Berikut adalah soalan yang telah kami hadapi untuk exam OSCE semalam :)
MINI OSCE
1. Gambar X-ray tangan. Diagnosis? Rheumatoid Arthritis
2. A woman comes with heavy menses. Gambar Blood Film Microcytic Hypochromic RBC. Diagnosis? Iron Deficiency Anemia.
3. CSF Analysis. Diagnosis? Bacterial meningitis.
2 lines of treatment : Antibiotic and steroid.
4. Man, (tak ingat age berapa), coming with fever, rash. Blood Film disertakan. Diagnosis? AML
5. Gambar Yellowish sclera + Red urine. Diagnosis? Hemolytic Anemia.
Why red urine? Hemoglobinuria.
6. CXR - Mass in the lung + Serum Na= 118. Diagnosis? - SIADH. (Untuk soalan ini, mungkin ramai yang bubuh Lung CA.)
7. Addison Disease. (tak ingat apa soalannya. Tapi serum ACTH high + others lab result)
8. ECG : SVT. Treatment ? IV Adenosine.
9. ECG : Inferior MI
10. ECG : Hyperkalemia
11. PFT : Bronchial Asthma.
12. A patient comes with dyspnea post-colectomy. CXR- normal.
Diagnosis? Pulmonary embolism. Further investigation: Spiral CT.
13. A woman comes with nervousness, weight loss. Next investigation? Thyroid Function Test.
OSCE
1. Patient come with cough. Take a history. Diagnosis? Pneumonia/TB (depends on station. Ada juga yang jawab acute pericarditis.:))
2. Patient come with vomiting + blood. Diagnosis? PUD. Others differential? Esophageal Varices etc.
3. Physical examination : 3 pilihan.
a) Examine abdomen.
b) Examine precordium.
c) Examine patient with acromegaly.
Sekian, wish us luck!!
Maaf terlambat pula merespons untuk soalan Surgery. (Khas untuk Puan Zayyani yang bakal menduduki peperiksaan OSCE yang terakhir inshallah. Kami yang lain ini masih berbaki satu lagi rotation..:))
Setakat yangboleh direcall dan direfresh, soalannya adalah seperti berikut.
Station 1
Patient complaining of scrotal swelling.
a) Take a focus history. (history suggestive epididymo-orchiditis)
b) What are the differential diagnosis?
c) What are the investigations you want to do
d) Name 2 predisposing/risk factors for this condition (UTI, STD)
Station 2
Lower limb examination in patient with intermittent claudication
Station 3
Post-Op Management.
a) Take a brief history
b) Physical exam
c) Management, counselling, nutrition.
d) From history and PE, patient has paralytic ileus. Give 2 investigations
Bittaufiq Wannajah.
Selamat bercuti dan berelektif untuk Zay. Doakan kami yang masih 'berusaha' ni..:)
Salam semua. lagi soalan dr group C..2010 --all 3 groups b4 us have 6 stations
MiniOsce ..
1. partogram - primary dysfunctional labour
2. Endometrial cancer
Station OSCE..
3. Ectopic pregnancy
4. IUGR
5. Ovarian Ca
6. Caunseling before c/s
Seperti yang telah saya teliti dan kata-kata jui yang meramalkan selalunya(kalau ikut rotation 5th year)..
OnG ni tak ulang topik yang sama..
Saya melihat senarai soalan setiap group dan ternyata untuk topik2 selain cancer tidak pernah berulang topiknya..
Maka, wallahu a'lam kita cuba la tumpukan mana yang tak kluar lagi..
seperti abortion, incontinence, menorrhagia, amenorrhea, n macam2 lagi yang belum kuar
Endometrial cancer dah kuar dua kali di OSCE mahupun mini OSCE. setiap kali exam ada 2 soklan cancer..satu kluar betulis n sati keluar oral..so wallahu a'lam..sama-sama la pentingkan yang mana yang dirasakan penting..dan doa banyak2..
selamat study semua..salam
salam, this is q for 1st group
Salam to all,
Hope that everybody is in good condition as the exam is just around the corner hehe. Included here are questions from round that i got from Dr Khaled in Badiah(those are past year questions and ans for 6th year. He was the examiner for the past few years. Also i put questions from cd(bil rafedeen) in case anyone dont have it yet. bittawfeq salam
- canseling combine OCP
- Cervical CA
- Incontinece
- DnC
- breech
- Post-abortive management(sgt2 imp)
- Infertility counseling
- Partogram
Indication , types , how to perform it.
2. Ectopic pregnancy hx ( bleeding in 1st trimester )
3. IUCD pic : what is this? Indication? Complications.
4. Fibroids pic : what is this? Symptoms, complications during pregnancy.
5. Placental abruption pic : what is this? Complications for fetus & mother, co conditions, treatment.
6. Anencephaly pic : what is this? How to diagnose? Complications.
7. CTG… read it …. What is your plan?
8. HSG pic showing blocked tubes…. What do u see? Give another test to assess patency of tubes? What is your plan….
- pelvimetry/ultrasound
InsyaAllah lagi 2 minggu, pelajar tahun 6 akan sekali lagi diuji fizikal & mentalnya dlm OSCE. Ini soalan2 OSCE O&G kumpulan D. Moga bermanfaat buat semua sahabat.
1) Q :counseling for the baby of gestational diabetic mother
Ans : fetal assessment of GDM baby as written in the Ru2ia lecture notes
2) Q : patient with history of gush of fluid (PROM)
a -what is your DDx?
b -what investigation should we use to diagnose PROM ?
c - if the patient does not have labour pain after 12 hours (not sure) what is your management plan?
3) Q : findings of patient with endometriosis
a - what is your dx?
b - what is the common site of endometriosis lesion
c - what is the diagnostic procedure?
d - what is the treatment ?
4) Q : patient with postmenopausal bleeding
a - what is your DDx?
b - what investigation will you order for the patient?
c - what is the medication?
d - what are the 2 side effects of progesterone?
InsyaAllah bittaufeq
Jelaskan matlamat...Tuluskan niat~
assalamualaikum adik2 n kawan2 d tahun 5,
salam kawan-kawan..
Mini Osce
1. Ventricular Tac, how to manage? If pulseless, dc shock, if not pulseless, amiodarone and lignocaine(ni my ans, according to notes written on slides doc faisal gtesh)2. Pneumopericardium, manage by? pericardiocenthesis
3. Oral trush, coz by? Candida albicans
4. Vascular ring, what anomaly related to it?
5. Erythema nodosum, what MO coz it? Streptococcus and TB
6. Gravis Mother, give birth to a child, what do u expect his TSH n T4 level.TSH very low, T4 vey high
7. ABG result, interprete it = Mixed Metabolic and respiratory acidosis
8. CBC result = Goes most likely with IDA, what’s ur next intervention? wAllahi dis q very puzzling, hatta doc khasawneh n doc hala pon tak pasti cuz actually ada kepelikan pada result tu snirik, papepun I put check serum ferritin level.
9. Result CSF = gram + cocci, pastu RBC 20(trauma gamaknya), len2 tak brapa ingat. apa next step? Give vanco(ni doc khasawneh punya jawapan). What most probably MO ? S.pneumonia
10. Lateral xray retropharyngeal abcess, hehe ni lagila sampai juling2 tgk pun gambar tu tak bayyin manala plak sign yang doc want, so what the best next investigation? Kalau retropharyngeal abcess, so most probably if would be laryngoscopy.
11. Dah takde soklan dah, tunggu next gp plak ^_^
OSCe(dah tertulis b4 ternampak ishikawa bagi..takpe bagi la jugak top up mana2)
Station 1
Patient 4yo male periorbital swelling since 3 days(lebih kurang ginila soklan dia), take related hx and answer soklan doc… hx of URTI last 2/1 week
Dx – PSGN
What do u want to find in PE? Dun forget scrotal swelling, BP
Investigation? U/A, streptozym, ASOT etc
What u want to find in U/A? Rbc cast jgn lupa etc
What’s ur management ? Fluid n water restriction, lasix, antihypertensive drug
What hypertensive drug u wanna give?
What mechanism increase BP in this pt?
Station 2
Male pt 9 yo came with bruising and rash since 3days kot tak ingat. Take hx n do PE
Most probably ITP, boleh la check apa yang patut
Station 3
4days old newborn, brought by mom bcz of yellowish discoloration since 2 days.
Hx goes wit Breastfeeding jaundice
What d modalities of treatment?
Whats d mechanism in exchange transfusion and phototherapy?
Len2 tak ingt plak..apepun InsyaAllah khair.soklan pedi takde susah sgt..pentingkan yang mana slalu jumpa dalam round..semoga berjaya semua salam
Bismillah
Alhamdulillah, selesai sudah part pertama peperiksaan mid term paediatric group B tahun 6 2009/2010
Method- OSCE (Objective Structured Clinical Exam),
Ada 6 stesyen kesemuanya
Tapi 3 stesyen adalah perhentian R&R
Jadi, hanya 3 stesyen sahaja kitorang bersemuka dengan soalan-soalan dan doktor-doktor
Saya bermula dengan stesyen R&R
"You, go inside the rest room"
Alhamdulillah! Memang itulah yang saya harapkan... taknak jadik orang 1st kena soal.
START! terdengar doktor-doktor resident menjerit, memulakan sesi exam OCSE kami.
8 minit berlalu....
MOVE!
Bismillah...
Mari kita lihat apa soalan di stesyen pertama..
1. Neonatal Jaundice (demam kuning) with bilirubin 22 mg/dL. Take a full history and answer related questions
History amik sebijik macam nota doktor and in this patient, dia adalah anak ketiga dan ada siblings yang pernah kena neonatal jaundice sebelum ni dan buat exchange transfusion. So this is a very important point, sebab having a previous baby with history of exchange transfusion for neonatal jaundice increase the likelihood of another newborn in the family to have an exchange transfusion if the baby develop jaundice in the first few days of life.
soalan 2- mode of treatment: exchange transfusion , another option is phototherapy (not dangerous)
soalan 3- apa mechanism of phototherapy dalam me'reduce'kan demam kuning di baby ni?
isomerization- tukarkan indirect bilirubin yang water insoluble kepada water soluble, so it can be excreted in the urine.
soalan 4- Kalau buat exchange tranfusion, apa yang dia bantu dalam me'reduce' jaundice?
Dia clear up antibody (kalau suspect hemolysis due to ABO / Rh incompatibility)
Dia clear up bilirubin
Habis...
Stesyen lain (selepas satu stesyen R&R)
Budak datang dengan facial swelling 2 days prior to admission. Take relevant history.
- Melalui history, this patient has post-streptococcal glomerulonephritis.
Jadi, pastikan anda faham post streptococcal glomerulonephritis sepenuhnya. Dari sudut history taking, physical examination, investigations, dan management. sebab memang semua itu pun yang doktor tanya.. 8 minit je ye....
Final station
A (lupe berapa umur dia) girl, presented with bruising all over the body, and skin rash 3 days prior to admission. Take relevant history, do physical examination and answer any question (memang pun doktor tanya apa2 je, tak sama dengan kawan2 lain, tapi berkaitan dengan kes ni)
Amik history yang berkaitan berdasarkan differential diagnosis yang di'generate'kan melihat kepada presenting problem si patient, and do physical examination accordingly.
Most likely this patient ada acute postviral idiopathic thrombocytopenic purpura (diagnosis of exclusion- jgn lupa tnya symptoms of leukemia, HSP, any bleeding disorder dan lain-lain disease yang boleh datang dengan bruising dan skin rash)
Rabu ni exam mini OSCE pula...
pukul 2 di Blue Hall KAUH
Doakan...
(Errr.. ade dengar citer orang tak suka blog ni ye.. tak kisah la... janji kitorang tak buat salah)- habislah kontroversi ayat ni
To be continued...
Wallahua'lam
Assalamualaikum wbth...
alhamdulillah dah selesai rotation pediatrics(peds)..sekarang saya meneruskan rotation dalam Obstetrics & Gynecology(O&G) Dept.Keluar dari peds masuk dalam O&G tak jauh bezanya sebab masih bersua muka dengan ibu-ibu tabah & bayi-bayi comel.
Di bawah ini adalah soalan OSCE peds baru-baru ni..moga bermanfaat untuk sahabat2 lain :
OSCE
1-Take history of a 10 year old girl with chief complain of intermittent headache for 4 months. What is your differential diagnosis & approach?
2-Take history of a 5 year old boy, complaining of abdominal pain since 3 months ago. What is your diagnosis and approach? he had constipation
3-PE station : 6 year old boy with chief complain of dyspnea,fever& ...... Perform chest examination & any related system.
4-PE station : A 3 year old boy present to ER, complaining of fever, headache & vomiting.
What investigation you would like to order?
(Dr read a CSF analysis) What type of meningitis-viral or bacterial?
The same patient present three days later with high fever, what is the probable cause?
5-Data & pictures :
i-picture of macular rashes on a boy's trunk. What is your diagnosis? What is your management plan?
ii-picture of an obese boy. What is your diagnosis?
iii-picture of baby with omphalocele. This baby is born with hypoglycemia, what is your diagnosis?
iv-x-ray of diagphragmatic hernia. What is your diagnosis? What do you expect to find during examination?
v-x-ray of wrist with fraying & cupping of metaphysis. What is your diagnosis? what is your management plan?
vi-ECG . How much is the heart rate? What medication would you give?
actually there are two more data interpretation station but I forgot. InsyaAllah i'll post them here soon. Enjoy peads.
Jelaskan matlamat...Tuluskan niat~
Assalamualaikum, semoga memberi manfaat kepada semua.
Berikut adalah ijraat bg Bachelor Degree in MEDICINE AND SURGERY (Darjah Bakalurius fi Tibb wal Jirahah) equivalent to MBBS:
0- Berdaftar diri utk menjadi alumni JUST- boleh bt di tngkat 2 di syuun tolabah.
1- Tarikh utk membuat ijraat akan diumumkan dlm internet(sblm graduation day).
2- Di maliyah (dkt mawazi):
- langsaikan segala hutang anda
- bayar JD 75(syahadah yang ada markah(musoddaqah)+syahadah jidariyah+kasyfu alamat dlm bhs arab )
- bayar JD 20 utk translate semua y di atas dlm english
3- Di qobul tasjil:
- Bawa surat y dapat di mawazi ke musajjil utk mendapatkan syahadah bhs arab, bhs inggeris akan dapat keesokan hr di Dewan.
- kt sini, anda akan dapat surat ta'min:
- utk student private: hantar surat ta'min ke pejabat maliyah di tngkat 3 dkt bangunan Vice President
- utk y lain2: hantar ke pensponsor masing2
4- Esoknya, dapatkan sijil anda y ditranslate dlm english di Dewan.
5- Selepas mendapatkan sijil anda y dlm bhs inggeris, dptkan cop wizarah ta'limi 'ulya di C5.tampalkan stamp hasil y dibeli di situ utk setiap 3 keping sijil English anda.jika rajin, boleh cop sekali di sijil bhs arab. setiap sijil stamp hasil bernilai JD1.
6- Kemudian ke Amman utk mdapatkan cop dari wizarah kharijiah dan MSD.
P/s:
- buku basyair akan dapat slps serahkan robe anda.
- jgn lupa tutup akaun anda kl guna bank di jordan.
Semoga Allah mempermudahkan segala urusan dunia dan akhirat kt. ameen...
Menuju redha-Nya
21 JUN 2009
Assalamualaikum..
Berikut adalah soalan oral saya, semoga bermanfaat.
Oral
1- surgery
1) acute peritonitis pathophysiology and types of primary acute peritonitis
2) complications of PUD n discussion of gastric outlet obstruction syndrome
3) a case of breast CA
4) small intestinal obstruction
5) hernia
2- o&g
1) discussion of IDA
2) Infertility
3) pap smear
3- medicine
1) DKA pathophysiology n mx
2) ECG – acute anterolateral MI, after 20 minutes new findings. Another ECG was given. Answer: Ventricular tachycardia
3) 18 yr old pt comes to ER complaining of fever n headache..approach
4) 20 yr-old pt comes with Hg=8mg/dl.ur ddx n ix
5) 70 yr-ol pt comes with back pain high calcium.
- how u want to cnfrm hypercalcemia
- ur ddx
- ur ix
Group e 2008/2009
osce dan oral
obstetrics n gynecology
1-hx ectopic pregnancy---ddx,dx,type of ectopic=tubal unruptured,mx
2-cevical smear procedure,finding,mx
slides:
1-hsg-tubal block
2-anencephale=cause,finding,mx
3-CTG finding=decelaration,tachycardia
4-placenta abruptio=etiology,risk,mx,definite mx
5-contraceptive-iucd cu,bila boleh psg,contraindication,complication
6-fibroid=etiology,risk,mx,definite mx
internal medicine
2 station hx + 1 station pe
1-hx-cough for 3 years..dx=COPD
2-hx-bilateral lower limb swelling=diabetic nephropathy
3-p/e-pansystolic murmur,
4-hand n face-scleroderma,
5-mechanical ejection click-prosthetic valve
slide;
1-xray-pericardial effusion
2-blood film-finding-microcyctic hypochromic,hypersegmental neutrophil .dx-ida
3-PFT-COPD
4-oral thrush causes-immunocompromised,steroid,HIV
5-hereditary telengectasis,common manifestation:epistaxis
6-ecg-acute ant.MI
7-ecg-ventricular tach..mx-dc shock
8-ABG-metaboloc acidosis
9-xray-pneumothorax
10-graves disease--pretibial myoxedema
surgery
2 hx + 2 pe
1-hx:1 day post op
2-hx: acute scrotum
3-PE: peripheral vascular disease
4-PE: breast examination.
6 slide with a lot of question:
1-osteomyelitis
2-angiogram-aortic aneurysm
3-gambar-hepatocellular ca
4-branchial cyst
5-intusseception-gambar barium enema
6-?
pediatrics
1-hx-puffiness dx-post strep GN
2-hx-knee joint pain ddx-JRA,rheumatic fever,hsp
3-oral station-congenital heart disease hx,p/e,dx-TGA,mx
4-P/E-focused examination of anemia patient
5-ABG-metabolic ascidosis
6-counseling.parent of asthmatic child.help him.education
7-pictures:1-erythema nodosum-causes.2-tonsil-diaphteria.3-gambar IUGR
8-x-ray-1-pneumothorax. 2-boot shape heart. 3-nephrocalcinosis
Oral:
Surgery:
1-approach to acute abdomen in 20 yr old female patient;hx,pe,invx(what is u/s),mx
2-approach to chest trauma: causes,mx pnthorax,flial chest pathogenesis n mx
3-pathogenesis of chronic venous insufficiency
4-diverticulum-definition, manifestation, complications
Obstetrics and gynecology:
1-fractional d n c
2-endometrial sampling.types and mx
3-case of amenorrhea vaginal spoting,abdominal pain-ddx,pe,inx.dx-ovarian cyst.mx
4-stages of labour.statistics questions-mode,mean,median,what’s meaning of percentile,what is normal distribution curve
5-instrumental delivery.management of 1st stage labour
Pediatrics(a lot subquestions):
1-FBA
2-nephrotic
3-Chronic Granlomatous Disease
4-sepsis
Internal medicine(a lot subquestions)
1-ecg: 2
2-hepathic encephalopathy-manifestation of chronic liver disease,clinical symptoms,specific test,
3-case of iron deficiency anemia
3-case increase thirsty.dx- DM type 2.hx,pe.lab result.mx
4-20yr-old loss of concsiousness.Er management,.dx-organophosphate poisoning.mx.
Ingat kami (batch 2002) dalam doa kalian
menuju redha-Nya
18 Jun 2009
Salam.
Jenguk-jenguk dalam draft ada 2 entry yang 'on the way' untuk sampai ke pembaca (eh? ngaku pula ada 'pembaca') - Satu BBB, satu lagi Exam Fever. Oleh sebab saya tak tahu BBB tu stands for what, saya amik lah tajuk entry ni. Xpe ek cik tut.
As the title implies, saya sendiri rasa sangat cuak. Kalau fever tu lebih kepada rasa panas-panas badan, chills pula dah buat rasa macam nak kejang. Seram sejuk. Aduh, janganlah terkena panic attack pula. Dengan 11 subjek yang bakal dipertaruhkan sepanjang 3 minggu mendatang ini, semoga usaha kami terus gigih ibarat ibadah hamba kepada Tuhan, mempersembahkan yang terbaik atas dasar konsep ihsan.
3 hari yang lepas, saya telefon kakak di Malaysia. Cerita-cerita tentang mid-exam yang baru berlalu, ada baur-baur kekecewaan dalam nada. Akak saya bukak cerita tentang bakal junior yang akan datang ke Jordan. Siapa lagi kalau bukan Nik Nur Madhihah. Ahlan wasahlan.
"Tahu tak, akak baca buku Nik Nur Madhihah tu. Sedih sangat. Kuat betul dia. Nak kata susahnya hidup dia, tak cukup duit nak beli buku apatah lagi baju baru yang dah lama tak berganti tu, dia sanggup salin kamus bahasa Arab! Selalu pergi library untuk buat revision, bukan senang-senang macam kita. Nak beli buku, scholar ada, tak pun minta bantuan mak abah. Dah lah ambil 20 subject, cuba bayangkan macamana dia belajar sampai cemerlang macam tu."
"Yeke.. kagumnya"
"Tahu tak lagi, akak tak pernah jumpa orang susah sangat macam tu. Ada tu, diorang tak cukup duit. Sampai kongsi manggi sebungkus untuk dimakan 4 orang! Ya Allah tak tahu nak cakap apa. Sayu sangat. Kita ni, alhamdulillah Allah bagi banyak nikmat, kurang bersyukur. kadang makan tu pun rasa tak cukup-cukup itu ini."
Terpukul saya dengar 'tazkirah online' petang tu. MasyaAllah..
"Tapi Madhihah tu bagus, family dia pun. Tak pernah merungut. mak dia cerita, tiap-tiap pagi kalau bangun mesti dah nampak dia buat solat tahajjud. Puasa Isnin Khamis, sebab tak cukup duit nak belanja kat sekolah. Cuba bayangkan orang yang susah macam tu, kalau diorang tak pandai nak salurkan 'rasa' mahu jadi orang tiga suku. Kalau tak pandai, mesti selalu merungut atau rasa keluh kesah - rasa Tuhan tu tak adil, kenapa diorang susah sangat. Cuba bayangkan kesan psikologi yang dia rasa kalau dia tak kuat, iman tak mantap."
Akak saya sambung lagi,
"Kita kadang rasa kita berusaha kuat, gigih. Tapi keputusan tak bagus mana. Kita rasa kecewa sangat, terkadang sampai mempersoalkan kenapa aku tak dapat keputusan yang bagus padahal aku dah berusaha itu ini. Rasa pulak tu macam Tuhan tak adil pada kita. Tapi kita lupa, ada orang berusaha lebih kuat lagi dari kita. Macam dalam hadith Muadz tu, yang amalan kita nak sampai kepada Allah kena melalui 7 lapisan langit kan. kadang kita rasa amalan kita dah cukup bersinar, solat tepat waktu, isnin khamis puasa. Sekali ada lagi hamba Allah yang lain, amalan dia lagi hebat, bukan setakat solat, hati dia jaga, selalu bersyukur, akhlak, sedekah lah macam-macam. Amalan dia bila malaikat bawa ke atas, lagi bersinar terang."
"Betul, betul."
"Dah tu, usaha lagi. Jangan rasa mengalah. Kita ni selalu sangat pandang sesuatu tu baik ikut mata kita, tapi pandangan dan hikmah Allah tu kita selalu lupa."
Panjang yang kami borakkan petang tu, hampir satu jam. Tu pun rasa cam x cukup. Walaupun hajat hati nak lagi, tapi saya cukup puas petang tu. Syukur alhamdulillah. Kadang-kadang memberi tak sama dengan menerima.
Ada sorang junior recommend cerita 'Kun fayakun versi Indon'. Terzipzas katanya. Sama macam kes diorang dengan perihal exam CVS yang lalu tu. Cari yang Indon punya yek, bukan wan maimunah punya hee. Dekat YouTube.
Lepas exam kita layan wokey.
Buat semua selamat berimtihan. Semoga dikuatkan hati kita untuk buat yang terbaik dan terus berusaha. Semoga rasa lesu dan mumil kita tak lama. Terus dan terus lagi. Macam trafik light kat jalan raya, yang banyaknya hijau. lampu merah paling lama saya pernah jumpa seminit - seminit setengah. Sesekali kuning untuk kita slow down. Mujur trafik light tak selamanya hijau, mahu berlanggar kereta-kereta. Dan mujur juga tak selamanya merah atau kuning - alamatnya tak sampai ke tempat tujuan kita.
Yallah, semua. Allah ma3ana!
Recommended related reading : saifulislam > Zikir yang berhajatkan fikir
JADUAL PEPERIKSAAN AKHIR TAHUN 5
Ahad (17/5) - family medicine : 10-12 pagi
Selasa (19/5) - neurology : 10.45 - 12.45 ptg
Khamis (21/5) - ophthalmology : 10.45 - 12.45 ptg
Ahad (24/5) - Obstetrics & Gynecology : 2.30 - 4.30 ptg
Selasa (26/5) - Dermatology : 1 - 3 ptg
Khamis (28/5) - Orthopedics : 10 - 12 ptg
Ahad (31/5) - Psychiatry : 12.30 - 1.30 ptg
Isnin (1/6) - Radiology : 10.45 - 12.45 ptg
Selasa (2/6) - Forensic : 12.15 - 2.15 ptg
Rabu (3/6) - Anesthesia : 2.15 - 3.15 ptg
Khamis (4/6) - ENT : 10 - 12 tghri
Bismillah
Alhamdulillah, selesai sudah rotation ONG selama 8 minggu. Selasa dan Rabu lepas, waktu untuk menguji kefahaman saya tentang ilmu perbidanan dan sakit puan ini melalui mid-term exam yang dibahagikan kepada mini-OSCE station dan OSCE station pada hari berikutnya. Sekadar untuk makluman, soalan-soalan exam buat rakan-rakan yang lain yang belum (cik ashiato dan cik jui) ataupun telah mengikuti rotation ini (korang-korang yang lainlah)
Mini OSCE Station
6 Slides
(Sorry, couldn't remember how the exact question is, I just stated the main idea what the examiners wanted from the questions given)
Slide 1 : A picture of intrauterine twins (With 2 chorionicities and 2 amnionicities, normal lie and presentation)
Name the type of the twins
Dichorionic Diamniotic
2. What is the presentation?
Cephalic/cephalic
3. With that type of presentation, what do you expect the mode of delivery will be?
Normal Vaginal Delivery
4. If the woman with this type of pregnancy presents to your clinic with abdominal pain at 34
weeks of GA, name 3 differential diagnosis?
(Here, you should state any related complication and risk of multiple pregnancy (hyperplacentosis, large uterus, etc) that will manifest as abdominal pain)
Eg: Preterm Labour Pain
Placental Abruption
Pre-Eclampsia
5. Complications during labour and delivery (cudn't remember the exact question)
Preterm Labour
Post Partum Hemorrhage
(Others, you can find them yourself)
Slide 2 : Rh isoimmunization
The question is quite long.
Main idea: Woman with G1P0, blood type O negative and her husband- B positive, came to your clinic with vaginal bleeding.
1. How do you manage this case regarding Rh Isoimmunization
ADMISSION !
Indirect Coomb's Test ( to check whether the mother has already sensitized or not, here we
don't need to do Blood grouping- because we already knew her blood group from the
question)
Amniocentesis and Kleihuer-Berke Test (Quantitative measurement of how much the fetal
blood has leaked into the mother circulation)
Give Anti-D within 72 hours (All the doses from British/American School recommendation,
you can read them yourself)
2. At 34 weeks of GA (maybe....) , you found out her indirect Coombs test was positive. What is
your next step?
Of course she needs admission
(Now, put in your mind, the mother has already sensitized.
Here, again we have to do amniocentesis to determine the severity . Management is based
on the Liley's Chart and Whitefield's Chart ( severity is determined by the level of
unconjugated bilirubin found in the blood à indicates hemolysis)
Based on the Liley's and Whitefield's Chart (a modified Liley's Chart), management is directly
proportional to the gestational age and the severity of hemolysis (before or after 34 weeks of
GA, Zone I, II, or III) whether to repeat the amniocentesis, to give intra-uterine transfusion
or to terminate the pregnancy (deliver immediately). )
3. (Here the doctor showed another slide with a stillbirth fetus)
What do you call this?
Immune hydrops/ Hydrops fetalis (a complication of failure to treat an Rh
isomummuized case)
Slide 3 :
A picture of laparoscope showing a mass in the fallopian tube, and collection of blood in the Pouch of Douglas.
Q- Main Idea: Woman with ….. ( cudn't remember the gravidity and parity), presents to the ER with abdominal pain and history of 4 weeks of amenorrhea.
1. What do you suspect ?
Ectopic Pregnancy
2. What are other symptoms she may have ?
(You should state other symptoms of ectopic pregnancy and early pregnancy)
Eg: vaginal bleeding, shoulder tip pain and symptoms of pregnancy (nausea,
vomiting, etc)
3. Before doing laporoscopy, what are investigations you need to do ?
(Here, remember to do pregnancy test - level of beta HCG, and serial level of beta HCG
reading after 48 hours- usually in normal pregnancy, beta HCG level will be doubling after
each 48 hours in early pregnancy, but never in ectopic pregnancy.
Don't forget to do U/S ( empty uterus-no gestational sac and if you are fortunate you can
see an extrauterine sac)
4. What are procedures that may be done in laporoscopy ?
Salpingotomy
Salpingectomy
Or, if we are sure the mother is hemodynamically stable,the fetus size is less than 3 cm (or
2 cm) in the fallopian tube, and no fetal heart is detected, we can inject methotrexate to kill
the ectopion (owh, am I using the word 'kill' here…?)
Slide 4 :
A Picture of contraceptive pills.
A Woman with P4 has this type of contraception after she deliver 3 month ago and is now lactating her newborn baby. She complain of irregular bouts of vaginal bleeding.
1. What type of contraception shown in the picture?
Progestogen-only pills (the picture was not so clear, but you can guess it,
because this type of contraception is safe in lactating mother)
2. Give 2 mechanisms of action this contraception can help in preventing
pregnancy
Thickening of the cervical mucus
Thinning and atrophying the endometrium
3. Name other method of this type of contraception that are available
Injectable
Subdermal implant
Hormone-releasing intrauterine system
4. Name other complications associate with this contraception use
Weight gain
Acne
Breast tenderness
Functional ovarian cyst
(Others, refer to your book)
Slide 5 :
A 45YO woman, P5 came to your clinic complaining of prolong and heavy bleeding
1. What clinical term for this condition?
Menorrhagia
2. What investigation you need to do on her?
CBC
Pap Smear
U/S
Hysteroscopy with endometrial biopsy
3. If all investigations turn normal, what do you suspect she may have?
Dysfunctional Uterine Bleeding
4. What kind of treatment you can offer before you decide to do surgery?
Medical treatment with hormonal and non hormonal drugs
a. Non-hormonal – anti fibrinolytic and anti-prostaglandin (NSAIDs)
b. Hormonal - Combined oral Contraceptive Pills
c. Levonogestrel releasing intrauterine device (Mirena)
5. If all the treatment above fail to improve her condition, what is the definite treatment?
Hysterectomy
Slide 6 :
(Now, it's your turn to find out the answer)
A pregnant woman at her 24 weeks of GA (ye kut..), with this result of CBC
HB : 8 g/dL
Sorry, cudn't remember other blood indices results. But, it was so obvious she is having Iron Deficiency Anemia
1. What is your diagnosis?
Iron Deficiency Anemia
2. What are other investigation to confirm your diagnosis?
3. What would you like to take in the history regarding her problem?
4. What are your initial treatment on her ?
OSCE Exam on the next day….
Station 1 :
A Genital Prolapse case in 53YO woman.
Remember to analyze the lump/ prolapse first, then ask about associated symptoms, and risk factors. Dr Faiz Jallad's wordà Genital prolapse is caused by childbirths, aggravated by increase intrabdominal pressure and, accelerated by menopause.
Station 2 :
Physical Exam without patient. You should tell every step you want to do to the examiner.
Case 1 : A 28YO woman, P2, delivered her baby by spontaneous vaginal delivery 14 days ago. She came to your clinic suspected of having puerperal sepsis.
What you may find from abdominal and pelvic examination?
Case 2 : A 24YO woman G2P1, 34 weeks of GA, diagnosed as a case of major placenta previa. What are your clinical findings from the physical examination?
Station 3 :
All about antenatal care
A 30YO woman G3P2, came to your clinic on her regular antenatal care. She is now at her 20 weeks of gestational age.
How do you confirm the gestational age?
How do you assess the gestational age on the basis of regular antenatal care?
Where do you expect her fundal height will be at this week of gestation?
What is the most accurate parameter to confirm the gestational age according to this case.
" ONG…
The highest medical specialty, because it deals with woman, the highest rank in society " – Dr Basel Obeidat, Head of Department, ONG, KAUH
P/s- Dr. Muui.. if you have time to read this, please check the answers (I got some questions wrong already.. (only some..? or many…?).. huhu )…
All the best, friends! Need your cooperation too in sharing the examination questions here.. Thank you
Wallahua'lam
