1 Mitral Stenosis.

A 35 year old lady with known mitral stenosis and a history of rheumatic fever attends the ante-natal clinic at
15 weeks.

What are the implications of pregnancy on mitral stenosis?

Outline your management of this lady during her pregnancy?
What considerations would you take during labour for this woman?
What is the role of induction in cases of mitral stenosis?

2 Twin Delivery.
You are the registrar on the labour ward. There is a nulliparous lady who is in spontaneous labour at 38+5
with DCDA twins. The first twin is cephalic. She is now 4cm dilated.
What are your considerations in managing this lady?
You are called to review her 2 hours later. Both CTGs are reactive however she is not progressing. What
would you do?
She gets to fully dilated. Outline your management for the delivery for both the first and second twin which is
now breech.
Outline your management plan following delivery.

3 Cervical Cancer
What is the FIGO staging for Cervical Cancer?
What is the treatment for Stage 1B Cervical Cancer?
Give 6 advantages of a Wertheim’s Hysterectomy over radiotherapy.
What do you know about the role of chemoradiotherapy in managing cervical cancer?
What is the role of a knife cone biopsy?

4 Antenatal Screening
A 38 year old lady presents to the clinic at 8 weeks gestation. She has a friend who recently had a baby with
Down’s Syndrome and she wants to know about testing available to see if her baby is affected.

5 Male Factor Infertility

A couple return to see you in the fertility clinic who have been attending with a 2 year history of primary
infertility. The woman has had a normal hormonal profile and investigations showing normal tubal patency.
Her husband’s sperm analysis shows azoospermia. How would you proceed?
History
?Cause
Management of a post-testicular cause.
Options available for this couple

6 Sexual Assault
An 18 year old girl presents to the E.R alleging a sexual assault has occurred. She appears disorientated.
Outline your management Think of medical reasons for slurred speech, etc!
On examination it is noted that she has significant PV bleeding with evidence of lacerations how would you
proceed.
In theatre what would you do in particular?
She attends for follow up in the gynae clinic 4/52 later. What would you discuss with her.

7 Counselling Station
A lady (Para 1) attends to see you 6/52 post difficult delivery. She had a Forceps delivery in theatre
complicated by a mild shoulder dystocia. She had an episiotomy. She had an epidural in labour which was
topped up and re-sited but she got little or no effect from it. She had a live male infant who was 3.6kg
8 Counselling Station
A 48 year old lady is referred to your gynae clinic with menopausal symptoms looking for advice regarding HRT

On discussion patient has menopausal symptoms which are having a moderate impact on her life. Her mother
died of Breast Cancer at 62 and she has no aunts or siblings. She smokes 10-20 cigarrettes a day. The
symptoms she attributes to menopause include flushes, mood swings and urinary frequency/leakage.

9 PID
A 29 year old lady present to the ER with sudden onset bilateral pelvic pain and vaginal discharge. She is
tachycardic and pyrexial. Her abdomen is tender and she is guarding bilaterally.

What is the most likely diagnosis?

Outline your intial management?
2 days later the patient has been on IV ABS but is not improving what would you do next?
Give four possible long term complications for this lady?

10 Eclampsia
What is the pathophysiology in the brain of eclampsia?
Outline your management of an eclamptic seizure?
If the patient continues to seize following administration of MgSO4 what other measures can you take to stop
her seizure?
How would you control her blood pressure?
What are the manifestations of hypermagnesia and what would you do to monitor for it?

6 week post natal Unexplained IUD counselling (needed to notice there were some blood test results missing)
VTE in pregnancy diagnosis and management
Reproductive endocrinology- given different hormone profile results- most likely diagnosis, differential and
further investigation and management
Urogynae- clinical scenario (can't remember) given different investigation results- pad test, bladder diary,
urodyamnics- discuss each

Beta thalassaemia management

PCOS – dx, mgmt., future consequences
Counselling for abnormal Dopplers
VZV exposure at 37/40
Molar pregnancy
Abnormal CTG – OP at spines fully dilated

Previous TAH for fibroids, now with incontinence

Hx Vag hyst for prolapse, now with vault prolapse and rectocele
31 wk TPTL mgmt.
35/40 undiagnosed placenta praevia presents with bleeding. Outline mgmt.
Noninfectious causes of hydrops; Rhesus
Management of pelvic abscess/ RIF pain

OSCE April 2014:

1. Thyrotoxocosis and effect on mum/fetus
2. 3rd degree tear – clinical diagnosis, management, consequences
3. Retained swab scenario
4. Omphalocoele on scan – meaning and associations with aneuploidy
5. Pre-op investigations for specific patient scenarios – eg 64yrs, previous MI going for a TAH
6. Colposcopy pic to describe, histology showing CIN3 with mircoinvasion and a cervical ca staging question
and mgmt
7. Labour ward roles – you, an SHO, two midwives and a consultant to cover various LW rooms – prioritise,
justify and allocate roles
OSCE November 2013:
1. Diagnosis and counselling for PMS
2. Interpretation of HSG film and discussion re same
3. Staging and management of ovarian cancer
4. Discussion on NICE guideline for menorrhagia
5. Management of shoulder dystocia (with model), consequences etc
6. Screening for T21
7. Management of principle requesting elective Caesarean section
8. Management of sepsis on DS and late decels during pushing
9. ITP-differentials and management in pregnancy
10. Stages in vaginal hysterectomy