University of sulaimany



University of sulaymany

OSCE exam

For sixth stage , college of medicine

Including theory exam and some important subjects that you have to know before the exam

Prepared by:

Dr.soran Mohamad Gharib

OSCE exam in surgery

FINAL 2006-2007

Room1:

Slides:

- encephalocele

- hydrocephalus( sunsetting eye)

- carcinoma of RENAL tubule

- meningocele

- meningomyelocele

- racon eye

Room2:

Slides:

-bells palsy

-flial chest

-Inguinasl hernia

-external fixator

Room3:

readiology :

- tension pneumothprax

- fracture of radius

- achlasia

- stag horn

Room4:

Recognition and Uses:

chest tube underwater seal , suture material,nilon, folly catheter

Room5:

short case :

apatient with colostomy ,abd examination( inspection)

Room6:

short case:

there is apatient who is postoperative patient who had pulmonary hydatid cyst, the senior ask u about treatment of this case postoperatively

Room7:

History taking : on a patient

Room8:

there is apatient who has been injured by knife in his abdomen and the senior ask u ( which structure is more liable and which structure is more dangerous to be injured in this case?)

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in surgery

Assessment 2007-2008

Room1:

-arterial forceps( recognize it and one indication)

-T tube (recognize it and one indication)

-normal saline (recognize it , does it contain energy ?does it cause extravasation ?)

- folleys cathetre (indication intraoperatively and complication )

Room2:

Inspection of apatient who had jaundise , some question on jaundice loke types of jaundice ?difference between types of jaundice ?complication of operation in this patnt?

Preoperative preaparation of jaundiced patient ?

Room3:

Just inspection of abdomen of afemale patient who has dressing on abdomen vertically . and she had RIF scar

Room4:

inspection of ajaudised face of apatient and inspection of his abdomen ( in abdomen he had umblical stitch till RL region _ kucher _)and what do u do for him preoperatively?

Room5:ortho

Zhnek dasty rasty post slaby habu wty inspect bka tab3an dressing y post slab habu wty lakwewa bo kweya ?harwaha qachy chapy lai hip joint dresing y habu wty an dwana bochy bayakawa ( walam : falling to ground)

wa hardu qachy hata knee expose krabu wa xrya radius u ulna danrabu lasary

Room6:

Inspection of genitalia of aman who had inguinal swelling ( scrotal swelling)

Treatment and DDx of inguinal hernia

Room7:

Examine thyroid for anirmal woman

Room8:slides:

- protrude of anus: DDx ? and how do u diffrentiate them clinically ?

- rasmy zhnek bu 3amaliaty thyroidy bo krawa w sphygmomanometer ek badasty rastyawa bu ka la elbow daflexion y krdbu

wty ama chya ?( carpopedal spasm

- komalek bardy rashy gawra danrabu wty ama la gall bladder da haya chand present haya ?

Room9:

N . surgery :

Mnalek 13 sala dressing lai rasty haya wty ama chya :shunt . bochy ?hydrocephalus,wty ama ventr—peritonem , wty chand jory try haya wtm pleura .

Harwaha jga la head bo vertebrash abet

Room10

xray:

- radioisotp indication

- multiple opacity _hydsatid cyst, 2ndary

- pnemothorax

- air fluid level _intest obs

- exostoses

Room11:

Cardiothorax’

Chest tube ( recognize it and indications)

Underwater seal ( recognize it and why we use it in chest tube )

Sag sig

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in surgery

Room1:

Dr abas &dr ali

1-Jaundice patient and investigation for jaundice

2- difference between obst &non obst T tube

Room2:

dr aso & dr ali kamal

-Git operation

-esophagectomy

-tube abdomen ( question about it)

Room3:

Slides: neurisyrgery:

- encephalocele

- hydrocephalus( sunsetting eye)

- meningocele

- meningomyelocele

- racon eye

- battle sign

Room4:

Dr sirwan

Slides:

- imp anus

- herpes zoster ( ddx :apendicitis surgery)

- hemorrohoid

- pead orange of breast cancer

Room5:

readiology :

- tension pneumothprax

- fracture of scaphoid

- esophageal atresia ( child )

- achlasia

- stag horn

- exostosis

- diaphragmatioc hernia

Room6:

Mnalek lazga drawa la dasty , du se jar xweny tekrawa: splenectomy , hypersplenectomy

Complication:nj -gastric dilatation

Room7:

Orthopedics:snake bite,

Pulse site,fasciotomy(indication)

Room8:

Recognition and Uses:

chest tube underwater seal , suture material,nilon, artery , ETT

Room9 :dr ary zangana : burn ,treat ment and stages( tetracyclen)

Room10:abd examination , surgical sites

Room11:

-D.V.T patient exam and some questions after operation

- goitre

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in surgery

Assessment 2007-2008

Room1: renal dr aso + dr sarwar

2 x ray of the same patient . plain KUB (show small ureteric stone) by IVU show left side hydronephrosis. How do u treat hydronephrosis?

Room2: vascular dr nzar + dr rzgar

Chest tube:1-Dx it?answer : chest tube underwater seal contain blood

2-Indications?

3-how do u put chest tube?by steps

4-if u put chest tube but tube underwater seal is not present what do u do?answer: Atwanyn lastiki pewa bkain

Room3:dr amir radiology

- bilateral stag horn stone

- ERCP , indications?

- pnemothorax

- air fluid level _intest obstruction

Room4:dr hiwa + dr jalal

Do general examination ?

Do thyroid examination?

Where is the duct of mandibular gland?drain to where?

Room5:

Dr abdulwahid

On the lastik cadaver(doll):

Suspect this is the trauma patient ,unconscious 1-how do u manage him?

Answer:

By primary survey ABC

2- how do u treat airway obstruction:?answer: by clearing mouth secretion (sucker), withdraw tongue .

Oropharyngeal airway: put endotracheal tube ( the senior ask u to put endotracheal tube on that doll ( jusa lastikaka )

Room6: dr xalid+ dr luaee neurosurgery

1- depreassed skull fracture: Rx it? Answer: craniotomy

2- if you have atumur of left pareital lobe what neurological defecit do u get by it?answer: aphasia, convulsion

3- if u have acase of breast carcinoma with supraclavicular LN and axilary LN , determine TNM ?and if on medial side of breast which LN will be affected?

Room7: dr muhamad kamil instruments

1- T tube indications?

2- Tracheostomy , indications?

3- Nylon , describe it ?suture material , nylon, synthetic, nonabsorbabale

4- Manitol , uses?

Room8: orthopedic dr baxtyar + dr hamid

1- apatient whose hand is normal , the senior will ask you :by inspection how do you know that median nerve is intact ?

answer: pointing sign , wasting

2-you have apatient with fracturein leg and they put skeletal traction , the senior will ask you :describe this ?

Answer: you have to say that this is skeletal traction and describe its parts: skinmanpin , itscomplication ?and the senior will ask you : how do u know that this patinet didn’t get (UMNL )?

Room9:dr abas + dr ibtisam

A 19 year old lady who is aknowun case of DM presented with multiple lesion in both leg : the senior will ask u describe these lesions:

Answer: multiple red papule in both leg : whats the casue of it?

_ there is one large purple patch on big toe :

- how do u examine all pulses in lower limb and its surfae landmark?

Room10 dr abdusalam cardiothorax

Aman presented with swelling of both leg for longtime duration whats this?

Answer: chronicDVT

- how do u mnage chronic DVT?

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in surgery

Surgery clinical examination for repeaters student in 2008

1- dr abas+ dr nzar dawd:

patient with intermittent claudication what do you do , how do u examine him?

2- Dr abdulsalam + dr aram

patient had operation yesterday the stich was at his forearm whats the operation ,he has atrial fibrillation

answer: thrombectomy a axillary artery using f.catheter

3- dr sarwar :

swelling in the left side of scrotum ? examin him and differential diagnosis?

4- dr luaee+ dr ibtisam:

patient with jaundice , examine. Type obstructive , what do u do in investigationand management ? why do u give vit K ? why do u give iv fluid ?

5- dr ali abdulnaby + dr baxtyar:

patient with back slab ,what is it?is it a POP or back slab? Why u do abackslab?look at the cannula what is it?is it in its proper position , where is the proper position?, why? If apatient with hypovolemic shock u cant find veins what u do?answer :venous cutdown

where do u do venous cutdown show me?

6- dr ismaeel:

history:female patient right hypochondrial pain radiate to the right soulder and weight loss 5 kgm no vomiting and fever .

ask this patient is the pain refered pain or radiated pain? Whats important question in systemicreview u like to ask?whats ur diagnosis? How do u exclude ur DDx?

Answer; dxgallstone , cholycystitis .if u hadPU how do u exclude ur diagnosis? Answer:

By endoscopy

7- instruments:all are forceps and needle holder (11 instruments)

8- pictures( 8 pictures):dr sirwan

1- patient with panda eyes

2- mamometry: is it malignant or benign tumor?

3- Hydrocephalus(congenital)?

4- CT scan of brain showing atumur at one side of the brain ? what sign will happen?

5- Meningomyelocele(whats contain)?

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in surgery

FINAL 2007-2008

Room1:

Surgical emergency:

Aman with sudden onset of severe epigastric pain ask:

1-DDx?(perforated pu, cholangitis)

2- how do u manage him?history , exam, invest

3-are u going to decide immidiate operation?

4-preopration and postoperative management ?

Room2:

Do abdominal examination on a patient with iv fluid +chest tube +midline laparatomy + tube drain( I examine for PR and genitalia )

Room3:

History :

Patient with bite

The patient said that something bitten him he doesn’t know what thing bitten him .

Ask about abdominal pain

And any rash, dypnoea, colur of urine, stool,ask about animal history at home

Room4:

1-Ct scan, is it normal or not?

2-fracture lower end of radius

3- popcorn calcification , uterine fibroid . KUB

4- chest xray with pulm hydatid cyst

Instruments:

1- intestinal clump ( uses)

2- T tube ( clinical uses )

3-differnece between vicryle and nylone?

4- endotracheal tube , indication?

Room5:

Slides :

1-thrombectomy by fogartey catheter

2- hydatid cyst , common sites?

3-paronychia , Rx

4-hydrocephalus , 4 clinical signs

5-skull fixation by instrument uses ( cervical spine fracture )

6-segment of bowel wich is become dark colur is it viable or not?why?

7-venous ulcer, varicose vein

8-breast cancer and he will ask u to which bone t metastasis first( vertebra) and by which route spread to bone ?( by blood)

Room6:

Uro-Foleys catheter ( types, indication , complication , how do u remove it)

ortho-

*examine all nerves of the hand

*examine knee joint

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in surgery

FINAL 2007-2008

Room1:

Surgical emergency:

Aman with snake bit come to u . ask:

1- how do u manage him?history , exam, invest

2-preopration and postoperative management ?

Room2:

Do abdominal examination on a patient –

Do general examination (there was alarge scar fro previous apendicictomy he asked why this scar is large?

Room3:

History :

Patient with hydrocephalus

(Vomiting, vaccination)

Room4

1-T tube indication?

2-esophageal fistula

3- stag horn stone. KUB

4- fracture of calcaneus :

1- intestinal clump ( uses)

2- NG tube ( how u clinically know tha it is not in its place )

3-differnece between PDA and polyglycone?

Room5:

Slides :

1-apendicitis

2- breast mass ?

3-goitre, complication if its retrosternal

4-CT acan , subarachnoid hemorrhage

5-diabetec fot., Mx

6-wt loss, weakness, abnormal xray , DDx?( TB, ca)

Room6:

Uro-Foleys catheter ( types, indication , complication , how do u remove it)

-

ortho-

*examine radial nerve

*examine knee joint

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in medicine

FINAL 2006-2007

History taking : on a patient and the senior will ask u some question ( investigation and management ) of that case

Room2

Halbzhardny zarfaka :emergensy

- Hypoglycemia

- Diabetic ketoacidosis

- Pulmonary edema (cause and treatment)

- Nephrptic syndrome (cause and treatment)

Room3:

Slides:

- cushing syndrome

- scleroderma

- ECG of MI

- Hand of rheumatoid arthritis patient ( swan neck)

Room4:: short case

-Examine abdomine

-Examine chest posteriorly

- general examination

Room5:

Short case on apatient , the senior ask u to examine radial pulse and he will ask u some question on pulse

Room6:

Halbzhardny zarfaka :neuropsychiatry

-subarachnoid hemorhage

- pontime hemorhhage

- guelian barre syndrome

- shchizophrenia ( positive and negative sypmtoms)

-feature of mania

- depression and antidepresant drugs

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in medicine

Assessment 2007-2008

Room1:

dr dler and dr taha karbuly

Slides:

- cushing syndrome( Dx , cl feature, Tretment medically and surgically)

- obstetrician hand (causes , treatment)

- ECG of VT ( diagnoses and treatmnet )

- chest x ray , pulm oedema ( read it? Diagnoseit and treatmnet)

- chest x ray , pulm mass ( hydatid cyst )

Room2::

Dr abubakr and dr omed oral

1-talk about clinical fetaure and management of addisons disease

2- talk about clinical fetaure and management of ventricular tachycardia VT ?

3-talk about esopageal motility disorder?

4-talk about hepatic encepahlopathy ?

Room3:

dr akram and dr nzar

Halbzhardny zarfaka :neuropsychiatry

-treatment of status epilepticus

- assess suisidal risk?

- risk factors of shchizophrenia?

-difference between typical and atypical antipsychotic drugs?

- enumerate and talk shotly about types of tremor ?

Room4:

Dr bilal and dr taha mahwy examination

There are 2 patient :

1- pateint with tender hepaticand spleen area and hepatosplenomegaly ( DDx of it?)

2- patient with asthma?

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in medicine

24-1--2007

History taking : on a patient with loin pain and the senior will ask u some question ( DDx ) of that case

Room2

Examine facial nerve( the patient had facial palsy)

Room3:

Slides:

- Iv abuse in forearm ,cause what?

- leg edema9ddx and dx)

- ECG of LBBB(dx and causes)

- RA (extra articular feature in eye(dx and treatment)?

Room4:: short case

- Short case on apatient , the senior ask u to examine chest posteriorly and he will ask u some question onit ? the case was pneumothorax as acomplication of asthma and senior ask u what are the complications of asthma?

Room5:

Short case on apatient , the senior ask u to examine chest posteriorly and he will ask u some question onit ? the case was pleral effusion, causes , treatment?

Room6:

oral

-diffrentiation between real epilepsy and pseudoepilepsy

- substance abuse

- avian flue

- vibrio cholera

-RX of SVT?

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in medicine

Final 2008

Room1:

1-hepatic encephalopathy , precipitating factors and management

2 DKA ,Mx?

Room2:

Examine chest posteriorly( patient with asthma)

Examine only radial pulse (rate, rhythm , delay)

Examine hand of RA?

Examine leg for DVT?

Room3:

1-Patient with ptosis of right eye and fixed dilated pupil of right eye only and when I examined she got diplopia ( 3rd nerve pulsy)

2-examine tone of upper limb

Room 4:

General examination of aboy have mild jaundice and pallor , extensive dental carries , pigmentation on cheek, on abdominal examination there was large midline scar and umbilical hernia (everted)(DDX) : thalasemia

Room5:

Chest xray and Ecg

You answer them by T or F

: XRAY:

1- criteria for right hemidiaphragmis normal?T

2-this is anodule in left segment ?F

3- can be diagnosed histologicaly by bronchoscopy?F

4-in full inspiratory film we can assess cardiac enlargement? T

ECG:

1- have second degree heart block and evidence of previous MI and abnormal rhythm

Room6:

Neuropsichiatery:

1-Causes and ddx of ptosis?

2- difference between real epilepsy and pseudoepilepsy?

What are the causes of pseudoepilipsy?

Answer : causes of pseudoepilipsy:

-Conversional disorder

-Trauma to head

-Any psychological fit

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in medicine

Final 2008

Room1: neurology:

Examine lower limb ( inspect, tone . power .reflex)

Room2:

Examine chest posteriorly( patient with asthma( decrease breath sound, , wheeze , crepitation,decreased vocal fremitus and vocal resonance)

Room3:

Examine face of this patient ( had hypothyroidism face) and tell me the neurological feature of hypothyroidism

Room 4:

Neuropsychiatry :

- suisdal risk

Clinical feature of panic attack-

Autism-

-TIA ,

-guillian barre syndrome,

-investigation of myasthenia gravis

Room5:

Chest xray and Ecg

You answer them by T or F

: XRAY:

1-is this PA or AP ?

2-this is anodule in left segment, s it benign ?

3- need CT or not?

4is it aortic aneurysm?

ECG:

1- is this right axis?

2-is this inferior MI?

3- is this heart block?

4-is v1 indicate anterior MI?

Room6:

Oral:

Causes and treatment of AF

Statatus asthmaticus

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in pediatrics

Room1:

cases :

1-Ten month child have diarrhoea , vomiting , fever fpr 3 days ,write 3 most important point in history taking for assessing dehyadration state?

Answer::

- frequency

- amount

-consistency

- wt loss

-urine out put

3 most important point in examination for asessing hydration state:

Answer::

- conscious ness

- drinking

- skin turgor

2- Ten month child have anemia Hg = 6gm /dl ,pcv=19,(mcv ,MCH ,MCHC ) are below normal

Serum feriitin above normal

1- whats the dx?

Answer: thalasemia

2- give another two investigation:

answer: blood film ”(target cell)

hb electrophoresis

3- ten month infant come to emergency department with convulsion , the mother says that the baby had fever last night whats ur response in step wise?

Answer:

1-ABC

2-diazepam + antipyretic

3- blood for electrolyte and sugar

4-LP and treatment accordingly.

Room2:

x ray :

-cardionegally( give 2 cause of it) ( very important )

-air fluid level

-renal atresia

-pneumonia

-mass

- rickets rossary

- marble bone disease

- rickets

- pulm collapse

Room3:

Slides ‘

1- chiken pox ( mention 2 complica tion)

2- apicture of a child with protruded tongue:

give 2 finding :(flat nasal bridge , protruded tongue)

give 2 DDx : down syndrome , hypothyroidism

3-cephalhematoma ,give 2 DDx cephalhematoma, caput succidanum

3- apicture of child of old face and muscle wasting: marasmus( (very important )

4- cafeaulet

5-Hydrocephalus( very important )

6- vitiligo

Room4:

cases:

1-Pneumonia :auscultate chest , DDx , common cause , Rx,

2 -Jaudice :general exam

3- Down syndrome

4- assess dehydration level of this patint ?

Room5:

case on paper

- celiac disease

- typhoid : compication , Rx

-pyloric stenosis

- management of emergency respiratory problem

- pyloric stenosis

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in pediatrics

6-3-2008

Room1:

cases :

- 1-infant with diffuse wheezy chest on auscultation there is rhonchi this is the first time get this problem

- Gve 2 DDx?bronchioloitis , asthma

- Give 4thong which support you to definite diagnosis or which differntial is most likely? Why?

( ,most likely is brochioloitis because it is the first atack , age less than one year , and by CBP if there is lymphocytosis it is viral bronchiolitis . if by PFT if normal so it is not asthma

2- Ten month child have hypochromic microcytic anemia

3- whats the dx?

Answer: thalasemia

4- give another two investigation:

answer: blood film ”(target cell)

hb electrophoresis

3- newborn babay with diabetic mother after 3 days of birth come to emergency department with convulsion , whats ur response in step wise?

Answer:

1-ABC

2- iv diazepam + antipyretic

3- blood for electrolyte and blood sugarand give glucose because of hypoglycemia

4-LP and treatment accordingly .

Room2:

Slides ‘

1- rash of chiken pox ( mention 2 complica tion)

2-ashleaf patch ( feature )

3- cutis laxa

4-rikets ( treatment)

5-marasmus ( 2 findings)

6- rash of measles

7- subconjuctival hemorrhage

8- xrya ( pneumonia) RX?

9- herpetic stomatitis( 2 line of treatment)

Room4:

cases:

oral examination : general examination :signs and symptoms of heart failure?

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in pediatrics

PEDIATRIC : practice:

Clinical examination for repeaters student in 2008: 2 sheets:

1st sheet question on the picture , on each picture there was 2 questions:

1- hydrocephalus( Dx and Mx)?

2- Down syndrome(Dx and Ix)?

3- Baby with malnutrition(Dx and other feature)

4- Abdomen with patches of hypopigmentation (Dx )?

5- Abdomen with red spot(Dx )?

6- Baby with cephalhematoma?

7- Describe xray ( unilateral pleural effusion)?

8- Describe xray?

Xray:

Xray one only newborn xray showing barium study , stomach and duodenum is the only part of GIT seen , the questions are:

Ahistory of newborn babay complaining of vomiting for 6 hours , vomitus contain bile stain:

1- describe the xray?

2- Give the diagnosis?

3- Whast the management?

Answer: small IO?

2nd sheet : case or data question

Case 1: ECG :

1- whst the rhythm ?

2- what maneuver u should do?

3- What first drug of choice?

Answer : SVT

Case 2:ababy with history of vomiting and no feeding for 2 days , his weight is ..kgm?:

1- what iv fluid u give?

2- How u will calculate the fluid according to weght in the first line of treatment :1- 2- 3- ( multiple number u should chose appropriate one)

3- What’s the number of fluid in ml u give the baby in the first 24 hour ?1- 2- 3-( multiple number u should chose appropriate one)

Case 3: newborn baby has history of vomiting after breast feeding , every thing is normal?

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in pediatrics

Final 2008

Room1:

-Examinefor knee jerk , what are the causes of hyperreflexia?(UMNL)

- Type of ABO groups , ask about infection transmitted by blood transfusion ?( HBV, HIV , TYPHOID, IMN)

Room2:

7 year old child come with red urine howdo u manage him?

By history: drug history , abdominal pain ,diarrhea, vomiting , rash

Room3:

xray

-( pneumonia)

Barium meal show pyloric stenosis-

Hyperdense bone marble bone disease(osteoptrosis)

Double buble sign

- cardiomegally-

Achild with jaundice , ask 4 questions to reach the possible diagnosis?

Dx(Gilbert syndrome)

-

Room4:

Slides:

Chiken pox( write its complication )

Henoch scholen purpura ( write 2 comlpication)

Abdominal distention +arm wasting(rickets)

Microcephaly,write 2 causes

Nephritic syndrome , 3 investigation

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in pediatrics

Final 2008

Room1:

Examine abdomen ( has hepatosplenomegally)he will ask u some question about typhoid and meningitis, complication of meningitis ?

Room2:

Assess dehydration level of 5 year old child? Howdo u treat him? By (ORS)

Room3:

xray

-GOO, investigation

Multiple air fluid level. (IO)-

Hyperdense bone marble bone disease(osteoptrosis)-

Achild with non bilios projectile vomiting , ask 4 questions to reach the possible diagnosis?

Dx(hypertrophicpyloric stenosis)

-

Room4:

Slides:

Herpes zoster( write its complication )

thalasemia ( write 2 comlpication lead to death)

2sign ( hypothyroidism)

Nephritic syndrome ,2 investigation

Comjuctivitis (pertusis), complication

Sternomastoid tumur ( Rx)

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in gynecology

Assessment 2007-2008

Room1:

Slides:

-amniocentesis , indication?

-placenta previa , method of delivery ?

-turner syndrome

-forceps delivery indication ?

-thretened abortion , causes ?

- Weeks of gestation

-vulval carcinoma

-ectopic pregnancy , causes

-Uterine fibroid and polyp

-pap smear

Room2:

instrumenys

-vollecelum (indication)

-Uterine sound(indication and complication )

-Higar dilator, uses ?

- xray of pelvis IUCD , do u need another investigation ? answer :yes ( us )

- ergometrin (indication and contraindication)

- what do u see in this xray ? answer : HSG show block falopian tube , indication of HCG ?

Room3:

HISORY (twin preagnanacy , polyhydramnios)

Room4: ABDOMINAL EXAMINATION: of preagnanat lady

Room5

Examination of first postoperative patient(inspection , palpation. Auscultation for bowel sound)

Room6

Cases:

1- theye give you a HB 7.5, ESR 10 in 3o years old preagnanat woman, whats this case ? HOW U MANAGE ?

answer: IDA

2-A 32 YEARS OLD WOMAN PRESENTED WITH MENORHHAGIA FOR 3 YEARS AND U/S SHOW ECHOGENIC MASS IN MYOMETRIUN SIZE 7,8,9 CM ? whats the diagnosis ? management?

Answer: fibroid , adenomyosis

3- G7P6A0 woman presented with excessive bleeding after delivery whats the diagnosis ? management?

Answer:PPH

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in gynecology

Fianal 2007

Room1:

Slides:

-bartholine cyst

-Ovarian carcinoma

-Loveset manueover

- brow presentation

- abdominal examniation of fetus which lie Transverse ly , method of delivery ?

- mersilene tape

- multiple genital wart

-seperation and desend of placenta

-Delivery of placenta by cord traction

Room2:

instrumenys

- wringleys Forceps (indication and complication )

-Uterine sound(indication and complication )

-Higar dilator

- xray of pelvis IUCD , do u need another investigation ? answer :yes ( us )

- featal head craniotomy

-- HSG( name the image)

- one end curette

- sponge holding forceps

- cusco speculum

- sims speculum

Room3:

HISORY

Room4: obstetrical EXAMINATION: of preagnanat lady?

Risk of transverse lie ?DDx of large fordate ?

Room5

Examination of first postoperative patient

Room6

Cases:

1-acase of endometrial hyperplasia , what other investigation u need to confirm the diagnosis in addition of endometrial sampling which was done for this patient ?management?

2-they give u U/S which show absent

fetal heart ? whats the diagnosis ? management?

Answer: missed abortion

3- pre eclampsia , management ?

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in gynecology

Assessment 2007-2008

Room1:

Slides:

-bartholine cyst

-Ovarian carcinoma ( distended abdomen)

-Types of prolapseur(urethrocele, rectocele m cyctoocele)

-Loveset manueover

-Laparoscopy

- Weeks of gestation

-Twin( breach / cephalic)

-Transverse lie

-Uterine fibroid

-Delivery of placenta by cord traction

Room2:

instrumenys

-Forceps (indication and complication )

-Uterine sound(indication and complication )

-Higar dilator

- xray of pelvis IUCD , do u need another investigation ? answer :yes ( us )

- oxytocine (indication and complication )

-Cusco speculum( indication)

Room3:

HISORY

Room4: ABDOMINAL EXAMINATION: of preagnanat lady

Room5

Examination of first postoperative patient

Room6

Cases:

1-theye give you a GUE WHICH show turbid , yellow , acididty whats this case ? HOW U MANAGE ?

answer : UTI

2-they give u U/S which show absent

fetal heart ? whats the diagnosis ? management?

Answer: missed abortion

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in gynecology

Assessment 2007-2008

Room1:

Slides:

-abdominal swelling?ovarian carcinoma

-controlled cord traction

-twin pregnancy

-laparoscopy

-lovesets maneuver

- gestational week:certain level marked in the abdomen , identify the gestational week which belong to each level?

- bartholin cyst

-transverse lie

- uterine fibroid

- rectocele, enterocele, cystocele

Room2:

instrumenys

-vollecelum (indication)

-forceps(2indications)

- cuscos speculum. Where do we use it?

- ergometrin (2 contraindication)

- what Is this xray ? answer : HSG ( HYSTEROSALPINGIOGRAPHY ), indication of HSG ?

Room3:

history taking from apatient with (UTI)

Room4: obstetrical examination of preagnanat lady

Room5

Examination of first postoperative patient(inspection , palpation. Auscultation for bowel sound)

Room6

Cases:

2- theye give you a US (show adnexial mass) of 30 years old woman with vaginal bleeding and pregnancy test positive, whats this case ? HOW U MANAGE ?

answer: ectopic pregnancy

3- theye give you acase: 30 years old woman with frequency, dysurea, pass cell in GUE , whats this case ? HOW U MANAGE ?

answer: UTI

4- 34 week gestational week developed vaginal bleeding whats this case? Management?

answer: APH

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in gynecology

Assessment 2007-2008

Room1:

Slides:

-partogram ( 2 indications)

-twin cephalic breech abnormalities; placetal bleeding

-laparoscopic veiw of hydrosalpinx

- prolapse

- bartholin cyst

- fibroid(Cx)

- pap smear

Room2:

instrumenys

-curatte (complications )

-uterine sound (2indications)

- cuscos speculum. uses?

- oxytocine ampule (2 contraindication)

- what Is this xray ? answer : HSG ( HYSTEROSALPINGIOGRAPHY ), finding ?

Room3:

history taking from apatient ( LMP , EDD,GPA)

Room4: obstetrical examination of preagnanat lady( fundal hight?

Room5

1- in 37 weeks pregnant lady PCV is normal , HB normal ,liver enzymes elevated , GUE revealed protenurea, high blood pressure: Whats this case ? management?

Answer : PE , MANAGEMENT : lower BP or terminae pregnanacy

2- menorhhagia in 17 years old female

3- treatment of a case of fibroid:

if complete her family do hysterectomy , if not myomectomy

Room6

Cases:

Obstetrical emertgency:

Apregnanat lady delivered a fetus vaginally there was no any bleeding outside but suddenly she became colapsed?whats this case? Manage it?

Answer:amniotic fluid embolism

Mx : ABC

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in gynecology

Final 2007-2008

Room1:

Abdominal examination of pregnant lady 31 wks gestation

Room2:

obstetrical emergency

37 wk s primigravida lady with blod pressure (190/110)now got convulsion manage her?Dx( Preeclampsic fit or eclampsia as acomplication of preeclampsia )

Rx( hydralazine , methyldopa +diazepam ,Mgso4)

Best treatment is termination of pregnancy

Room3:

Instruments and radiology:

-HSG bicornate uterus ( write 2 complication)

-wrigley forceps (write 2 indication)

-Combined oral contraceptive pill( write 2 side effects)

-oxytocine ampule (write 2 indication)

-case:apregnant lady come with vaginal discharge her ultrasound show non viable fetus , Dx , Rx?

Dx : missed miscarriage

Rx:D and C and oxytocine

Room4;

Slides

1- delivery after coming head of breech with forceps

2-ectopic pregnancy

3-gestational age ,36 wk

4-ambigous genitalia(investigation:karyotyping)

5-60 year old female with abdominal distension (ovarian tumure)

6-amniocentesi(write 3indication)s

7- cystourethrocele ,rectocele, enterocele

8-placental abraptio

9-cardiotopography(write3 uses)

10-breech baby.

Prepared by:

Dr.soran Mohamad Gharib

2008

OSCE exam in gynecology

Final 2007-2008

Room1:

Obstetrical examination of pregnant lady, tell me gravida, para, EDD, gestational age

Room2:

obstetrical emergency

-PPH ( causes . Mx)

Room3:

Instruments and radiology:

-HSG ( write indication. Finding( hydrosalpinx)

-IUCD(write complication )

-sims speculum ( write 2 indication)

- higar dilator ( uses)

- vollecellum( indication)

-ergometrine ampule (write 2comlpication)

-case:apregnant lady come with placenta previa, Dx , Rx?

Room4;

Slides

1- controlled cord traction

2-ectopic pregnancy, risk factor

3-fibroid , types

4-episiotomy , indications

5-which hormone secreted by follicles

6-pap smear , sims spatula (write indication)s

7- diameter of post-ant , transverse, of pelvis

8-genetal wart

9-turner syndrome

10-16 year old female with amenorrhea , pain, tell the causes?.

Prepared by:

Dr.soran Mohamad Gharib

2008

Theory

Pediatric theory:

theory examination for repeaters student in 2008

Part1: 4 cases:

Case 1:

Questions for XLR there was agenetic graph and the question :

1- if the baby of third generation might have the disease?

2- Give example of the disease?

3- Type

Case 2:one and half year old girl aby has palor , anemia, bleeding tendency , factor Vlll normal:

1- whats the diagnosis?

2- Investigation?

3- Management?

Case 3: table put increase or decrease or normal:

| |Bleeding time |PT |PTT |

| Thalassemia | | | |

|V.W.D | | | |

|Vit, K difficiency | | | |

Case 4:

CSF taken from achild bac .2, everything else were normal, glucose8 mg/dl:

4- whats the diagnosis?

5- Investigation?

6- Management?

Part 2: essay :

1- complications of measle?

2- Complications of meningitis?

3- Immunization sqedual in iraq?

4- Write shortly about bone age?

5- Write some characteristic feature of kwashiorkor?

6- Clinical feature of IMN?

7- Criteria of rheumatic fever?

8- Difference between croups and epiglotitis?

9- Factors that precipitate hemolytic jaundice?

10- Hemolytic disease in new born?

11- Thalassemia?

12- Down syndrome?

13- DM?

14- Hypoglycemia?

Part 3 : MCQ

Surgery:Theory:

theory examination for repeaters student in 2008:

1- long case 10 marks: presentation and management of hydatid cyst?

2- Short case :

1- postoperative fluid management for apatient of age .. in the first 24 hour?

2- Signs of basal skull fracture ?

3- Diagnosis of intussception of anew born babay ?

4- Management of aburn patient ,second degree, 30% , 70 kg

5- Anti tetanus prophylaxis ?

6- Acute scrotum?

7- Carple tunnel syndrome?

8- Perforated PU ,presentation and management?

3- blanks:fill in the blanks:

1- A, C precaution -------

--------

--------

--------

2- Degree of snake bite: -------

--------

--------

--------

3- Chest trauma life threatening in : -------

--------

--------

--------

4- Risk factors of AIDS : -------

--------

--------

--------

4-match

5- MCQ

Medicine:theory

theory for repeater students in 2008

Cases:

1- diabetic ketoacidosis ?

2-bronchogenic carcinoma?

3- Alzhimer disease

Essay : megaloblastic anemia

Gynecology:theory

theory for repeater students in 2008

- Infertility( investigations)

- Cervical arcinoma

- Complications of twin

- Preeclampsia

- Side effects of oral contraceptive pills

Radiology :

Prepared by : Soran Mohamad Gharib

Sixth stage 2007-2008

1- PTC : indications( obtructive jaundice)

2- secondary metastasis:( ca prostate, ca breast)

3- achalasia (dilated esophagus)

4- hysterosalpingiography( indications: infertility and patency of fallopian tube )

5- right side pneumo thorax

6- right upper zone opacity( secondary or hydatidcyst)

7- hair on head in thalasemia major

8- MRI contraindications:

-Intraocular forign body

-Pace maker

-Cocclear implant

9- vesical stone:

10-bone scan:it is very sensitive

indications:

- secondary ca

- early oseomyelitis

- occult fracture

- TB

11-ERCP

12- antegrade pyelography

13-congenital digphragmatic hernia

14- mamography(indications)

15-exostosis in knee joint

16-esophageal atresia with fistula

Prepared by:

Dr.soran Mohamad Gharib

2008

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