
years F
c) It can cause
amenorrhoea T
d) It can be used as part of
a hormone replacement
therapy regimen T
e) It contains oestrogen
and progestin F
5/2/2018 7Okechukwu A. Ugwu

8. This instrument
a) It is useful in the
management of ante-
partum haemorrhage F
b) A systolic blood pressure
of 90mmHg is an
indication for its use T
c) When weaning a patient
off it, it is removed in the
reverse order i.e from no 5
to no 1 F
d) A pulse rate of 60/min is
an indication for its use F
e) It can be employed at
every level of care T
5/2/2018 8Okechukwu A. Ugwu

9. Regarding this lesion
a) It is caused by herpes
simplex virus F
b) Similar lesions may be
found on the vagina,
cervix and uterus F
c) They are generally
painless T
d) Spontaneous healing
occurs within 3 weeks F
e) Pregnancy can make the
lesions large T
5/2/2018 9Okechukwu A. Ugwu

10. Mechanism of Ureteric injury
• Crushing T
• Laceration T
• Ligation with sutures T
• Ischaemia/devasculrisat
ion T
• Segmental resection T
• Transection T
5/2/2018 Okechukwu A. Ugwu 10

11. Concerning this instrument and its use
a. It is used in a minimally
invasive procedure T
b. Intestinal obstruction is a
contraindication for its use F
c. The procedure can be
performed under general
anaesthesia T
d. It is useful in the diagnosis of
uterine perforation F
e. It is contraindicated in the
treatment of endometriosis F
5/2/2018 11Okechukwu A. Ugwu

12. About this instrument and its use
a. This instrument is called
the Mayo’s scissors. F
b. The procedure must be
carried out on all
primigravid women. F
c. Its use can lead to a 3rd
degree perineal tear T
d. Dysmenorrhea is a late
complication of its use F
e. The midline incision is
easier to repair than the
medio-lateral type T
5/2/2018 12Okechukwu A. Ugwu

13. About what is shown
a) It is useful in the
management of cervical
stenosis F
b) It is an absorbable tape F
c) It is usually removed at
gestational age of 36
weeks F
d) It should be removed
when there are preterm
contractions F
e) When its use is indicated,
it is inserted after the
second missed period F
5/2/2018 13Okechukwu A. Ugwu

14. The procedure shown
a) The patient should lie in
the left lateral position F
b) The tip of the spatula is
introduced into the cervical
canal and the instrument
rotated through 180
degrees F
c) A cytobrush can be used
in place of Ayre’s spatula T
d) Samples taken are
immediately fixed with
70% alcohol F
e) The cervix is painted with
Lugol’s iodine prior to
sample collection F
5/2/2018 14Okechukwu A. Ugwu

15. Features of delayed ureteric injury
Prolonged ileus T
Watery vaginal discharge T
Prolonged high output
from drains T
Fever/sepsis. T
Persistent flank/
abdominal pain T
Flank mass T
Elevated creatinine or
BUN T
5/2/2018 Okechukwu A. Ugwu 15

16. About the condition depicted below
a) It is common in
postmenopausal women F
b) Cystic degeneration
usually precedes hyaline
degeneration F
c) The intraligamentary form
can cause polycythaemia T
d) GnRH antagonists are
useful in its management T
e) Iron deficiency anaemia
secondary to chronic
blood loss is an indication
for surgical management.
**T
5/2/2018 16Okechukwu A. Ugwu

17. Concerning this
a) It is a permanent
measure of
management F
b) Pregnancy is a
contraindication F
c) It should be changed
every 6 months F
d) It can be complicated by
vaginal infection T
e) If it fails, surgery is
indicated T
5/2/2018 17Okechukwu A. Ugwu

18. About this instrument
a) It is a high cavity forceps F
b) It is a non-rotational
forceps and so can be used
in the correction of
asynclitism F
c) It has a sliding lock T
d) The cervix should be at
least 8cm dilated for its
use F
e) It causes more maternal
injury compared to the
vacuum extractor T
5/2/2018 18Okechukwu A. Ugwu

19. Prevention of ureteric injury
1. Generous surgical
exposure T
2. Meticulous surgical
technique T
3. IdentifIcation of Risk
factors T
4. Ureteric stenting T
5. Pre operative IVU not
necessary F
5/2/2018 Okechukwu A. Ugwu 19

20. . About this instrument
a) It can be used for
hindwater rupture of
membrane F
b) Its use is associated with
cord prolapse T
c) Its use is associated with
foetal injury T
d) It can cause uterine
hyperstimulation F
e) Its use is contraindicated
in retroviral positive
patients F
5/2/2018 20Okechukwu A. Ugwu

21. Concerning this picture
a. This is a complication of
external cephalic version
T
b. Coagulation failure is a
complication T
c. Foetal parts will be easily
outlined on palpation.F
d. The uterus will have a
hard wooden consistency
on palpation T
e. Caeserian section should
be performed if the fetus
is dead on presentation.
F
5/2/2018 21Okechukwu A. Ugwu

22. Multiple gestation
a. Cleavage of zygote on day 9
after fertilization produces
the picture shown F
b. The intertwin membrane is
made up of 2 layers of
amnion with no chorionic
layer F
c. Inheritance as autosomal
recessive trait is recognised F
d. There is a risk of twin to twin
transfusion F
e. Caeserian delivery is
indicated if the presentation
of the first twin is vertex and
the second twin non-vertex F
5/2/2018 22Okechukwu A. Ugwu

23. Concerning uterine incisions during
Caesarean delivery
a. A is associated with less likelihood
of adhesion formation to bowel or
omentum T
b. A is more commonly used than B
T
c. B allows for easy entry into the
uterus when there is fibroid in the
lower segment T
d. B is associated with less likelihood
of subsequent uterine rupture
during pregnancy F
e. A is indicated in the presence of
carcinoma of the cervix F
A
B
5/2/2018 23Okechukwu A. Ugwu

24. Concerning the picture shown
a. Birth weight of 1400gram is
an indication for Caeserian
delivery. T
b. Engagement of the
presenting part in the pelvis
is not a contraindication for
external cephalic version. F
c. High parity is a predisposing
factor T
d. Lovset manouvre is used to
deliver the head F
e. Kielland’s forceps can be
used in the delivery of the
aftercoming head F
5/2/2018 24Okechukwu A. Ugwu

25. Concerning the picture shown and
intrapartum monitoring
a. The duration between two
vertical lines on a partograph
is half hour. T
b. In the primigravida, the cervix
dilates at a rate of at least 1
cm/hr in the active phase T
c. The alert line is parallel and
4hours to the right of the
action line F
d. Vaginal examination is done
four hourly. T
e. Plastic Pinnard stethoscope is
better than the metallic one in
monitoring fetal heart rate. T
5/2/2018 25Okechukwu A. Ugwu

26. Concerning the use of this instrument:
a. It is used to reduce the
bisacromial diameter and
allow for vaginal delivery F
b. Cervix need not be fully
dilated in experienced hands T
c. It is employed in the
commonest type of
destructive surgery. T
d. Continuous bladder drainage is
essential after its use T
e. At least 2/5th of the fetal
head must have gone into the
maternal pelvis if its use is
indicated F
5/2/2018 26Okechukwu A. Ugwu

27. About this instrument
a) A tourniquet can be
used in its place. T
b) It is useful in vaginal
hysterectomy F
c) It is used in clamping the
isthmus of the fallopian
tubes F
d) It helps reduce blood
loss during surgery T
e) It can be left in place for
at least 2 hours F
5/2/2018 27Okechukwu A. Ugwu

28. Concerning this instrument,
a. It is used in fistula repair
T
b. Cusco’s speculum can be
used in its place F
c. Its use requires one
assistant T
d. Its use requires more
than one assistant F
e. Autoclaving is
contraindicated F
5/2/2018 28Okechukwu A. Ugwu