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Obstetrics picture test 2

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picture test OSCE

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Obstetrics picture test 2

  1. 1. OBSTETRICS PICTURE TEST DrOkechukwuA.Ugwu
  2. 2. 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 11/13/2017 Okechukwu A. Ugwu 2
  3. 3. 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 11/13/2017 3Okechukwu A. Ugwu
  4. 4. 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 11/13/2017 4Okechukwu A. Ugwu
  5. 5. 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 11/13/2017 5Okechukwu A. Ugwu
  6. 6. 1. Also known as pathological retraction ring T 2. Formed between thinned out upper segment and lower segment F 3. Contractions wane off with time in primigravid women T 4. Electrolytes derangement is common T 5. Increased risk of PPH T 11/13/2017 6Okechukwu Ugwu
  7. 7. 6. Spermatozoa must be immobilized before injection. T 7. Inverted microscopy is utilized T 8. When indicated, male karyotyping should be done. T 9. ‘OAT’ syndrome is a contraindication. F 10. Holding pipette provides gentle sunction. T 11/13/2017 7Okechukwu Ugwu
  8. 8. 11. Commoner in multipara T 12. Usually symptomatic F 13. Intermenstrual bleeding is a recognized symptom T 14. Recurrence rate of about 3% F 15. Monsel paste has a role in controlling bleeding post-avulsion T 11/13/2017 8Okechukwu Ugwu
  9. 9. 16. HPV is a double stranded DNA virus. T 17. Smoking doubles risk of Ca cervix T 18. Risk due to COCP falls to baseline in 10 years after stopping. T 19. Presence of nodal involvement increases mortality by 30% stage for stage. F 20. Pregnancy does not adversely affect outcome. T 11/13/2017 9Okechukwu Ugwu
  10. 10. 21. Cervical length of less 25mm at 24wks in a primigravida is an indication F 22. Outcome is the same as no intervention in multiple gestation. F 23. Removal of Shirodkar type requires anaesthesia T 24. Immediate removal following PPROM optimisises outcome. F 25. Recent evidence supports laparoscopic over laparotomy for abdominal cerclage F 11/13/2017 10Okechukwu Ugwu
  11. 11. 26. Rupture of this type may be catastrophic T 27. Typically ruptures around 11weeks. F 28. Progesterone assay could help localize gestation. F 29. Wedge resection is the management of choice. T 30. Total removal of the ipsilateral tube is recommended. T 11/13/2017 11Okechukwu Ugwu
  12. 12. 31. Provides illumination and magnification T 32. 3 consecutive inadequate pap smear samples is an indication T 33. Ablative technique may be used for glandular disease. F 34. CCI has a maximum score of 10 T 35. It is unsatisfactory when the endocervical canal is not visualised F 11/13/2017 12Okechukwu Ugwu
  13. 13. 36. Incidence of 0.2% T 37. Delivery by extension F 38. Presenting diameter is 9.5cm T 39. Anterior neck mass is the most common course. F 40. Mentoposerior is better delivered by CS. T 11/13/2017 13Okechukwu Ugwu
  14. 14. 41. Cost effective investigation T 42. This is risk factor for ectopic gestation T 43. Live birth rate is reduced by 35% in patients with this condition undergoing IVF-ET FALSE 44. Salpingectomy or proximal occlusion is indicated. T 45. NNT in IVF patients undergoing treatment for this condition is 6. T 11/13/2017 14Okechukwu Ugwu
  15. 15. 46. This is a pneumatic anti-shock garment. F 47. One size fits all F 48. Made of Neoprene T 49. Segments 4, 5 and 6 should be applied by only one person. T 50. It is a definitive treatment. F 11/13/2017 15Okechukwu Ugwu
  16. 16. 51. Time consuming T 52. 10-15cm long T 53. Preferred in Misgav-Ladach technique F 54. Utilizes blunt dissection F 55. Has cosmetic appeal T 11/13/2017 16Okechukwu Ugwu
  17. 17. 56. Two thirds of patients bleed PV T 57. Transvaginal USS is contraindicated F 58. Bleeding is mainly maternal T 59. Hospital admission yields better outcome than being at home F 60. Risk of morbidly adherent placenta in cases of 3 previous CS and Placenta previa is 45%. T 11/13/2017 17Okechukwu Ugwu
  18. 18. 61. Routinely done for primigravida F 62. This type bleeds less T 63. Restrictive used increases anterior perineal traumaT 64. May have a role in management of fetal distress T 65. The technique with best outcome is unknown T 11/13/2017 18Okechukwu Ugwu
  19. 19. 66. Should be inserted between Day 1-5. T 67. Levels of hormones in the blood return to normal in a week. T 68. Biodegradable. F 69. Failure rate of 2 in 1000 F 70. Discontinuation rate of 15-25% F 11/13/2017 19Okechukwu Ugwu
  20. 20. 11/13/2017 Okechukwu Ugwu 20
  21. 21. 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 11/13/2017 21Okechukwu A. Ugwu
  22. 22. Mechanism of Ureteric injury • Crushing T • Laceration T • Ligation with sutures T • Ischaemia/devasculrisation T • Segmental resection T • Transection T 11/13/2017 Okechukwu A. Ugwu 22
  23. 23. 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 11/13/2017 23Okechukwu A. Ugwu
  24. 24. 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 11/13/2017 24Okechukwu A. Ugwu
  25. 25. 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 11/13/2017 25Okechukwu A. Ugwu
  26. 26. 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 11/13/2017 26Okechukwu A. Ugwu
  27. 27. • 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 11/13/2017 Okechukwu A. Ugwu 27
  28. 28. 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 11/13/2017 Okechukwu A. Ugwu 28
  29. 29. 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 11/13/2017 Okechukwu A. Ugwu 29
  30. 30. 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 11/13/2017 Okechukwu A. Ugwu 30

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