obgyn osces

8/15/2019 Obgyn OSCEs

1/3

OBGYN

1. llq pain – pid, ectopic2. menorrhagia

3. infertility

4. amenorrhea5. dymenorrhea !endometrioi"

#. 1t trim $leed

%. 3rd trim $leed&. ocp

'. a$ortion

1(. )$ac co*nelling

11. )aginiti

+o*plet tation

-/0N YONG O/N 0 6 70N778 99-, :Y -. /N;, 0Nith 1 day ? of 6 a$dominal pain. Physical exam only. 7oiti)e re$o*nd,

ha@e, g*arding, co*gh tenderne. Aectal e?am re)eal ided tenderne. On pel)ic

ha 09, ided tendene, cer)ical motion tenderne. No + a$do pain. 9o a phyical e?am. oe8 he ha profo*ndtenderne in A6, >onCt traighten leg no matter ho> often yo* a@ her. >ritten8

hat are5 thing yo* >ant to @no>, three mot li@ely diagnoe...and if he i diagnoed>ith chylamidia, >hat are 2 reponi$ilitie yo* ha)e to p*$lic healthD

Medical history of diverticulosis - LLQ pain

History

E a$dominal pain, O76A; E relation to meal etc.

E aociated ymptom E na*ea, )omiting, flat*, a$do ditenion, diarrhea, contipation,

melena, hematocheFia, hematemei

E AO gyne ca*e E e?*ally acti)e, /7, mentr*al h?, $irth control etc.E AO renal ca*e E flan@ pain, *rine o*tp*t, hemat*ria, dy*ria, o$tr*cti)e ?C

E contit*tional ymptom

E diet E Dfi$er E medication E ;, heparin, co*madin, other $lood thinner

E family h? of cancer, di)ertic*liti, polypoi

E pat medical hitory E colonocopy, G0 d, ee $elo> for dd?

PEP - Ddx LLQ pain

di)ertic*liti

rarely appendiciti


2/3

$o>el o$tr*ction

0B9

@idney toner*pt*red o)arian cyt

t*$al torionalpingiti

ectopic preganancyendometrioi

poa a$ce

: -. =AO/ O/N 0 /NOAAG0

778 99-, :Y - /N;, 0No year old e?ec*ti)ela>yerD >ith hea)y $leeding per )agin*m. =oc*ed hitory.

B. 9d?, teting

oman thirtie >ith infertility, co*ple trying to get pregnant 1& month. *$andco*ldnt $e there $eca*e of *dden $*ine trip.

B. 9d?, teting

menorrhea8 hitory and ca*e

ith cramp, teenager, ethic OB GYN

15 year old female preent after miing one day a month of chool $eca*e of painf*l

period. 9o a foc*ed hitory.

Findings: heavy painful periods for six months, flow getting heavier over the last sixmonths, deep dyspareunia, now using mother’s Tylenol #3s for pain, prior was using

about 10 ibuprofen a day !he will as" if you will tell her mother about the onversation

6*etion8 >hat i the diagnoiD hat in)etigation >o*ld yo* orderD hat treatment>o*ld yo* offerD ho can ma@e treatment deciion for thi patientD

3rd trimeter $leed OB GYN2& year old >oman, third trimeter, preent >ith )aginal $leeding. 9o a foc*ed hitory.

Findings: first pregnany, 30 wee"s gestation $leeding started %& hours prior, heavy,

with ramping starting about ' hours prior (renatal are normal, did not have

ultrasound )o problems otherwise during pregnany6*etion8 mot li@ely diagnoi. o*ld yo* do a )aginal e?amD hat i yo*r

managementD

1( min tation

+ON; YONG O/N 0 NN9 7AGNN+Y !/O;Y A8

ABOR!O""

+ON; YONG O/N A8 ORAL #O"RA#$P!%$ P!LL


3/3

7reeclampia8 co*nel

35 = pregnant !& >ee@" >orried a$o*t ri@ of genetic defect. +o*nel. ;he a@ yo*

>hether it her right to ha)e an a$ortion if he o chooe. Hx only &counsellin' (

#L$O) OBS/GYN

3( yo f pre)io* c ection for tr*e @not in cord. 1( >@ pregnant, here total@ to yo* a$o*t

deli)ery option. Yo* are gi)en her deli)ery report o*t in the hall. here >ere no pro$>ith the $irth and the cection >a *nanticipated. Baically, he i irritated and *pet

$eca*e he co*ldnCt ha)e a )ag deli)ery, and a@ yo* to g*arantee her a )ag deli)ery

thi time. lo >ant to try to ha)e the $a$y at home and >ant yo* to tell her thi i o@.

arning her a$o*t ri@ aociated >ith home deli)erie for a not a q*etion in other citie, o it >a li@ely a Ipilot tationJ, meaningit might not $e repeated.

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