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OSCE Picture test in
Obstetrics and Gynaecology
DRAdegbengaAjepe
And
Dr.OkechukwuA.Ugwu
. 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 2Okechukwu A. Ugwu
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 3
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 4Okechukwu A. Ugwu
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 5Okechukwu A. Ugwu
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 6Okechukwu A. Ugwu
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 7
About the Instrument
1. They are indicated in maternal
exhaustion. -T
2. Bladder must be empty but the
catheter bulb need not deflated-F
3. Associated with more maternal
worries about the baby compared to
Vacuum. -F
4. Associated with lower APGAR scores
compared to vacuum.-F
5. Ideal traction of 30-45 lb.-T
5/2/2018 82014 SET, LUTH
6. Cervarix offers protection-F
7. May contain oncogenic subtypes of
HPV-T
8. Contraception is mandatory while
using podophyllin-T
9. Neonatal laryngeal papilomatosis is a
recognized potential problem.-T
10. Histology is necessary for diagnosis-
F
5/2/2018 92014 SET, LUTH
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 10Okechukwu A. Ugwu
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 11Okechukwu A. Ugwu
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 12Okechukwu A. Ugwu
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 13Okechukwu A. Ugwu
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 14Okechukwu A. Ugwu
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 15Okechukwu A. Ugwu
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 16Okechukwu A. Ugwu
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 17Okechukwu A. Ugwu
11. Used by 2% of Nigerian women.-T
12. Failure rate of ideal use is 2%.-F
13. Use associated with deep vein
thrombosis but not myocardial
infarction in obese women.-F
14. Increased risk of rheumatoid
arthritis.-F
15. Risk of Stroke is increased in women
with migraine but lower in those with
aura.-F
5/2/2018 182014 SET, LUTH
16. Outer ring needs to be held prior to
penetration.-T
17. Can be noisy and cumbersome-T
18. More likely to rupture than male
condom.-F
19. Contains spermicide-F
20. Failure rate of 5% with ideal use.-T
5/2/2018 192014 SET, LUTH
21. Sensitivity of 96%-F
22. Liquid based type make diagnosis of
HPV and Chlamydia possible-T
23. Abnormality found in 10% of all
samples-T
24. False negative result may be up to
70%-F
25. Nationwide programme has reduced
incidence of Ca. Cervix by 95%-F
5/2/2018 202014 SET, LUTH
26. This is a Karman syringe- F
27. Volume of syringe is 50cc- F 60CC
28. 5-10mm cannula for 9-12weeks-F
29. Provides sunction pressure of about
640mmHg-T
30. Can be used for menstrual
regulation.-T
5/2/2018 212014 SET, LUTH
31. Size and rate of growth influenced
by sexual stimulation.- T
32. N. gonorrhoeae and Chlamydia
Trachomatis are most often isolated in
the abscesses-F -E.coli
33. Word Catheter has a role in
management.-T
34. Silver Nitrate ablation may be used
in treatment. -T
35. Biopsy is mandatory in patients
under 40years-F
5/2/2018 222014 SET, LUTH
36. Postdatism and malpresentation
may be complication-T
37. Oligohydramnios often associated-F
38. Defect results from malformation
around day 35 of embryonic life.-F 25
39. Late neonatal death is common.-F
EARLY
40. Folic acid supplementation may
reduce incidence.-T
5/2/2018 232014 SET, LUTH
41. Monoclonal in origin-T
42. Red degeneration is the commonest
form of degeneration-F
43. Only submucous type has been
shown to be linked with infertility-F
44. Uterine artery embolization not
recommended for women who wish to
preserve fertility. -T
45. Recurrence after myomectomy is
about 20%.-F 10-15
5/2/2018 242014 SET, LUTH
46. About 80% of patients are above
55years –F 65
47. Commonest site is labia minor-F
48. Two-thirds occur in women with
Lichen sclerosis-T
49. 4-8% of squamous cell type linked
with Paget disease.-F <1%
50. Stage 3 has 5-year survival rate of
about 75%.-T
5/2/2018 252014 SET, LUTH
51. Bilateral in about 25%-F
52. Stroma ovarii if parathyroid tissue is
demonstrated.-F
53. Immature variant accounts for 20%
of all ovarian malignancy in females less
than 20 years-T
54. Immature variant are commonly
bilateral-F
55. Squamous cell carcinoma is the
most common histology of malignant
transformation in mature variant.-T
5/2/2018 262014 SET, LUTH
56. Flexion point is 3cm from anterior
fontanelle-F
57. Negative pressure of 600mmHg is
recommended-T
58. Use associated with increase risk of
shoulder dystocia-T
59. Retinal haemorrhage commoner in
forceps than in this instrument.-F
60. May be used during Caesarean
section.-T
5/2/2018 272014 SET, LUTH

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Osce picture test in obstetrics and gynaecology

  • 1. OSCE Picture test in Obstetrics and Gynaecology DRAdegbengaAjepe And Dr.OkechukwuA.Ugwu
  • 2. . 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 2Okechukwu A. Ugwu
  • 3. 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 3
  • 4. 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 4Okechukwu A. Ugwu
  • 5. 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 5Okechukwu A. Ugwu
  • 6. 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 6Okechukwu A. Ugwu
  • 7. 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 7
  • 8. About the Instrument 1. They are indicated in maternal exhaustion. -T 2. Bladder must be empty but the catheter bulb need not deflated-F 3. Associated with more maternal worries about the baby compared to Vacuum. -F 4. Associated with lower APGAR scores compared to vacuum.-F 5. Ideal traction of 30-45 lb.-T 5/2/2018 82014 SET, LUTH
  • 9. 6. Cervarix offers protection-F 7. May contain oncogenic subtypes of HPV-T 8. Contraception is mandatory while using podophyllin-T 9. Neonatal laryngeal papilomatosis is a recognized potential problem.-T 10. Histology is necessary for diagnosis- F 5/2/2018 92014 SET, LUTH
  • 10. 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 10Okechukwu A. Ugwu
  • 11. 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 11Okechukwu A. Ugwu
  • 12. 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 12Okechukwu A. Ugwu
  • 13. 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 13Okechukwu A. Ugwu
  • 14. 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 14Okechukwu A. Ugwu
  • 15. 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 15Okechukwu A. Ugwu
  • 16. 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 16Okechukwu A. Ugwu
  • 17. 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 17Okechukwu A. Ugwu
  • 18. 11. Used by 2% of Nigerian women.-T 12. Failure rate of ideal use is 2%.-F 13. Use associated with deep vein thrombosis but not myocardial infarction in obese women.-F 14. Increased risk of rheumatoid arthritis.-F 15. Risk of Stroke is increased in women with migraine but lower in those with aura.-F 5/2/2018 182014 SET, LUTH
  • 19. 16. Outer ring needs to be held prior to penetration.-T 17. Can be noisy and cumbersome-T 18. More likely to rupture than male condom.-F 19. Contains spermicide-F 20. Failure rate of 5% with ideal use.-T 5/2/2018 192014 SET, LUTH
  • 20. 21. Sensitivity of 96%-F 22. Liquid based type make diagnosis of HPV and Chlamydia possible-T 23. Abnormality found in 10% of all samples-T 24. False negative result may be up to 70%-F 25. Nationwide programme has reduced incidence of Ca. Cervix by 95%-F 5/2/2018 202014 SET, LUTH
  • 21. 26. This is a Karman syringe- F 27. Volume of syringe is 50cc- F 60CC 28. 5-10mm cannula for 9-12weeks-F 29. Provides sunction pressure of about 640mmHg-T 30. Can be used for menstrual regulation.-T 5/2/2018 212014 SET, LUTH
  • 22. 31. Size and rate of growth influenced by sexual stimulation.- T 32. N. gonorrhoeae and Chlamydia Trachomatis are most often isolated in the abscesses-F -E.coli 33. Word Catheter has a role in management.-T 34. Silver Nitrate ablation may be used in treatment. -T 35. Biopsy is mandatory in patients under 40years-F 5/2/2018 222014 SET, LUTH
  • 23. 36. Postdatism and malpresentation may be complication-T 37. Oligohydramnios often associated-F 38. Defect results from malformation around day 35 of embryonic life.-F 25 39. Late neonatal death is common.-F EARLY 40. Folic acid supplementation may reduce incidence.-T 5/2/2018 232014 SET, LUTH
  • 24. 41. Monoclonal in origin-T 42. Red degeneration is the commonest form of degeneration-F 43. Only submucous type has been shown to be linked with infertility-F 44. Uterine artery embolization not recommended for women who wish to preserve fertility. -T 45. Recurrence after myomectomy is about 20%.-F 10-15 5/2/2018 242014 SET, LUTH
  • 25. 46. About 80% of patients are above 55years –F 65 47. Commonest site is labia minor-F 48. Two-thirds occur in women with Lichen sclerosis-T 49. 4-8% of squamous cell type linked with Paget disease.-F <1% 50. Stage 3 has 5-year survival rate of about 75%.-T 5/2/2018 252014 SET, LUTH
  • 26. 51. Bilateral in about 25%-F 52. Stroma ovarii if parathyroid tissue is demonstrated.-F 53. Immature variant accounts for 20% of all ovarian malignancy in females less than 20 years-T 54. Immature variant are commonly bilateral-F 55. Squamous cell carcinoma is the most common histology of malignant transformation in mature variant.-T 5/2/2018 262014 SET, LUTH
  • 27. 56. Flexion point is 3cm from anterior fontanelle-F 57. Negative pressure of 600mmHg is recommended-T 58. Use associated with increase risk of shoulder dystocia-T 59. Retinal haemorrhage commoner in forceps than in this instrument.-F 60. May be used during Caesarean section.-T 5/2/2018 272014 SET, LUTH