‫اﻟﺤﻤﺪ ﷲ ﺣﻤﺪا ﻛﺜﯿﺮا طﯿﺒﺎ ﻣﺒﺎرﻛﺎ ﻓﯿﮫ ﻣﺬﻛﺮة اﻟﺠﺎﯾﻨﻲ ﺷﺎﻣﻞ ﻣﻦ‬

‫ﺳﯿﺒﺘﻤﺒﺮ اﻟﻰ ‪ ٥‬دﯾﺴﻤﺒﺮ ‪ ،‬ﻣﺼﺪر اﻻﺳﺎﻟﺔ ﺟﻠﻮري ﺗﯿﻢ ﻓﻘﻂ ‪.‬‬

‫ ﻧﺑرء اﻟﻠﮭم ﻣن ﺣوﻟﻧﺎ وﻗوﺗﻧﺎ ﻓﺎﻟﻠﮭم وﻻ ﺣول وﻻ‬، ‫ وﻻ اﻟﮫ اﻻ ﷲ وﷲ اﻛﺑر‬1 ‫ ﺳﺑﺣﺎن ﷲ واﻟﺣﻣد‬، ‫ﺑﺳم ﷲ اﻟرﺣﻣن اﻟرﺣﯾم‬
‫ اﻟﻠﮭم ﺳﮭﻠﮭﺎ ﻋﻠﯾﻧﺎ ﺟﻣﯾﻌﺎ ﯾﺎرب‬، ‫ﻗوة اﻻ ﺑك‬

1Contraindicantion to pregnant
🌹 drugs should be avoided in pregnancy: A. amoxicillin B. nitrofurantoin C. ciprofloxacin
…
🌹 female G3p2 had previous C/S due to breach and one vaginal delivery. Shes at 34
weeks and fetus is breach, she wants to do ECV. US: anterior low lying placenta and amniotic fluid
of 4 Digital exam: “normal” Whats the contraindication for ECV?
A. -gestational age and Echotocography. B. -US findings✅
........
🌹Contraindication of IUFD ? A. Multipla B. Previous c/s C. Child death due to IUFD ✅
..
🍒Per vaginal examination contraindicated in Placenta previa
…
-Which one of the following don’t give to pregnant lady?zoster
…
Contraindicated vaccine in pregnancy:
Hepatitis B A.Meningococcus B. Zoster ✅ C.Human papilloma
…
🌹Which vaccine has absolute CI in pregnancy?zoster
..
🌹Contraindications vaccines during pregnancy = live vaccines 🌹
…
🌹Which of the following is an absolute contraindication for thrombolytic
A. pregnancy B. HTN 180/110 C. intracerebral hemorrhage 2 years ago
….
🌹Pregnant in her 38 week and 2 weeks ago she was admitted and ECV was done for her.
Currently the fetus position is in linear (or lateral not sure) with amniotic fluid index 12. What’s the
contraindication for ECV in her condition? fetal position🌹
…
🌹Women diabetic controlled developed dysuria and frequency urine analysis nitrate, creatinine
high. Which drug is contraindicated?
A- Amoxicillin B- Septrin✅ C- Ciprofloxacin D- Pipracilintazopactam🌹
..
🍒Vaccine contra in pregnancy = Varicella 🍒
…
Pregnant uti which drug contraindicated= ciprofluxacin ✅
..
pt came to clinic want to get pregnant she has a history of epilepsy 6 years and not compliance
on medication what best initial management? A folic acid B_review all medication
..
ECV in 34 weeks pregnant absolute contraindication?
a) Previous CS (relative contra b) Ultrasound finding of low lying placenta✅✅
c) CTG finding and gestational age
….
contraindication to External cephalic version = = Bicornate uterus ✅
…
Which antibiotic is contraindicated in pregnancy? A-Nitrofurantoin B-Ciprofloxacin✅ C-Penicillin
….
🍒 Female use paroxetine with history of suicidal attempts and depressions pregnant what to do
= : Discontinue
antidepressants are an option during pregnancy: SSRIs are generally considered an option
during pregnancy, including citalopram , fluoxetine and sertraline .🍒
Some studies have indicated using paroxetine during pregnancy may increase your risk for
miscarriage. In addition, there may be an increased risk of your newborn experiencing heart
defects if you use Paxil while pregnant.

1Preeclampsia
🌹Pregnant with blurred vision, headache and ... BP 170/ What to do ?
A. stabilize + mg and wait till 37 weeks B. call anaesthesia now and deliver
C. stabilize and give MG and deliver
…
🌹 Mgso4 toxicity ? A. discontinue mgso4 B. calcium gluconate
…
🌹Primigravida 32 came with mild headache with no abdominal pain, or visual disturbance, Blood
pressure 150/90, urine analysis +3 protien, appropriate management?
A. close outpatient after 1 week B. Admission and observe✅ C. induction of labor D. C/S
…
🌹Pregnant 32 GA, with 150/90 BP and protinuria +3. Whats next
A- Admit and observation ✅🌹 A.Emergency CS B.Induction of labor C.Discharge and Follow up
….
Pregnant , 10 weeks with HTN never went to doctor before (chronic HTN) what is the
complication? Pre-eclampsia
…
🌹Pregnant present in 38 weeks in labor , BP 150/90 and elevated proteins /creatinine ratio. A. -
preeclampsia✅ B. - chronic hypertension C. - gestational hypertension
.....
🌹39 week, women with proteinuria Bp 140/90 , ur action:
_
A. admit and observation ٣٥ ‫ع اﻗﻞ ﻣﻦ‬r‫ اﻻﺳﺒ‬ln m ‫ﺎن‬i ‫ ﻫﺬا ﻟﻮ‬B. Labor induction✅ ٣٩ gh‫ع اﻻﺧ‬d‫ ﻻﻧﻬﺎ `^ اﻻﺳﺒ‬C.
Follow up and observe
..
🌹 Pregnant with pre-eclampsia mild 140/40 with abdominal pain .platelet and, uricaerd what
indicate severity?Abdominal pain.‫ﺣﻞ ﺟﻠﻮري‬
…
🌹 Case of preeclampsia on labetalol she’s 32 weeks, fundal height 28. what will commonly occur
with IUGR: a. oligohydramnios✅ b. polyhydramnios
…
🌹 IUGR , witch one of the following can be the cause? Oligohydramnios 🌹
oligo‫ ﻻن ﻣﺎﻓﻲ ﻣﺎء ﯾﺸﺮب ﻣﻨﮭﺎ‬IUGR = ‫… رﺑﻂ = ﻗﻠﺔ اﻟﻨﻤﻮ داﺧﻞ اﻟﺮﺣﻢ‬
…..

🍒2 case about Pre-eclampsia : 32 weeks other case ; 34wks has hypertension and proteinuria,
management?
A. Admit and observe ✅🍒 B. Immediate CS C. IOL
Delivery is the only cure for preeclampsia. Patients with preeclampsia without severe features are
induced after 37 weeks' gestation.
Before this, the patient is usually hospitalized and monitored carefully for the development of
worsening preeclampsia or complications of preeclampsia, and the immature fetus is treated with
expectant management with corticosteroids to accelerate lung maturity in preparation for early
delivery.
In patients with preeclampsia with severe features, induction of delivery should be considered
after 34 weeks' gestation. In these cases, the severity of disease must be weighed against the risks
of infant prematurity. In the emergency setting, control of BP and seizures should be priorities.
:‫اﺧﺗﺻﺎر اﻟﻛﻼم‬
‫ ﺳواء ﻛﺎن ﻓﯾﮫ ﻣﺿﺎﻋﻔﺎت او ﻻ ﯾوﺟد ﻣﺿﺎﻋﻔﺎت ﺳواء ﺣﺎﻟﺔ اﻻم ﻣﺳﺗﻘرة او ﻏﯾر‬، ‫ او ﺑﻌدھﺎ ﻓورا ﻧوﻟدھﺎ‬37 ‫ ﻓﻲ اﻻﺳﺑوع‬pre.eclamsia ‫ﻟو وﺣدة ﻋﻧدھﺎ‬
‫ ﻟﯾس ﻋﻠﻰ‬، ‫ ﻋﺷﺎن ﯾﻧزل اﻟﺿﻐط‬laptelol ‫ وﻧﻌﺎﻟﺟﮭﺎ ب‬observantion ‫ ف ﻏﺎﻟﺑﺎ ﻧﻌﻣل ﻟﮭﺎ‬٣٧ ‫ ﻗﺑل اﻻﺳﺑوع‬preeclamsia ‫ ﺑﯾﻧﻣﺎ اﻟﻲ ﯾﺟﯾﮭﺎ‬، ‫ﻣﺳﺗﻘرة‬
، ‫طول وﻻدة‬
٣٧ ‫ وﻛﺎن ﻋﻧدھﺎ ﻣﺿﺎﻋﺎﻓﺎت ﻧﺗﯾﺟﺔ ﺑرﯾﺎﻛﻼﻣﺳﯾﺎ ھذه ﻛﻣﺎن ﻻاازم ﻧوﻟدھﺎ وﻻ ﻧﻧﺗظر اﺑدا ﻧﻔﺳﮭﺎ ﻧﻔس اﻟﻲ ﻓﻲ اﻻﺳﺑوع‬٣٤ ‫ﻟﻛن ﻟو ﺟﺎت وﺣدة ﺑﻌد اﻻﺳﺑوع‬
‫ ﻻن ﺧﻼص‬، ‫ ﻧوﻟدھﺎ‬pre.eclamsia ‫ ﺣﺗﻰ ﻟو ﺣﺎﻟﺗﮭﺎ ﻣﺳﺗﻘرة وﻛل ﺷﻲء ﺗﻣﺎﻣﺎ ﻟﻛن ﻋﻧدھﺎ ﻋﻼﻣﺎت‬37 ‫ اﻧﮫ اﻻﺳﺑوع‬34 ‫ و‬37 ‫ ﯾﻌﻧﻲ اﻟﻔرق ﺑﯾن اﻻﺳﺑوع‬،
‫ ﻻااﻧوﻟدھﺎ اﻻ ﻓﻲ ﺣﺎﻟﺔ ﺳﺎرت اﻣورھﺎ ﻏﯾر ﻣﺳﺗﻘرة وﺑدء اﻟﺟﻧﯾن ﯾﺗﺎﺛر ھﻧﺎ ﻻزم‬٣٤ ‫ ﺑﯾﻧﻣﺎ اﻟﻲ ﻓﻲ اﻻﺳﺑوع‬، ‫ﯾﻌﺗﺑر اﻟﺟﻧﯾن ﻧﻣوه اﻛﺗﻣل ﻓﻣﺎﯾﺣﺗﺎج اﻧﺗظر اﻛﺛر‬
. ‫ ﺑﯾﻧﻣﺎ ﻟو ھﻲ ﻣﺳﺗﻘرة ﻋﺎادي اﻧﺗظر و اﻋﺎﻟﺞ اﻟﺿﻐط اﻟﻌﺎﻟﻲ واﺳوي ﻟﮭﺎ ﺗﻧوﯾم ﺣﺗﻰ ﺗﺳﺗﻘر وﻧﻌﺎﻟﺞ اﻟﺿﻐط‬، ‫اوﻟدھﺎ‬
admited , ‫ ﻟذﻟك ﻧﺧﺗﺎر‬pre.eclamsia . ‫ ﯾﻌﻧﻲ ﻣﺎﺳﺎر ﻟﻠﺟﻧﯾن ﻣﺿﺎﻋﻔﺎت او ﻟﻼم ﺑﺳﺑب‬، ‫ﻣن اﻟﺳﯾﺎﻧﺎرﯾوا ﺣﺎﻟﺗﮭﺎ ﻣﺳﺗﻘرة‬
. ‫ وﻻن ﺣﺎﻟﺗﮭﺎ ﻣﺳﺗﻘرة‬37 ‫ ﻻﻧﮭﺎ ﺗﺣت اﻻﺳﺑوع‬C/s ? ‫ﻟﯾﮫ ﻣﺎ اﺧﺗرﻧﺎ‬
. .. . . . . .. . . .
🌹Pregnant 34 week with preeclampsia, high BP 170 /100 what to give ?
A. Stabilize , MgSo4 and admistion ✅🌹 B.Stabilize ,corticosteroids and deliver

🌹preeclampsia what drug to give to prevent convulsions? Mg sulfate .🌹

🌹Pregnant 34 wx, vaginal bleeding open cervix 6, preeclampsia Fetal bradycardia:

A. mgso and deliver ✅ B.stabilize and mgso wait until 37 week C.stabilize give steroid then labour
…
pregnant in 32 weeks with pre eclampsia what to do? a) Admit to IOL b) Admit to observation ✅
‫ ﻧﻌﺎﻟﺟﮭﺎ وﻋﻠﻰ ﺣﺳب وﺿﻌﮭﺎ ﻧﻘرر ﻧطﻠﻊ‬، ‫ ف ﻧﻌﻣل ﻟﮭﺎ ﺗﻧوﯾم وﻧﺗﺎﺑﻊ ﺣﺎﻟﺗﮭﺎ ﻣﺳﺗﻘرة وﻻ ﻻ‬34 ‫ﻟﯾﮫ ؟؟ ﻻﻧﮭﺎ ﺑﺎﻻﺳﺑوع اﻗل ﻣن‬
‫ او ﻓوﻗﮭﺎ ﻧوﻟدھﺎ‬34 ‫ ﻟو ﻗﺎﻟك اﺳﺑوع‬. ‫اﻟﺟﻧﯾن او ﻻ‬
….
🌹34 wk pre eclamsia pt came with epigastric pain, headache, bullerd vision .. non stress test
reassuring mx ?
a) Mg sulf + delivary ✅ b) mg and wait for 37 wk c) Call anesthesiologists for deliver
Mg sul‫ واﺧﺗﮭﺎ‬Pre.eclamsia ‫ ﻛﻠﻣﺔ‬.. ‫ ﻣﺎ ﯾﺳﺗﻐﻧوا ﻋن ﺑﻌض‬، ‫اﺛﻧﯾن اﺧوات ﻣﻊ ﺑﻌض‬
..
🌹Magnisium sulfate given to HTN pregnant to = prevent the attack eclampsia. 🌹
…
🌹Pregnant, now bp 140/90, platelets 90, hx of previously severe preeclampsia. What indication
here of severe preeclampsia? A. bp B. platelets✅C. uterine contraction
….
🌹Preganat c/o sever abd pain and uterine cotractions she was given 6mg Mg sulfate and the e
contractions become normal then decrease the dose to 4mg Then complained of shortness of
breath What to do? after stop Mg sulfate give the Ca gluconate✅
..
🌹 Case of preeclampsia with very low plt and high urea what indicators that is preeclampsia: A.
low plt B. high urea
…
🌹pregnant with seizure take 6 .. mg sulphate then decrease to 4 , There is
absent deep tendon reflex : Stop mg sulphate > THEN GIVE CA GLUCONATE

Patient on oxytocin and MgS04, preeclampsia. Her CTG: absence variability. What's the cause?
MgS04 toxicity.

🌹 mother with preeclampsia was given oxytocin and MGso4 and now CTG of child is non-reactive.
Which drug is the cause? MGSO4
…
🌹pt at 32 week presented with seizure and high blood pressure, what is the next
appropriate 'There was no medication for seizure
A. steroid B. hydralazine C. magnesium sulfate ✅D. Abx
…
🌹Why administering MgSo4 in case of preeclampsia? To prevent seizure🌹
….
🌹 Severe preeclampsia, acute management of HTN drug?
A. hydralazine✅ B. Methyldopa C. Nifedipine D. Sodium nitroprusside
…
🌹GDM type F with nephritis + and controlled HTN, She is pregnant now what’s most
complications will occur ?
A. pre eclampsia✅ B. stillbirth C. Shoulder dystocia D. Large baby
….
🌹pathophysiology of GDM = placental hormones (lactogene)
…

1Weeks
🌹when is ultrasound to confirm gestational age best done?
A. 14-16 w B. 20-22 w C. more than 22 w
…
🌹 Pt with preterm symptoms ( contractions and cervical changes before 34 wks) the best test to
confirm your diagnosis is :
A. US to determine cervical length B. continues CTG C. forceps
…
🌹Gestational Diabetes at what week screening? A. 4 B. 14 C. 24 D. 34
….
🌹 K/c of cervical incompitance came for antenatal care. When to do surgery? 12 to 14 weeks
…
🌹married women came to routine antenatal care most important thing? pelvic examination
..
🌹What's the minimum number of days should do muscle strengthening activities Answer is 2nry
pregnancy.
…
🌹 55 years old female done mammogram now, when to do it again : after 2 years
…
🌹 50 y women no family Hx of breast ca , mammogram normal When to do next mammogram ?
A. after 1 year B. 2 y C. 3 y D. 5 y
…
🌹 Screening of breast Ca from age 50-74
A. Every 2 years B. Every 3 years C. Every 4 years D. Every 5 years
…..
🍒US to check for gestational age ? 11-13 W. 🍒
..
🍒🍒mammography screening for 50y: 2 years
…
● More than 50 every 2 years ● Less than 50 every 1 year🍒🍒
…
🌹solid mass of ovary+ca125 high = gynecologists oncology referral🌹
…
- when is ultrasound to confirm gestational age best done? a. 11-13 w b. 20-22 w
…
- pregnant 1st visit at 10 weeks what is the most important to be done on 1st visit
a. ultrasound to see sac b.cbc for anemia
..
🌹Pic of anembryonic pregnancy and asks about the Dx an embryonic tx:
A. Follow up to 4 week✅ B. Admit for evacuation
....
🌹Gestational age diabetes screening
4 weeks 12 wee 24 weeks ✅. 34 weeks
.‫ ﺳﺎﻋﺔ ﯾﻛون اﻟﺣﺎﻣل ﻋﻧدھﺎ ﻣرض اﻟﺳﻛر أﻟﯾن ﻣﺎ ﺗوﻟد‬٢٤ ‫رﺑط = ﺳﻛر اﻟﺣﻣل = ال‬

Pregnant at 22 weeks gestational age oral glucose challenge test after one hr high after 2 hrs high
after three hrs high.. What is next?
A- Repeat same test B- HgA1c✅✅✅ C- Fasting blood glucose D- Random blood glucose = Correct
answer : B. gestational from 24-28
…

1infection pregnancy
Female came with left leg pain and swelling with red streak, what is the causative organisms?
A. strept pyogen✅ B. bacteroides C. klebsiella
…
🌹Female used herbal cream in vagina then started to have Redness and itching :
A- contact dermatitis
…

🍓Couples came to infertility clinic the wife had PID 2 years ago with chlamydia inf and got treated
the husband semen was normal what is the appropriate step: IVF
…
Female pt with her husband for fertility counselling. BMI and All labs are good, Regular menses.
Your advice:
A- Keep physicaly active B- Eat less fast food✅ C- Include 2 portion of vegetables and grains
...
most significant examination in gyne for general check up in newly married women:
A. general inspection B. pelvic exam✅ C. vaginal inspection D. abdominal ex
…..
Couple came to OBGYN clinic, need to check infertility, what to assess first?
A- start abdominal ex B- vaginal inspection C- general appearance✅. D- PV
… N.B: General appearance of the couple might help you to reach diagnosis, for example:
*Hirsutism on the female supports , Lymphadenopathy or parotid enlargement in male
..
Couple come by infertility after investigation done show bilateral fallopian tube obstruction
what will do == Tell couple ✅
..
🌹 Infertility and cysts in ovary what is the problem? Ovulation. .🌹
…
🌹couple seeking infertility clinic after 3 months what is ur advise? try more
…
🌹After how many months you will start call a couple infertile?12 months
…
🍒Wife with down syndrome husband try to conceive for 3m? try more and come back after
complete 1 year✅🍒
…
🌹Couple present with 3months infertility, next step: nothing
…
Couple after 2 years failed to get pregnant, husband sperm normal what is the cause of infertility
a-Vaginal factor b-Coital factor c-Husband factor
Answer: after excluding male factors we should look for ovulation cuases✅
….
Couple came to the infertility clinic. Semenalysis was normal, cervical exam not done yet. The wife
has regular menstrual cycles every 36-40 days. Investigations show monophasic basal
temperature. What is the cause of infertility?
• Coital • Vaginal • PID Anovulatory ✅✅
.....
🌹 Female complain of infertility since 2 years, regular period, normal semen analysis, monophasic
basal body temperature. What the cause of her infertility?
A. Male factor B. Cervical C. Anovulation
…
🌹woman in her 30s with irregular cycles and anovulatory cycles since several years endometrial
biopsy was done and showed atypical hyperplasia what is the best treatment? A. oral progestin B.
Tamoxifen
….
🌹Couple present to infertility clinic everything normal after taking history and doing examination
which first investigation to start? Serum analysis 🌹
….
🍓 Female with regular menses come for infertility evaluation?
A. 21 progesteronb.✅. B. Lh/ fsh ratio?
.......
🍓Couple came to you, with infertility issues. Upon investigation, wife has bilateral tubal
blockage (not sure). Who should you inform?A. Wife B. Husband С. Both✅
..
Couples present with infertility for 3y, what you will order:
A. nothing. B. Sperm analysis. C. Histosulpingogram D. Laproscopic exploration
…
🌹Pt came to infertility clinic, wife ha ha of PID everything else is normal, what to do?
Hysterosalpingogram
….
🌹pregnant lady, G4p3 ,35yo, 34GA came complaining of bleeding 2hours ago, what question will
you ask next? Intercourse✅

283- F Hx of chlamydia infection, wants to get pregnant, best next step? Hysterosalpingography
‫ﻒ‬Œ‫ﻼم ﻛﺜ“’ وﺳﻮاﻟ‬i ‫ﻪ‬Œ‫ﻜﻮن ﻓ‬Ž ‫ﻼم ﻛﺜ“’ =ﻫ”•ﺗﻮا =اﺳﻬﺮوا =ﻣﻊ اﻟﺴﻬﺮ‬i= ‫ﺎ‬Ž‫ﺪ‬Œ‫ﻼﻣ‬i .

🍒Woman had adhesion in pelvis and peritoneum and signs of obstruction what is the organism?
Chlamydia 🍒
….
...... . . .
Pt with history of PID (pelvic infection dis) and treated for it is now coming in the clinic because of
infertility despite regular sexual activity what investigation will you do first:
A)_Hystrosalpingoraphy (adhesions)
‫ﻠﻤﺔ ﻫﺬا‬i ‫ﺸﻮﻓﻮن‬£ ‫ اول ﻣﺎ‬، ‫ ﺷﻮﻓﻮا‬:
( *pelvic infection disease* )
‫ ﯾﺣﺻل اﻟﺗﺻﺎﻗﺎت ﻓﻲ‬adhesion ‫ ھو‬pelvic infection diseas ‫ اﻛﺛر اﻛﺛر اﻟﻣﺿﺎﻋﻔﺎت اﻟﻲ ﺗﻌﻣﻠﮭﺎ‬، infertility ‫وﺟﺎء ﻣﻌﺎھﺎ‬
adhestion ‫ ف اول ﻣﺎﺗﺷوﻓون وﺣدة ﺟﺎھﺎ اﻧﻔﻛﺷن ﺑﯾﻠﻔك وﺗﺷﺗﻛﻲ ﻣن ﻋﻘم ﻓﻛروا ﻋﻠﻰ طول ﻓﻲ‬، ‫اﻟرﺣم وھذا ﯾؤدي اﻟﻰ ﻋﻘم‬
:‫طﯾب ﻛﯾف ﻧﺷﺧص ھذه اﻻﻟﺗﺻﺎﻗﺎت ؟؟ ﻋﺑر‬
Hystrosalpingoraphy
….
🌹Pt came with feature of PID what is the investigation: Hysterosalpingo
….

🌹 Which bacterial infection is associated with intrauterine device in PID ? Actinomycosis

…
🌹most common cause of ectoplc pregnancy ( no hx of anything )
A. previous ectapic B. PID ✅ C. IUD
Becarful
Most common risk factor of ectopic is PID
Most significant factor is previous ectopic
.......
🌹But if there’s amoxicillin or cephalosporins more accurate couples use condom which type of
infection : . PID 🌹
…
🌹 Chlamdiya + pregnant woman, what is the most commonly infected part of the neonate:
A. Eyes ✅✅✅. B.Lungs

🌹Strawberry cervix with yellowish to grey discharge : chlamydia trachomatis

..
🌹 Which vaginal infection diagnosed:
A. Vilvopnea B. Bacterial vaginosis C. Candida D. Trachominas
…
🌹pelvic adhesion causes :chlamydia
…
🌹 A case of 20 yrs old with GTD ( grossly abnormal mass on cervical examination) with
hemoptysis, What is the next in management ?
A. admitted for D&C B. Admitted for staging and chemo ✅ C.preoperative preparation for
hysterectomy D.discharge and follow up
…..
🌹Vaginal discharge under microscope flagellate what dx ? Trichomonas vaginalis🌹
. . . . .. . . . . .
🌹Yellow green vaginal discharge: Trichomoniasis
…
🌹Vaginal discharge pseudohyphae cell under microscope what treatment? Fluconazole 🌹
..
A woman with smiley vaginal discharge and itching..her husband has a Hx of
urethral discharge, asking about ttt?
A- progestérone creams B-ceftriaxne ✅ ‫ اﺻﺤﻬﻢ‬C-estrogen cream D-Defer all vaccines
….
women want to get pregnant in winter what to give her before pregnancy ?
a) Rubella? b) Influenza ✅ c) Varicella If already pregnant give her influenza
Want to get pregnant depends:
Less than one month >> influenza
More than one month >> rubella
…
🌹influnza during pregnancy , rubella before conception 🌹
…
Contraindicated vacation in pregnancy? rubella ‫رﻋﺐ =اﻟﺤﺎﻣﻞ‬
…
🌹 Female her previous pregnancy is stellbirth and now she want to pregnant and ask the doctor
about all the vaccines that she is need before consumption and
.reduce the stillbirth ?
= stillbirth ‫رﻋﺐ =ﻣﻮت‬rubella=
A.rubella B. varicella C. influenza
...

🌹vaginal infection can cause incompetency =Bacterial vaginitis 🌹

….
🌹what vaginal infection can cause incompetency?
1o Bacterial vaginitis✅✅ 2o Candida 3o Trichomoniasis
🍬. Cervical incompetence = Cervical weakness, also called cervical insufficiency, is a medical
condition of pregnancy in which the cervix begins to dilate (widen) and efface (thin) before the
pregnancy has reached 🍬
…
🌹Patients with sx of BV: What’s the test: gram stain🌹
…
🌹Clinical scenario of (painless genital ulcer + skin rash). What is the dx? A- Secondary syphilis.🌹
…
post-op fever :
0-2days: atelectasis or pneumonia.
3-5 days> UTI
5-7 days > DVT
7 day > wound infection
..
Pregnant came because his son has infection, What to give her? .influenza
..
🌹Vaccine in pregnancy=Influenza, Dtap.🌹
…
🍒🍒Pregnant with Rh-negative blood type her baby have Rh-positive blood type present with
jaundice ask about Pathophysiology Answer is: autoantibodies against fetal RBCs (Mother’s
antibodies attack fetus RBCs🍒🍒
🌹Mother A negative Newborn o positive, what to do ? Give RH 🌹
…
🌹when to give inti D? if mother rh ve- and child rh ve+. 🌹
….
🌹Pregnant 28 wk primigravida came for routine check up and she mentioned that
she is -RH and her husband is +RH what next : Give her anti D in this visit
….
Femal has cottage like vaginal white discharge, what could this Pt suffer from?
A- DM✅ B- HTN
‫ ﻓﺎﻟﻔطرﯾﺎت ﺗﺻﯾب اﻟﻲ ﻣﻧﺎﻋﺗﮭم ﻣﺎھﻲ ﻗوﯾﺔ ﻣﺛل‬، ‫ ﯾﺟﻲ داﯾم ﻟﻠﻣﻧﺎﻋﺗﮭم ﺿﻌﯾﻔﺔ ھو ﻋﺑﺎرة ﻋن ﻓطرﯾﺎت‬candidiasis ‫ھذا ال‬
‫ وھذا اﻟﻔطر ﯾﺟﻲ ﻟﻣرﺿﻰ اﻟﺳﻛر‬candidias ‫ داﯾﻣﺎ ﻓﻛروا ﻓﻲ ﻓطر‬cottage ‫ ﻓﻛﻠﻣﺔ‬، ‫ﻣرﺿﻰ اﻟﺳﻛر‬

🌹 hyphae in urine microscopy? Candida🌹

…
female with white-gray vaginal secretion , odorless, adherents to vaginal wall
in microscope there’s spore , what’s the dx:
A. bacterial vaginosis B. vaginal candidiasis✅
…
🌹budding yeast cells and pseudohyphae in vaginal discharge= Viginal Candadia treat by
fluconazole 🌹
…
🌹woman presented with itchiness and white patchy vaginal lesions. There were
thick white secretions but she denied them being foul smelling. What is the most
appropriate treatment? A. topical itraconazole ✅B. Metronidazole
…
🌹pt with vaginal itching and bad smell the microscopic is flatellaprazite = trichominosis
…
Female had hx of two pregnancies loss , she tried to conceive but she didn’t succeeded , she want
improved her immunity....etc what vaccines appropriate in her case ? 1) rubella✅. 2) influenzas 3)
pneumococcal 4) varicella.
🌹 Rubella >> risk for miscarriage🌹
... .... ...
Female with painful genital ulcer, rash, conjunctivitis, there was a test done and was +ve
called anti coccal something antigen, diagnosis? I think STD A- Gonorrhea
‫ ﺟﻨﻮن ﻣﻊ‬gen ‫ﺨﻮف ﻣﺮة و ﻣﺆﻟﻢ‬Ž= ‫ﺟﻦ‬

🌹pt with infected HBV husband concerned about sexual ?Wear condom
…
🌹 🌹When detecting pregnant women is infected with HBV, what kind of prevention?
A. Tertiary B. Secondary C. Primary D. Primordial
…
🌹Mother with HBV. Baby delivered 12 hours ago. What to give baby?
A- HBV Vaccine and IG ✅ B-IG C- HBV Vaccines
….
🌹female with fishy smell discharge and itching , on vulva scratch mark tx:
A. Metronidazole tablet ✅ B. zole cream bacterial vaginosis treated by First-line: oral
metronidazole
…
Female with Thin gray vaginal discharge wiff test positive and Ph above 5 treatment? A-cipro. B-
amoxicillin C-metronidazole✅✅. D-cefoxime
‫ﻠﻤﺔ اﺟﺮي‬i ‫= ﺟﺮاي ﻣﻦ‬Gray +++ ‫’روا‬µ‫ﻼ اﺟﺮي ارﻛﺐ اﻟﻤ‬Ž ‫’وا‬µ‫ﻠﻤﺔ ﻣ‬i‫و‬
....... . .. . . . .. . . . . . .
🌹Bacterial vaglnosls : fishy odor metronidazole
..
Patient with symptoms and signs of Bacterial vaginosis we took a sample and analysed it what
will be there:
A/overproduction of Lactobacillus B/multinucleated giant cells C/Granular epithelial cells
bacterial . . . ‫ ﻧﻔﻛر ﻋﻠﻰ طول ﻓﻲ‬sample ‫ ﻓﻲ‬epithilial cell ‫اذا ﺷوﻓﻧﺎ‬
…
🌹Pic of clue cells diagnosis?A-candidas B-Tricomanis C-(( bacterial vaginosis))✅
‫„ﺎ‬gh‫ﺨﻮف =ﻻن ﻓ†ﻪ •ﻜﺘ‬‰ ‫ﻞ‬Œ‫•ﻠﻮا =اﻻ‬
..
🌹 Female come with grayish vaginal discharge + PH Dx, bacterial vaginosis what is ttt? Oral
metronidazole 🌹
….
Sx of vaginal discharge when examined by microscopy: motile flagilla what is the treatment for the
husband? A. Metronidazole ✅ B.No treatment C.Tetracycline
….
treatment of Trichmonas vaginalis:A- metronidazol✅✅ B- doxycycline C- clindamycine
. . . . . .. . ‫ = ﻣﺗروا‬metronidazol =‫ =ﺗرﯾﻛوﻣوﻧﺎس = طرﯾق = ﻻزم طرﯾق ﻛوﯾس ﯾﻣﺷﻲ ﻓﻲ اﻟﻣﺗروا‬Trichmonas = ‫رﺑط‬

🍓Female with vaginal discharge Cheese segment What will you give the husband?
А. Cipro B. Metronidazole C. No need for tt✅
.........N.B: cheesy> candida no need for treatment to partner.
..
🌹pregnant lady complains of foul-smelling vaginal discharge what u wll give?
Metronidazole.🌹
…
🍓Pregnant lady with term baby had recapture of membrane 1 h ago but she had history of
multiple vaginal herps attacks what you will did next:
A. Cs B. Iv acyclovir C. Pelvic speculum exam✅ D. Induction of labor
..
🍓-Pregnant hepatitis B positive what will u give baby in first 12 hrs:
a. hep b vacc + immunoglobulins✅ b. hep b vacc only c. hep b immunoglobulins only
…
🌹Pregnant hbs positive what will u give baby in first 12 hrs: A. hep b vacc + immunoglobulins B.
hep b only
......
🍓Couple came to your clinic for counseling of their sexual relationship, the wife was
worried as.her husband is Hep B +ve and she’s Hep B -ve, what are you gonna tell them:
A. Use condom✅ B. Hep B is STD C. Reassurance as hep B is not an STD D. Abstinence
..
🍓-Pregnant came with rupture of membranes and history shows herpes lesions previously what
will u do? a. speculum exam✅ b. give acyclovir c. cesarean section
……
🌹Pregnant came with rupture of membranes and history shows herpes
lesions previously what will u do? A. speculum exam B. give acyclovir C. c section
….
🍓*Active herpes?* CS*Previous history of recurrent herpes?* Acyclovir

......
🌹painful vesicles in labia and cervix( HSV) management? acyclovir 🌹
‫½ﻞ‬Œ‫ﺲ =ﻫﺮب =¼ﺎﻟﺴ‬¹’“‫ = ر·ﻂ =ﻫ‬cycle 🏍
......

-woman with dyspareunia and spotting fresh blood after intercourse . She had a history of warts
on vulva with cryotherapy done 2 yrs back what is the site of the bleeding?
a. valva b. vagina c. cervix uterus ✅ d. body of uterus
..
Hx of Genital warts and treated, after 2 years she complain of bleeding after intercourse, where
is the lesion? A. Vagina B. Uterine cervix ✅
..
🌹Screening of cervical CA. To which age group? cervical 21 🌹
…
🍓 pregnant women in 26 weeks GA has large vulvar warts how you will treat her:
A. Cryotherapy✅ B. Electrocautery C. Resin D. Intralesional interferon
.......
pic of female genitalia with warts , Pt have history of multiple sexual
partners, what you are suspect the dx : = condylomata lata
..
🍓Warts which organism ?HPV 6-11🍓
..
🌹A female patient came to the clinic complaining of a mass on a vagina she has a history of
repeated unprotected intercourse with multiple partners, upon examination. she has a wart in
the vagina, the causative agent is:‫ي‬
A- Herpes simplesB- Neisseria Gonorrhoea C- Treponemma pallidum D- Molluscum
contagiosum🌹
............
🌹female pt with small papule on genital area with central pitting, h/o unprotected sexual
intercourse with multiple partners.
A- Herpes simples B- Neisseria Gonorrhoea C- Treponemma pallidum
D- Molluscum contagiosum✅🌹
….

…
🌹22 years old, female married never done Pap smear before when to do it : Immediately 🌹
….
🌹pap smear screening = 21 🌹
…
🌹pap smear , screening? A. every 2yrs B. every 3yr ✅
..
Married woman pap smear screening start at? A. 20-24
..
🌹23 yo female came complain of breast tenderness before period and all history is negative an
she plan to be pregnant in 2 years, What screening recommended for this patient : A. Breast US
B. Pap smear ✅
..
🌹40 y Female with hx of Wart 7 or 10 years back, last pap smear normal, what is investigation u
went to do in this visit?A. - Repeat pap smear B. -colonoscopy
…
🌹 27 year old female came for follow up she is asymptomatic last Pap smear was 3 years ago and
it showed unconcerned squamous cell, what to do:
A. repeat Pap with cytology ✅ B. Reassure C. mlposcopy
…
Female with cervical lesion measuring 11mmx12mm with irregular borders, pap
was done, no results yet, what to do ?
A. Excise the lesion B. biopsy✅ C. reassure until pap results are available D. HPV test
…
🌹Female patient Pap smear done before 7 years ago result was atypical hyperplasia Now came to
clinic what to do: A. Repeat Pap smear B. colposcopy C. CT
‫ﻓﻨﻌﻤﻞ‬.‫ ﻋﺸﺎن ™ﺸﻮف ˜ﻞ اﻟﻮرم اﻧ”–• وﻻ ﻻ‬C.T
....

🍒Pregnant lady with suspicious cervical changes , next step = A. Pap smear B. Colposcopy
How to approach pregnant with cervical lesion: 1st pap smear
If high suspicious or abnormal Pap smear >> do colposcopy🍒🍒
…
🌹Pregnant female with suspicious lesion in the cervix on exam what's the next step?
A. pap smear B. colposcopy C. cone biopsy
…
🌹56yes postmenopausal her pap smear hx was normal except one month ago revealed ASCUs,
then given local estrogen for one month then pap smear. Repeated reveale dintra epithelia
lesion. Next step is: A. conization B. hysterectomy C. colposcopy✅
…
Pap test came with high dysplasia, next step is? A. colposcopy✅✅ B. repeat pap test C.
hysterectomy
30y old female came for pap screening, all her past results were negative, now
results show low grade squamous epithelial lesion. What's the appropriate next step? colPoscopy
.......
🍓Case of postmenopausal women, on pap smear found ASC-US. Pap was repeated 6 months
after that & found same resu Its. you do next? colposcopy.
colopscopy‫ ﺛﺎﻧﻲ ﺧطوة‬pap smear ‫ﺣطوھﺎ ﻗﺎﻋدة اذا ﻟﻘﯾﻧﺎ ﺗﻐﯾر ﻓﻲ‬
........
🌹60 year old with pap smear showing ASCUS. Doctor gave her estrogen, and after one months
repeated pap smear showed also ASCUS. What will you do? Colposcopy
…
🌹 How to do a Pap smear = From transformation Zone (endocervix)🌹
…
🍒When should married women start to have pap smear for screening? 21 ✅
…
🍒What is the age recommended for screening by pap smear for married women?
A. 20-24 ✅ B.26-30 C.30-35 D.36-40
….
🍒40y/o female patient underwent PaP smear histopathology showed ASCUS, your
next step?
A. Do HPV test✅ •Ä‫ﺎ‬i ‫½ﺎل‬Ž‫ﻌﻤﻞ ﺳ“’ﻓﺎ‬Ž Ân‫ ا‬Á n À‫ﻻن ﻫﻮ اﻟﺴ¾ﺐ اﻟﺮؤ‬
B. Colposcopy. C. Re-evaluate after 6 months D. Surgery
….
🍒Ascus positive twice in 45 yrs what to do next = HPV🍒
...........
🌹Case of 34 year women have ASCUS what to do next? HPV test 🌹
…
🌹females with abnormal Pap smear and colposcopy show invasive carcinoma :
A. clinical staging ✅ B. Hysterectomy and chemotherapy C. Hysterectomy and radiotherapy
…
🌹 27 years old female she did Pap smears before 3 years it was normal what is your advice for
her? A- Reassurance B- no pap test C- pap test with cytology✅🌹
..
🌹female with the result of cervical biopsy by microscopic is ASCUS what next?
A- Coloscpy✅🌹
….

Mother comes around 2 weeks postpartum complaining of clear discharge that is positive for
leukocytes and epithelial cells?
A-Antibiotics B-Urine culture C.Reassure that it’s normal✅✅

Post partum and cesarean section fever? A-Retained products of conception B-Endometritis
🍬Postpartum endometritis is an infection of the lining of the womb which can occur up to six
weeks after childbirth. It is much more common after caesarean section births.🍬
….

🌹Female was delivered by C-section. Presents with vaginal bleeding 15 days later. She has a fever.
What is the dx?
A. retained product of placenta B. mastitis C. wound infection . endometritis✅
…
🌹 women come to ER 15 days after CS complain of persistent vaginal bleeding.
BP 110/70 , HR 85 , T 38.1 . What’s Dx ?
A. mastitis B. endometritis C. wound infection
…
🌹 Pt marriage 33 years complain of mastitis /redness /tenderness what’s treatments? A.
metronidazole B. ceftriaxone✅

🌹Campylobacter jejuni treatment ?

A. Ceftriaxone B. Azithromycin C. Metronidazole D. Fluconazole
‫ ازﻫﺎر‬azethro 🌻‫ﻼ‬Œ‫ﺎﻣ‬i camyl= ‫ﻠﺔ‬Œ‫ ﺟﻤ‬.
.....
🌹C. Difficile ? A. I.v vanco B. IV metro
‫ﻠﺔ ﻋﻼﺟﻬﺎ اورال وﻟ”ﺲ‬Ér‫’ة ﻃ‬µ‫’ة اﺳﺘﺨﺪام اﻟﻤﻀﺎدات اﻟﺤﻴﻮي ﻟﻔ‬Ë‫ ﻣﻦ ﻛ‬Ên µ ‫ﺎ ﺗﺎ‬É’“‫ﻜﺘ‬Ç‫ ﻫﺬە اﻟ‬I.V Ô
m “ ‫ﺴ‬Ó‫ﻓﺎﻧﻜﻮاﻣﺎ‬
.....
🌹7 weeks gestation, she presented with vaginal bleeding and brown discharge = Observe🌹
…

1drug pregnancy use

Familial Mediterranean Fever which drug to avoid= C. Macrolids +verapamil ✅
A. aspirin B. NSAID C_Amox
…
🌹Pregnant women with pneumonia, her Immune systems respond for this condition by ig
production What type of immunity should baby take in this infection?
A. passive artificial immunity B_Passive natural ✅
…
🌹Pregnant 35w came with sever headache,abdominal pain and feel dizzy
A- give mg salfate and admission for delivery ✅
B- give steroid and admission for delivery
C- give mg salfate and wait
.........
🌹lady presents to your clinic after cardiac event. Which of the is true about her condition?
A. Antiplatelet use for short duration prevents ischemic disease
B. CCB is indicated indefinitely in patients with ischemic heart disease
C. Estrogen replacement therapy in post menopausal women prevents ischemic events
D. ACE inhibitors are indicated indefinitely for heart failure ✅
…
🌹Pregnant KC of hyperthyroidism 28 weeks GA on 15mg carbimazole came with Sx of
hyperthyroidism, labs: low TSH high t4, what's the most appropriate management ?
A.switch to PTU B.increase carbi dose to 20mg ✅ C.referral for thyroidectomy
…
💐Pregnant with hyperthyroidism , what to give : A. PTU ✅✅💐(forst give drug) B.Surgery C.RAI
…
🌹 6 week pregnant lady came with diarrhea, heat intolerance and another sign of
hyperthyroidism i forgot it, Lab show low TSH, high free T4 and positive thyroid
antibody Ask about management
A. propanol B. carbimazole C. PTU✅ D. total thyroidectomy
….
● What is true about hydroxychloroquine?
A. Reduced efficacy with smoking B. Contraindicated in pregnancy C. Contraindicated with
lactation
….

🌹Asthmatic pregnant what to told her about her medication? safe Take all of your meds🌹
….
Pregnant lady, just delivered and she's known to have bronchial asthma. Which of the following
uterotonic medications you would avoid giving?
• misoprostol • carboprost F2 alpha✅ • Oxytocin • Methylergonovin
…
🌹Pregnant lady,justdelivered and she's known to have bronchialasthma.Which of
thefollowing uterotonic medicationsyou would avoid giving?
A- misoprostol B- carboprost F2 alpha ✅ C- Oxytocin D- Methylergonovine
..
how to prevent hypercalciuria that causes stones: A- allopurinol B- thiazide✅✅
…
🌹G3 P2 GA20 weeks presented with history of preterm delivery twice on examination
cervical is 30mm. what is the management?
1_ Strict bed Rest. 2_ cerclage now 3 _ progesterone✅✅
Progesterone Supplementation and the Prevention of Preterm Birth :
progesterone supplementation during pregnancy to reduce the risk of recurrent preterm birth in
women with a history of at least one prior spontaneous preterm delivery. This is the first time that
the FDA has approved a medication for the prevention of preterm birth.
…

🌹Mom just eat polished rice, what is the deficiency?Vit . B1🌹

‫ ر·ﻂ‬B1 = rice .
......
….
🍒females want to get pregnant what supplements she should use =Folic acid 🍒
…
🌹Patient had seizures. uncontrolled. now came to women health clinic wants
to get pregnant what to do: A. give her folic acid ✅ B. review medication
…
Pregnant women on salbutamol for her asthma presented with severe asthma symptoms what to
give her ? A.LABA B.ICS ✅ C.corticosteroid tablets
…
-woman in her 30s with irregular cycles and anovulatory cycles since several years endometrial
biopsy was done and showed atypical hyperplasia best treatment?
a. oral progestin ✅ b. Tamoxifen

-Pregnant with dysuria studies showed 20 wbcs in urine treatment

a. nitrofurantoin Note : If third avoid nitro > cephalaxin or amoxicillin
….
🌹Pregnant with dysuria studies showed 20 wbcs in urine treatment= A. nitrofurantoin✅
…
Pregnant ( with anti-thyroxine medication for 10 years not controlled what to do :
A- double the dose B- Same dose Correct answer :increase the dose
…….
long history of pregnant lady received IV mgso4. What drug reverse the action? Ca Gluconate✅✅
…
pregnant with symptoms of hyperthyroidism asking about management =
A-Probothuracil (( FIRST Trimester)) B-Carbamezole (second Trimester Depend on which trimester
…
🌹Bleeding diagnosed with Ovulatory dysfunction treatment?OCP🌹
…
🍓Pregnent type of estrogen= Estriol
‫ﻂ‬œ‫ = ر‬i = ‫ اي =اﻟﻢ‬+ O ‫ ﺣﺮف •ﺎﻧﻪ ﺣﺎﻣﻞ‬.
Estrone: during post menopause Estradiol: childbearing age Estriol: pregnancy
…
🌹 Abundant estrogen in pregnant lady?
A. E1 B. E2 C. E3 D. E4
🌻E1 Estrone >> Menapouse
🌻E2 Estradiol>> Reproductive age
🌻E3 Estriol>> Pregnancy
....

1breast
🌹most important immunoglobulin in breast milk? A. lgA✅ B. lgM C. lgG D. lgE
‫ﺎة اﻟﻄﻔﻞ‬Œ‫ ¼ﺎﻟﺤ‬Ö ×
n ‫ء اﺳﺎ‬Ö
n ‫ﺐ‬Œ‫ = اﻟﺤﻠ‬A
..
🍓HIV mother on HIV medication what you will tell her regarding her disease?
A. Baby HIV +ve B. She can't breast feed her baby✅
C. She's undergo CS D. I think HIV medication will protect her child from being HIV +ve
…
🌹Which mother can give breastfeeding to her son?
A.direct breastfeeding HIV mother
B.expressed milk HIV mother
C.direct breastfeeding TB mother
D. expressed milk TB mother ✅
….
🌹Pregnant lady known case of HIV, she wants to know the HIV transmission to her baby?
A. Start the HIV treatment for baby after delivery immediately decrease the risk of
transmission
B. Treatment of the mother during pregnancy decrease the rate of transmission✅
C. The HIV will transmit to the baby nomal tter what
..
🌹 Breastfeeding mother after 7 days of delivery, asymptomatic, culture sensitive to cipro, nitro,
amoxicillin Wbc high 10K maybe (it was borderline of wbc)
A. Nitro B. Cipro C. Amoxi D. No treatment
…
🌹 Postpartum 2 weeks woman lactating asymptomatic, came for follow up, urine
cx showed 100,000 e coli, ttt?
A. no need for ttt ‫ خ‬B. nitrofurantoin C. trimethoprim sulphamethoxazone D. ceftriaxone
‫ﺔ ﻫﺬە ﻣﻤﻨﻮوووﻋﺔ ﻋﺸﺎن‬É‫ﻞ اﻻدو‬i breast feeding
…
🌹Mother just delivered she has +ve hbv, child was given hbv vaccination and immunoglobulin
What is true regarding breastfeeding :
A. Breastfeeding after 12 hours B. Encourage breastfeeding
…
🌹Hep+ve mother asking about breast feeding== Continues breastfeeding🌹
…
🌹 Positive hepatitis B mom recently delivered wants to breast feed. Your advise ? Continue
breast feeding
…
🌹Female after delivered present with unable to breast fed her baby and no milk at all. diagnosis?
Sheehan syndrome✅
..
......
female difficult breastfeeding? Sheehan.....
….
🌹The most risk factor of breast ca ?
A. Age ✅✅ B.Late menepose c C.Early menarch D.Get pregnant in late age
…
🌹Athlete female with delayed breast devopmemt compared to classmates and ammenorrhea ,
cause ? hypogonadotropic hypogonadism.
…
🍓breast development ; coarse pubic hair; no mens; and high testerone, what do?
A. complete androgen insensitivity B. Mullerian Agenesis✅
C. Mayer Rokitansky Kuster Hauser syndrome
Müllerian agenesis, also known as Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) or
vaginal agenesis, is a congenital malformation characterized by a failure of the Müllerian duct to
develop, resulting in a missing uterus and variable degrees of vaginal hypoplasia of its upper
portion.
............
Pt has amenorrhea pupic hair and axilary hair and high testosterone:
A. Mullerian agenesis ( another name Mayer Rokitansky Kuster Hauser syndrome B. Androgen
insensitivity
.........

🍓Female with breast mass and family hx of cancer what to do ? First mammogram not BARCA🍓
..
Breast feeding mother with swelling hotness and mass diagnosis =
A) fibroadenoma. B) ectasia. C) abscess✅
…
....
🌹Lady 26 Y with lift breast redness around areola, mass in the right outer quadrant tender and
red , there is lymph node enlargement,temp high, dx
A. inflammation cancer B. abscess C. fibroadenoma
…
Female postpartum presented with breast pain on examination there's local erythema,
tenderness, WITH thining OF SKIN. How will you manage?
A. Observation B. Incisions and drainage C. Antibiotic✅
..
🌹Postpartum with a swelling redness breast lump the is mobile and lymph node is palpable:
Abscess == I and D
..
(55 years old) female her last mammogram was normal when she will do the next after? 2 year
MM
..
🍒 Pregnant lady with unilateral mobile breast mass next step
A. Bilateral US✅🍒 B. Pressure and reevaluate after delivery C. Bilateral mamo
......... ......
🌹A newly married 22 year old comes to you for a regular follow-up for her gynecological health.
She is medically free and has a regular 28 day cycle; complaining of mobile breast lumps
bilaterally that are painful right before her menses. She wants to get pregnant, but she is worried
about her breast lump. What is the most appropriate action?
A. bilateral mammography B. Pap smear C. Breast ultrasound ✅
….
Female pregnant and smoking, Best advice?Smoking cessation
..
🌹 contraindication for breastfeeding? cracked nipple🍒🍒
….
Breast mass in female under 40 i forget the age and suspected malignancy what to do ? A-
Mamo✅✅ B- us C- biopsy
mamogram‫ ﺧﺎااﺻﺔ ﺷﺎﻛﯾن ﻓﯾﮭﺎ اﻧﮭﺎ ﺧﺑﯾث ﻧﻌﻣل ﻟﮭﺎ‬mass ‫ ﺳﻧﺔ وﻋﻧده‬٣٠ ‫ﻣﺛل ﻣﺎ اﺗﻔﻘﻧﺎ ﺳﺎﺑﻘﺎ وﺷرﺣﻧﺎ اﻟﻲ اﻛﺑر ﻣن‬

…
lactating came with mastitis 5 cm tx? This case of breast abscess size 5 cm so treat by :
A. I&D ( inscistion and drain and Abx) ✅ B. Mastectomy C. needle aspiration D. Abx ( for mastitis)
# Antibiotics can usually cure mastitis.
#Mastitis can lead to a breast abscess, which feels like a hard, painful lump.
abscess needs to be treated with antibiotics, and the pus needs to be drained with a special
needle.
…
🌹cystosarcoma phyllode mange? a-Wide local excisions✅✅ b-mastectomy
..
🌹What's most risk increases breast cancer ? Age
…
35)_ Breast cancer screening in women older than 55yrs: 2 y
…..
Advanced breast Ca fixed unilateral breast mass involving skin wht is the next step in mx ==
-core biopsy ✅ -CXR bone scan for staging( if already diagnosed) -excisonal bx

Breast feeding mother the nipple is inverted and slit like ‫ﻣﺜﻞ اﻟﺸﻖ‬wht is the mostlikely dx?
Duct ectasia ✅ Breast Ca
Other options ((Mammary duct ectasia occurs when a milk duct beneath the nipple widens,
becoming blocked or clogged with a sticky substance and inflamed))

🍓 Which Immunoglobulins that mother give to child? I think in breast feedin

A. IgG. B. IgM. C. IgA✅
- breastfeeding counseling is best done a. before conceiving b. 1st trimester d. 3rd c. Postpartum
…
In breast abscess The mother stop breastfeeding from the affected one or both ...? continue
feeding from the other breast✅✅
…
🌹 * Mother and sister had breast cancer what investigation she may need to
reassure: = . Bilateral mammography
....
🌹32yr patient Pregnant 33week lady r breast mobile mass 5x5
A. bilateral US✅✅ B. bilateral mammogram C. imaging after delivery
,,,,
40years old lady underwent mamogram and US Mamo showed fibroglandula tissue US shows
multiple cysts, BIRAD 3 What to do?
- core bx-exision bx -annual screening -short duration follow up? smth like that ✅
….
2 years old girl came with her mother with breast enlargement no pubic & axillary hair no acne or
adult oder
A. Precarious puberty B. central puberty C. premature adrenarche D. Early Breast development✅

1Ectopic pregnancy
🌹 Newly married women with no cycle for 2 months came with bleeding what is the source?
A.cervix B.ovary C.peritoneum D. tube> right ✅✅
…
- Case ectopic pregnancy ( history given) mother refusing OR hcg 3500 size of sac 3 non viable no
signs of rupture. what will u do =
a. explain that failure is high b. treat medically but sign consent c. laparoscopy d. laparotomy

1postmenopausal
🌹Pt with compressive fracture with Dexa scan result what’s the diagnosis?
A. Osteomalacia B. Osteoporosis C. Osteopenia D. paget
....
Female 41 yrs want to get pregnant, lab done (high LH, high FSH) More prone to what?
A- endometrial cancer B- osteoporosis✅ C- ovarian cancer
High FSH indicates ovarian failure > menopause > low estrogen > osteoporosis
….
dx of premenopausal syndrome :- . FSH
…
year old female on orall contaceptive pill for 12 years, developed gradual RUQ pain (not something
acute), CT was ordered, Hepatic adenoma 5 cm diagnosed, how to manage? A. stop OCP✅✅ B.
Excision C. left hepatectomy D. liver transplant (not sure, but something wrong)
orall ‫ وھﻲ ادوﯾﺔ‬liver ‫ ﻓﻛروا ﺑﺎﻟﺳﺑب اﻟﻲ طﻠﻊ ورم ﻓﻲ‬، ‫ ﻻ ﺗﻔﻛروا ﺑﻌﻼج اﻟورم اﻟﻲ ﻓﻲ اﻟﻛﺑد‬، ‫ﺑﻐض اﻟﻧظر ﻋن ﺑﺎﻗﻲ اﻻﺧﺗﯾﺎرات‬
. tumor ‫ ﻻزم ﺗوﻗﻔﮭﺎ ﻓورا وﻻ ﻋﺎد ﺗﺳﺗﺧدﻣﮭﺎ ﻻن ﺳﺑب ﻟﮭﺎ‬contaceptive pills
🌷
Pt postmenopausal want (hotmon replacment therapy ) = refuse to give✅
…
postmenabousal with urine incontince what is the first ttt?
_ excersice program for pelvic muscle for 8 week ✅
..
🍓Pathogenesis of postmenapausal hot flushes = cutaneous thermoregulators or low estrogen
…
🌹Postmenopausal complain of hot flashes what is hot flashes ? increase in core body temp due
to hormones 🌹
…
🍒Postmenopausal pt want hormon replacment thyrapy ? Rfuse 🍒
…
- Menopausal patient complaining of itching in valva and watery discharge, on examination
scratches and scaly ur diagnosis.= atrophic vaginitis ✅
…
Old lady with vaginal bleeding, uterus looks healthy, but the vulva looks shiny‫ﻓﺎﺗﺢ‬, bleeds with
touch? atrophic vaginitis
…
Pt with valvular lesion Histo > carcinoma in situ Mx ? Carcinoma in site > WLE or superficial
valvuctomy.
…
Valvular cancer most common type=scc🍒
…
valva “ abnormalities I forget but it’s either a mass or cell change “ + carcinoma in situ tx ?
a) Vulvctomy b) local superficial excision with margins ✅
…
Case of valvular cancer biopsy : Carcinoma in situ Management
A. superficial local excision✅ B. Vulvectomy
Treatment options for carcinoma in situ = Surgery, such as laser surgery, wide local excision, or a
skinning vulvectomy may be used, depending on the size and location of the cancer.
🍒🍒valvular cancer biopsy = Carcinoma in situ= its stage 0 = wide local excision🍒
…
🌹Pt with vulvar psoriasis.. how to confirm dx ..? Biopsy🌹
….
A picture of vuvalr rounded brown to black in color skin change that bleeds on trauma ? skin tag
…
🌹Atrophic vaginitis classic itching, dryness, bleeding in postmenopause , ttt ? Estrogen
…
A female patient present with heavy PV bleeding. Her bleeding is associated with pain and of large
volume. Upon vaginal examination, you noticed pooling of blood. Pregnancy test is negative, BP
low, Labs: RBC low, Hb low What is your next step in management?
A. Progesterone B. Conjugated estrogen C. Blood transfusion

🌹 Post-delivery 6 weeks. Exclusive breast feeding. Doesn’t want kids for at least 2 years. Which
contraceptive method?
- Depo provera injection✅ - Transdermal patch- _ Vaginl ring _ Oral combined
contraceptive
‫ ( = ر·ﻂ‬Dopo = )‫ ﺗﺤﻤﻞ‬ámÇ‫ ) دو· ـﻬﺎ )واﻟﺪە ﻣﺎﺗ‬.
🌹 Female want not conceive for 2 years : A. Patch B. Vaginal ring C. OCP D. Depovera✅
…..
55 year old F, postmenopausal bleeding, Hx of myomectomy, biopsy 20 mm endometrial
thickness. Ddx? A- Cancer✅✅ B- fibroid
‫ ﻻن ھذا دﻟﯾل ﻛﺑﯾر‬، ‫ ﯾﻌﻧﻲ ﻓﻲ ﻋﻣر اﻟﯾﺎس وﺟﺎھﺎ ﻧزﯾف ﻣن اﻟرﺣم ﺧﺎﻓوا وﺧﺎﺻﺔ ﻟو ﻛﺛﯾر‬postmenopausal ‫ اي اﺣد‬، ‫ﻋﻠﻰ طول ﻓﻛروا ﻓﻲ ﻛﺎﻧﺳﯾر‬
.‫ وھذا ﻛﻣﺎن ﯾﺧوﻓﻧﻲ ﻣن اﻧﮫ ﺳرطﺎن‬endometrial thickness ‫ ﺛﺎﻧﯾﺎ ھﻲ ﻋﻧدھﺎ ﻣن اﻻول‬، ‫ ﻟﯾس ﺷرط ﺑس اﺣﺗﻣﺎل ﻛﺑﯾر‬، ‫ﻋﻠﻰ وﺟود ﺳرطﺎن ﺑﺎﻟرﺣم‬
pt Hx breast cancer, on Tamoxifen, postmenopausal bleeding, best next step? Biopsy✅
... ...
pte with breast cancer and fibroid on tamoxfin develop vaginal bleeding US show fibroid 8cm
and hypoechogenic area. what is the diagnosis? endometrial cancer.✅
…
🌹Female on tamoxifen, Lead to what? Endometrial carcinoma🌹
…
🍒Strawberry cervix With post coital bleeding, whats the management and organism?
Trichomonase And management by metronidazole 🍒

🌹.Female with scanty vaginal bleeding she noticed that postcoital. what’s your action? A-Pelvicus
B-CBC C-assess the vagina and cervix ✅🌹

🌹45 years old female with postcoital bleeding what is the best initial step:
A. Inspect the vagina and cervix✅ B. Do vaginal ultrasound

🌹What is most likely to be indicative of a cervical source of bleeding? postcoital bleeding ✅🌹

🍓Most common site for postcoital bleeding =Uterine cervix

🌹A lady with postcoital bleeding takes a speculum exam which shows a fungating mass on the
cervix. What next? A. cone biopsy B. targeted biopsy C. Pap smear

🌹40 years old with post coital bleeding and intermenstrual bleeding She had 3 pap smears
positive and did a cystoscopy showed intraepithelial carcinoma ,What is the next step ?
A. MRI abdominal B. Cone C. LEEP D. Ct abdomen chest pelvis
…
Abnormal pap smear insignificant result with colposcopy, next? Cone biopsy
…
🌹29 years old complaining of urine leaks during coital and after urination What is diagnosis? A.
Urethral diverticulosis B. Urethral fistula C. Stress incontinence
.. .
🌹Case of women have dysuria and dyspareunia with normal urinalysis and no fever ? Urethral
diverticulum= Note: triad of dysuria, dyspareunia, urinary incontinence
…
🌹48 years old women with irregular menses, Abnormal uterine bleeding, they ask about best Tx:
Medroxyprogesterone
…
🌹 13 year old female presents with amenorrhea after menarche for 1 year, how
would you manage? A. OCP B. medroxyprogesterone

🌹Abnormal uterine bleeding with biopsy of emdometrial showing complexed endomertrial

hyperplasi in postmenopause . ask about treatment: hysterectomy 🌹
…
🌹 old with Endometrial biopsy shows hyperplasia with atypia what is the treatment: === Total
abdominal hysterectomy
…
🌹Abdominal hysterectomy complicated by upper abd bleeding what is the cause:
A. PE B. Splenic stenosis C. Liver hemangioma ✅
…
🌹Pt underwent total hysterectomy with bilateral oophorectomy what to give her:
A-Estrogen patch ✅ B-lUD C-Progesterone and estrogen "two choices with diff types
Answer is Estrogen only
…
🌹60 y/o female patients complain of scanty bleeding only the little on her pads. What is the
source? A. Lower genital tract B. Uterus C. Ovarian D. Fallopian tube
..
🌹Pt delivered her baby and she doesn’t want to get pregnant for 2 years, medically free and no
hx of any illness or complication , most appropriate method?
A. OCP B. Patches C. injection D.vaginal ring
….
🌹Female came with symptoms of vaginal atrophy what is the Tx =
A. Estrogen Topical ✅B. progesterone
…

1Endometriosis
🌹30 y/o female patient complains of dyspareunia, dyspnoea and other symptoms.., US finding
bilateral ovarian mass with classification. What is management?
A. D AND C B. Laparoscopic C. Laboratory
…
🌹PV bleeding in old female pt, where’s the bleeding from?
A. uterus ✅ B.Fallopian tubes C.ovaries D.lower genital tract
…
🌹women completed her family, previous right oophorectomy for endometrioma, presented with
left ovary endometrioma, management? oophorectomy with ablation of other lesions 🌹
…
US of uterus showed ground glass appearance ( Endometrioma ) , what it causes?infertility

🌹pt with dysmenorrhea what is the cause : Endometriosis ✅

Classic Triad of Endometriosis Dysmenorrhea 2)Dyspareunia 3)Dyschezia

🌹post menopausal women with abnormal uterine bleeding, what to do: Endometrial biopsy ✔
Postmenopausal bleeding is endometrial cancer until proven otherwise
....
🌹endometrial hyperplasia : Verbal consent ✔
..
🌹 Women obese , PCOS ,, regular period with history of dysmenorrhea that not relieved by
analgesic .. normal pelvic abdomen examination no adenexal masses What is the diagnosis ? A.
Endometrial hyperplasia B. Endometriosis
🌷 Patient k/c of endometriosis, she was on progesterone for withdraw blood, now the patient
has stopped the drug, she’s at what risk?. Endometrial cancer🌷✅
..
🌹 Symptoms of endometriosis management? - laparoscopic exploration🌹
..
🌹endometriosis =A. Laparoscopic Myomectomy✅ B. Abdominal Myomectomy
..
Endometriosis ask about risk of malignancy ? A. No risk B.Epithelial ovarian tumor ✅
..
🌹Very heavy periods and infertility.= Endometriosis✅🌹 = Treat by> laproscopy🌹
..
🌹.40years old women have hx of dysmenorrhea and excess bleeding per
examine...abdomen soft and not palpable uterus ..= A. adenomysis B. Endometriosis✅
…
🌹60 y.o with Abnormal uterine bleeding, hx of myomectomy 12 years ago, 2 D&C, abdomen
bulky and tender, no adnexal mass, with US picture “18 mm thickness” , Dx?
A. Endometriosis B. Adenomyosis C. Endometrial CA bez she is post menopuse
…
🌹64 Years postmenopausal bleeding since 5 days HB 11 Pt ,PTTnormal,tvus revealed normal
except thickness 13mm, Best management?
A. progesterone B. Endometrial biopsy. C.Hysterectomy D.reassure
.....
🌹Postmenopausal women , last menses 12 years, presented with vaginal bleeding , suspected to
be due to intrauterine polyps On US: thickness 13 mm (no mention of polyps)What is the
appropriate management?
A.endometrial ablation B. laparoscopic hysterectomy ✅ C.vaginal hysterectomy
D.polypectomy Answer is B
……
🌹Long senario Postmenopausal with endometrial thickness pic :what the best approprie next step
A. MRI pelvic B. Endometrial biopsy
…
What cause severe dysmenorrhea = endometriosis ✅
…
🌹 Post menopausal women with a history of fibroid "certain size" increased ,what's the diagnosis
''endometrium were 5mm pt on tamoxifen"
A. Leiomyosarcoma ✅ B. Endometrial cancer C. Adenomyosis
…
🌹Female presented with recurrent vaginal bleeding, she has hx of c/s I (week/month, forgot) ago
Temp 38 other lab within
normal ,What suspect? A. mastitis B. endometritis ✅ C. retained fetal tissue D. wound infection
….
Female 28 y.o complaining of dysmenorrhea and dyspareuia pelvic ultrasound done and showes a
hypoechoic mass (ground glass) what statement is true?
A-highly malignant B-partner need to be treated C-antibiotes should be given
D-future fertility is a concern✅
…
🌹charestaritic of endometrial bleeding :- -heavy bleeding 🌹
…

1Cancer
🌹61 Y/O F ē Multi separated and bilateral ovary tumor
A. observe B. consult gynae oncology✅
…
🌹Pregnant came with multi small masses around areola nontender not erythematous not ass with
nipple discharge:
A. Lactiferous ducts✅ B. mordon disease C. fibrocystic breast
…
🌹Female nulliparity with Family history of thyroid cancer and she is taking progesterone to
control her cycle .. what risk factor of endometrial cancer ?
A. Nulliparity B. Progesterone C. FH of thyroid cancer
..
Old age lady in her 50s, US showed large Rt ovarian mass, measures 9x2. CA level 900 or 9000
(not sure but it was high). What you will do? A. Refer to Ob oncologist ✅ B. Do TAH-BSO
…
🌹 60 yo woman, has advanced epithelial ovarian cancer cell Treatment:
A. - surgery B. – chemotherapy C. - surgery followed by radio D. Surgery followed by chemo✅
…
🌹 Case about Ovarian cancer , Ask abot management :-
A. chemo B.radio C. surgical and chemo ✅ D.surgical and radio
..
🌹Cancer in the labia majora >>>.SCC🌹
…
🌹Pt with malignant phylloid tumor what is next? A.Contrast ct of chest B.pet scan
…
🌹Case of malignant Phylloid tumor Most important next step? CT
///
🌹Healthy Women came to doctor for screen cancer bcs her family have history of ovarian and
breast cancer is the best investigations ?
A.mammography B. BRCA gene ✅ C.self examination breast
….
59 years old woman who has abnormal uterine bleeding, last peroid 12 years ago, on
examinatioin pale & dry vagina and loss of rugae, uterus normal size with no masses. ultrasound
show endometrial thickness of 15 mm otherwise nothing to report .what's the next step :
’æ‫ﺤﺘﺎج ﻋﻴﻨﺔ ﻟﻠﻤﺨﺘ‬Œ‫ﻃﺎن ﻓ‬ä ‫ﺔ‬Ž‫اﺣﺘﻤﺎل ¼ﺪا‬
a-pelvic mri B-endometrial sampling ✅ c-exploratory laparotomy
…
🌹 urgent deliver on 27weeks GA. infant is tachypneic and retracted chest wall. What diagnosis?
1_ Transient tachypnoea. 2_ preterm apnoea. 3_Respiratory distress syndrome✅.
…
🌹 Risk factor for endometria cancer = Nullipara✅🌹
…
🌹A question about how to differentiate normal and malignant ovarian cysts in US?
A. Hypoechoic ✅✅🌹 B. Bilateral C.Septated cyst
…
🌹Ovarian cyst > features in us i think > hypoechoic = malignant cyst 🌹
..
Risk of ovarian cancer ? Infertility/low number of pregnancies + Early menarche and late
menopause
…
🌹65 years old femal presented with vaginal bleeding and abd pain Ca125 very high what u wll
do?- biobsy ✅🌹
…
🌹Woman with abdominal discomfort and bloating, initial imaging shows ovarian mass. CT shows
features consistent with ovarian cancer which of the following is a marker of that? A. Ca125
..
🌹Elderly with high Ca 125 what will you do? Refer to gyn oncologist
…
🌹 pleural effusion , ascites , and overin tumer? Refer for gynee oncology ✅🌹
‫ﻄﺔ‬Œ‫ﺴ‬ç ‫ ﻣﻌﻠﻮﻣﺔ‬:
overin tumer .‫ ؟؟ اﻟﺟواب‬pleural effusion ‫ و‬ascites ‫ اﻟﻲ ﯾﺳﺑب‬tumor ‫ﻣﺎھو‬

🍒🌹Woman comes with postcoital bleeding and on exam you see the above cervical mass. What
to do? Excision in the clinic🍒🍒
..
🌹Pregnant lady 3-4 cm firm small mass Since 4 month mild pain but not cancerous symptoms or
increase in size what most appropriate management :
A. FNA ✅ B. Reassure and follow up after delivery If polyp B
…
🌹Patient presenting with vulvar lesion. On examination the lesion is 0.5 cm localized.
Investigation shows intraepithelial neoplasia in situ. How would you treat the lesion?
A. Vulvectomy B. Radio/chemo C. Cauterization D. Local superficial excision✅

🍓 Management of vulvar intraepithelial carcinoma in situ:

A. Vulvectomy B. Chemoreduction C. Superficial local excision✅✅
......
🍓young female has smooth benign+ ( round shape ) mass contains (viscous mucus) on
examination it os dome shape translucent In incision viscous mucus appeared: A. Molluscum
contagiosum B. Vulvar mucinous cyst✅
.............
🌹Female had a lichen planus in her vulvular = Squamous carcinoma🌹
…
🍓 Megis syndrome the name of the tumor that cause it = SeX stromal
‫ﻂ =ﻣ†ﺠﺲ‬œ‫ ر‬megis = ‫ = ﻣﻘﺎﺳﻚ‬x ‫ او‬smal
….
🍓 Highest diagnostic yield in cervical cancer? A-Pap smear B-Colposcopy C-Cervical biopsy ✅
…
🌹ROM , what Increases that? Smoking

1Pregnancy disease
🌹pregnant with jaundice and itching more details most likely dx ?
A. budd chiari syndrome B. pregnancy cholelethiasis ✅
…
🌹Pregnant lady routinly check mid systolic murmur and asymptomatic dx
A. AS. B. Physiological pregnancy murmur✅
…
🌹Pregnant come for her natal care there is mid systolic murmur radiate to carotid
with displaced apex no diastolic murmur what is the cause of murmur?
A. AS✅ B. MS C. murmur of pregnancy
.......
🌹Most common cause of morbidity in multiple gestation
A. prematurit✅ B. trauma
….
🌹Due to what we use forceps in delivery?
A.Mitral stenosis ✅ ‫ ﺻﺤﺔ ﻗﻠﺒﻬﺎ‬ë‫ﻐﺎﻫﺎ ﺗﺘﺎﺧﺮ او ﺗﺠﻬﺪ ﻧﻔﺴﻬﺎ ¼ﺎﻟﻮﻻدة ﻻن ﺧﻄﺮررر ﻋ‬Ç‫ ﻣﺎﻧ‬،
B.asthma C.prolonged first stage D.prolonged second stage
…
🍓 Pregnant women with brown spot ? A. melasma B.chloasma ✅
…

…
-dizygotic means:
A. Monochorionic & monoamniotic with same gender
B. Monochorionic & Diamniotic with sesame gender
C. Dichorionic & Diamniotic regardless gender ✅

…
🍓 Pregnant woman with right abdominal pain , doctor rolled out obstetric condition ,diagnoses?
a- Cholecystitis b- Appendicitis✅✅
….
🍓 Women with midline bulge known as multiparity
1- diverticula rect✅ 2- weakness in transveres muscle 3- incisional herni
Recti divarication occurs when the two sides of your recti (or rectus abdominus) muscle separate
in pregnancy. This separation is a normal occurrence of pregnancy which is only a 'problem' if the
muscles do not go back to their correct position.
…
🌹Multiparous presented with bulging mass since 3 yrs Increase with muscle contraction and
leaning forward: Recti divarication
…
🌹 Ig can cross placenta? IgG🌹
. 🎑 .‫ ﻣﻛﺎن ﺟﻣﯾل‬G ‫ وﺧﺎﺻﺔ وﻗت اﻟﺷﺗﺎء ﻧﺣﺗﺎج ھذا اﻟﺣرف ال‬G . ‫ = ﻣﻛﺎن = ھذا ﻣﻛﺎن ﺟﻣﯾل‬place ‫رﺑط‬
….
🌹10 weeks pregnant come with weight loss 2 kg +fatigue + appetite + vomiting after each meal
what is the. cause of these symptoms?hyperemesis gravidarum🌹
…
🌹 Os closed, US empty sac, she mentioned no passage of tissue ? Anembryonic pregnancy
‫ ﻣﻦ اﺳﻤﻬﺎ‬An _ embryo ln m Ô
m “ ‫ ﺟﻨ‬lm‫ ﻣﺎ‬ìm‫ﻌ‬Ž uterus = Empty sac 🌹
n n
..
🌹OS closed, US empty sac, she mentioned no passage of tissue ?
A- follow up 4 weeks ✅ B- admitted and observe C- terminate pregnancy D- CS
…
🌹Pt 13 weeks pregnancy came to the Er complaining of bleeding internal os closed Pic of empty
sac A. come after 4 weeks for follow up B. admission for observation. C. induce labor.
…== 🌹 Same scenario and what is the diagnosis = Anemberionic sac
….
Patient presented with jaundice, labs showed high direct bilirubinemia (obstructive jaundice),
what’s the most likely diagnoses: = Choledochal cyst
all other choices were non obstructive jaundice causes
….
About 28 years old, came to ER with heavy vaginal bleeding, she is nulliparous,
pregnancy test negative, no pain, regular cycle, but always with menorrhagia, how to stop the
bleeding now ?
A- give estrogen (just estrogen, no OCP)✅ B- give progesterone C- give GnRH
D- inserted levenogestrel IUD
(Acute AUB in hemodynamically stable patient → high-dose conjugated estrogen)
#heavy vaginal bleeding= To stop bleeding from menstural give Estrogen alone .
..
1/one of this is confirmatory for pregnancy=
a.uterus just above symphysis pubis ✅✅ b.uterus between symphysis pubis and umblicus
c.uterus at the umblicus
...... . .. . .

Old lady multipara with urine inconsistency during laugh and cough and sneeze first line
treatment? A-surgery B-kegal exercise✅ C-medical
‫ﺎﺿﺔ ﻧﻘﻮي ﻋﻀﻼت اﻟﺮﺣﻢ‬É‫ء ر‬Ö × µ
n ‫ ﻃﻮل اﻓﻀﻞ‬ë‫ﺴ¾ﺐ ﻛﺤﺔ او ﻋﻄﺲ ﻋ‬ç Ên ‫ﺎ‬Ž ‫اي ﻣﺮة ﺳﻠﺴﻞ ﻟﻠﺒﻮل‬
…
🌹Female, multipara, complaining of 3 years history of urinary leak 4 times/day , and urgency 7-
8/day, affecting her life she avoided travel and she use pad for it, on examination marked pelvic
muscle weakness. What is the best initial management?
A.Anticholinergic drugs for 6 weeks B.Pelvic m exercise and behavioral bladder therapy for 6 w ✅
C.Cystoscopy. D.Urine culture. and ABx indicated.
….
g2 P1+0 , 10 weeks pregnant has gallbladder stone years on medication and now she is having
pain when to do cholecystectomy ? -2nd trimester ✅
..
pregnant lady with recurrent pain known case of gallstone what wll do? belter laparoscopy in 2nd
trimester.

Pregnant in 9 week with colicystitis when should colicysectomy preform?

A-immediately B-delay to second trimester ✅✅ C-delay to third trimester D-delay to after
delivery
…
Biliary colic symptomatic in pregnant women in 20 weeks What the management ?
a) Conservative ✅ b) Lap chole
..
🌹After doing salpengotomy for ectopic, what is next ? Every weak bhcg 🌹
…

🍓Pt did to her medo-lat epistemology and ask why they did that : =
prevent 4th degree perineum tear
…..
🍓Which position cause 3 + 4 degree tear? Occipto-posterior position
…
🌹Fourth-degree vaginal tears = rectal mucosa
…
🌹 Mediolateral episiotomy after some hours patient developed swelling ,redness in site of
episiotomy, what do? A. open suture B. dressing In choices i think C.. sitz path and dressing
…
🌹 Laceration after labour risk of bleeding mx? A_ Manual exploration B. prostaglandin f2
…..
🍓Female with biliary colic attack she is 20 weeks pregenant when to do surgery:
Lap cole now= First attack > Consevitiv. Recurrence > Lap 2nd trimester
........
🍓Pregnant with dm what is the best to know the prognosis :
A. HA1C✅ B. random glucose readings C. nucal translucency

🌹 pregnancy and pigmentation with pic,dx? Choalasma= ´` _ ‫ﻮﻻ =ﻟﻮﻧﻪ ﺑ‬²‫ ﻛﻮﻻ ﺳﺎﻣﺎ =•ﺎ‬.

🌹Female had D&C and turned out over the D and C was done on deeper layers she didn't have
bleeding for menses, which layer is damaged: Basalis ✅
‫ =ر·ﻂ‬basalis = absent menesis
🍓Patient with a history of multiple D&C for recurrent miscarriages , she can't get
pregnant, what is the endometrial layer removed? Basalis
🌹30y old woman Hx of more abortion more than 3...in 9__12 week most common cause ? A.
Anatomic B. Immunological
IN CASE OF ANATOMICAL
🍒Arcuate uterus = causes miscarriage in the second trimester
🍒Septate uterus =causes miscarriage in first trimester
....
🍒 Female patient was planned to do D&C and instead of taking the patient to the
room she was taken to the room of hysterectomy and hysterectomy was done by mistake what
should you do? Tell the patient✅🍒
…
..

1Pregnancy hypertension (HTN)

🌹Female 36 year , pregnant 15w GA complaining of headache, blurred vision since 2 weeks ago
,with hypertension , what is the diagnosis?
A. primary HTN. B. pregnancy induced HTN. C. white coat syndrome. D. Eclampsia.
….

🌹Pt in 22 wk pregnancy with HTN, no protein in urine, start which medication:

A. methyldopa B. nifedipine C. hydralazine D. labetalol
..
🌹management of chronic hypertension in pregnancy > Methyldopa🌹
🌹 hydralazine and labetalol for severe HTN, because they can be given IV 🌹
….
🍓Pregnant 37 week with BP 160/110 every thing else was normal
Her BP during pregnancy was 120/90 = A. eclampsia B. gestational htn✅ ✅
…
🌹pregnant with high blood pressure in 15 weeks? Essential htn ( ‫ع‬r‫ اﺳﺒ‬٢٠ ‫🌹)اﻗﻞ ﻣﻦ‬
…
‫ ﻣﻌﻧﺎھﺎ‬20 ‫ اذا اﻟﺿﻐط ﺟﺎء ﺑﻌد اﻻﺳﺑوع‬.. ‫طﯾب ﻣﺗﻰ اﻗول ھذا اﻟﺿﻐط ﺟﺎء ﺑﺳﺑب اﻟﺣﻣل او ھﻲ ﻣﺻﺎﺑﺔ ﺑﺎﻟﺿﻐط ﻣن اﻻﺳﺎس‬
Gestational Hypertension‫ ھذا ﯾﺳﻣﻰ ب‬20 ‫ھذا اﻣﺎ اذا ﺟﺎء ﻗﺑل اﻻﺳﺑوع‬
🍓Pregnant 15 week have BP 170/100 what is the cause = essential HTN ✅
…
🍓wonen with htn what do you expect the complications? A. IUGR✅ B. Abnormal placental lining

🌹 36 y.o , pregnant 15 wks , with htn 180/110 no proteinuria ?

A. preeclampsia B. gestational HTN C. Essential HTN Approved✅
🍓Case of pt all things are normal and now in week 39 with HTN all the next visit is normal what is
dx :
A. Eclamsia B. preeclampsia C. chronic Htn D. superimposed HTN✅✅ Its Fall in in blood pressure
that occure in the First trimester secondary to peripheral vsodalation.
…
primigravida at 32 weeks GA with BP of 150/90 mmHg. There is edema of hands and legs. What to
do?A. Diuretics ‫ اﻟﺤﻮاﻣﻞ‬ë‫ع ﻋ‬r‫ ﻣﻤﻨ‬B. Tabs Labetalol✅ ‫ ﻋﺸﺎن اﻟﻀﻐﻂ‬C. Continued evaluation
….
🌹Diabetic mother came at 10 weeks what test will tell u the risk of chromosomal anomalies?
A. glycated hb B. Michal translucency
‫ وﻫﺬا اﻟﺼﺢ‬، ‫ ﺳﺎ¼ﻘﺎ ﺣﻠﻴﻨﺎ اﻟﺴﺆوال ﻫﺬا ﺧﻄﺎ‬.
....

🍒Pregnant has T2DM and HTN on ACEI, her HBA1c is 8, wants to get pregnant, best next step? .
ACEI will Cause malformation, first defer pregnancy to control the blood sugar
…
🍒 skin pigmentation over back of neck and axillary region in female= Acanthosis nigrican
..
Pregnant and diabetes and hypoglycemic in ER and has to given glucose what the route that will
give her and don’t harm the baby ‫ ﺗﺎﺧﺬ ﺟﻠﻮﻛﻮز ا¼ﺶ أأﻣﻦ ﻃ¸„ﻘﺔ ﺗﺎﺧﺬ ﻓﻴﻬﺎ‬Á_À‫ﻌ _ `´ ﺣﺎﻣﻞ وﻋﻨﺪ˜ﺎ اﻧﺨﻔﺎض •ﺎﻟﺴﻜﺮ وﺗ‬‰
_ h ‫اﻟﺠﻠﻮﻛﻮز •ﺪون ﻣﺎ ﺗﺎذي اﻟﺠﻨ‬
Ç
A.Nasogastric B.Orogastric C. Peripheral venous ✅ D.Central venous
….
Pregnant lady with HTN (controlled) DM uncontrolled What do u suspect in the fetus? shoulder
dystocia 🍒
…
🌹Safe in pregnancy with DM?Insulin🌹
….
🌹10 week pregnant women with repeated vomiting what you will find in urine ? Ketones 🌹
…
🍓Pregnant lady with one abnormal GTT reading (after 1 hr)
A. repeat GTT✅✅ B. Lifestyle modification C. Measure hg A1c
….
🌹 Patient diabetic and pregnant what's the most useful test that will determine
prognosis for the baby? A. OGTT B. fasting blood glucose C. glycosylated hemoglobin
…
🌹Pt 39 years old new married have dm and htn she want to pregnant HbAc 8 on ACEI, BP was
high, what to do? A. Increase dose of ACEI B. Controlled dm✅
…
Pregnant, C/O vomiting multiple times, dry mouth with white plaque “ I’m not
sure”, decreased skin turgor, urinalysis ordered, what finding in UA will confirm the diagnosis?
A. Leukocyte B. Proteins C. Ketones D. Glucose
...

1postpartum hypertension(PPH)
🌹after delivery and complete placenta delivery:
A- Uterus massage.✅✅(first do this) B- 20-unit oxytocin
…
🍓32 years old female amenorrhea for months , FSH and LH were high She is risk of what : A.
osteoporosis ✅ B. endometrial cancer C. ovarian cancer

🍒Pt on deliver and finished and placenta still inside and full description of Postpartum
hemorrhage and asked about Primary and 2ndry ! =
 ‫ ﺳﺎﻋﺔ ﻣن ﯾوم ﻣﺎوﻟدت ھذا‬٢٤ ‫ ﻟو ﻧزﯾف ﻛﺎن ﻗﺑل‬، ‫ اھم ﺷﻲء ھو اﻟوﻗت‬scondry ‫وﻻ‬primary ‫اول ﺷﻲء ﻋﺷﺎن ﻧﺣدد ھل ھو‬
scondry‫ ﺳﺎﻋﺔ ھذا ﻧﺳﻣﯾﮫ‬٢٤ ‫ وﻟو اﻟﻧزﯾف ﺳﺎر ﺑﻌد‬primary ‫ﻧﺳﻣﯾﮫ‬
What are the 4 most common causes of postpartum hemorrhage? *"four Ts"
are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy,
commonly referred to as the "four Ts":🍒
If the blood loss occurs in the first 24 hours following delivery, this is termed primary postpartum
haemorrhage. Secondary postpartum haemorrhage refers to excessive vaginal bleeding between
24 hours and six weeks following childbirth
.....

🌹Patient has postpartum hemohhrage , 800 ml with retained placenta. What is type of PPH ?
1ry > FIRST 24 HR ✅
🍒recurrent postpartum haemorrhage in all her pregnancies, asking how to prevent it this time ==
reduce maternal stress and labor duration 🍒
🌹 PPH after 4 hrs of delivery what type of pph= A. Primary ✅ B. Secondary

🍓Postpartum hemorrhage treatment: = Oxytocin🍓

💐Postpartum bleeding after vaginal delivery due to macrosomic baby

A. Oxytocin ✅💐 B. Ergometrine C. Carboprost

highest rate successful drug used in PPH ? A. Oxytocin B. carboprost C. misoprostol

....
Most common drugs used to treat PPH after Uterine atony ? A. Oxytocin
..
🌹 pregant lady in labor with active regular contractions every 3 mins and cervix dilated 5 cm.
After 4 hrs still the same, and CTG shows grade 1 heart activity. What will u do? Oxytocin🌹
…
🍓PPH not responding to oxytocin and massage what you will do next :
A. B lynch B. Hysterectomy C. Uterine Vessel ligations✅ D. Angoi embolization
..........
🌹utrine atony, thru did message and oxytocin did not stop what to do (Primary post partum
haemorrhage) = A - lynch sutures ✅B - hysterectomy C - arterial embolization
The B-Lynch suture or B-Lynch procedure is a form of compression suture used in obstetrics. It is
used to mechanically compress an atonic uterus in the face of severe postpartum hemorrhage. ...
It can stop postpartum hemorrhage without the need for pelvic surgery and potentially preserving
fertility.
Postpartum hemorrhage is defined as a blood loss greater than 500 mL during vaginal delivery or greater than 1 L during
cesarean section. The most common cause is uterine atony (75%-80% of cases). Uterine atony is caused by
overdistention of the uterus (as a result of multiple gestation, Treat with a dilute oxytocin infusion, and use bimanual
compression to massage the uterus while the oxytocin infusion is running. If this approach fails, use ergonovine ،If these
strategies also fail, the patient may need a hysterectomy; ligation of the uterine vessels can be attempted if the patient
wants to retain fertility

🌹 overall deaths percentage due to post part hemorrhage: 25%🌹

🌹PPH with asthma Contraindicantion medication == carpoprost 🌹
🌹PPH how to prevent it ?
A. Manual extraction placenta B. Wait spontenus C. Fundus massage✅
..

1polycystic ovary syndrome

🌹 Irregular periods Hairstism increase LH and normal FSH increase testosterone
Next ?. Glucose tolerance test and lipid profile
..
🍓px presented with infrequent menses, hairiness, obese, Infertility Diagnosis?
B. Cushing's disease С. РСOS✅✅

🌹 Pt with polycystic ovary syndrome Regarding investigations what you expect ?

A. High TSH > Hypothyroidism B. FSH to LH ratio 1:3 > right✅
C. Low testosterone > Should be High D. Decrease androgen activity > Should be High
…
🌹simple test for turner pt with amenorrhea?? FSH /LH
…
🌹45 yrs female, her last pregnancy was 15 years ago, she came with Hx of 7 months amenorrhea,
pregnancy test was -ve. She wants to get pregnant, what is the most appropriate inv. to do:
A. Endometrial sample B. FSH and LH levels✅ C. TSH levels D. Hysterosalpingography
….
she complain of infertility and US show dmed multiple small cyst on the peripheries of the
ovaries ==polycystic ovarian syndrome.
..... ....... .....
30 yrs Female with polycystic ovary obese comes to you she doesn't want to get pregnant what is
action=A.give metformin B.progesterone only bills C.combined estrogen & progesterone✅
‫ ﯾﻌﻧﻲ ﻣﺗﻌدد ﻓﯾﺣﺗﺎح ھرﻣون ﻣﺗﻌدد وﻟﯾس ھرﻣون واﺣد وھو اﻻﺳﺗروﺟﯾن واﻟﺑروﺟﯾﺳﺗرون‬poly ‫رﺑط زﯾﺎدة = ﻣن اﺳﻣﮭﺎ‬
..
Polycystic ovary syndrome, what blood test for hirsutism?
A- Testosterone✅✅ B-progesterone C- ACTH
.🌷Polycystic ovary ‫ ھو اﻟﻣﺳؤول ﻋن ظﮭور اﻟﺷﻌر‬Testosterone ‫ﻣن اﺳﻣﮭﺎ ﻗﺎﻟﻛم ﻋﻧظﮭﺎ ﺷﻌر ﻛﺛﯾر ﯾﻌﻧﻲ ھرﻣون‬
…
🌹polycystic ovary syndrome does not want to get pregnant what to give her? Ocp🌹( estrogen
and progesteon)
..
🍒 polycystic ovarian case, asking about the diagnosis=Stein leventhal syndrome🍒
‫ ﻟﻞ‬Ên m ‫ ﻫﺬا اﻻﺳﻢ اﻟﺜﺎ‬PCO .
Stein-Leventhal syndrome, also called polycystic ovary syndrome
..
🍒Ultrasound finding ( which was provided) renal with multiple nodules?
Polycystic kidney disease
..
40 years old women with BMI 32 with amenorrhea. She has two children and her partner had
vasectomy 5 years ago. An US scan is performed, which shows with endometrial thickness 6 mm
ovaries have polycystic appearance. What would be the recommended management?
A-endometrial biopsy B-induction of 3 monthly withdrawal bleeds with progesterone ✅
C-metformin twice daily D-ovulation induction with clomiphene citrate
…
🌹 male his sister has adult polycystic kidney asking about screening for him
B. Ultrasound abd ✅C. CT abdomen
..
what is the action of metformin in treatment of polycystic ovarian syndrome:-reduce insulin
resistance ✅
..
🌹PCOS wants to become pregnancy, What to give: clomiphene
..
🌹PCO .. cause of endometrial thickness?Unopposed estrogen 🌹
..
pt has irregular menses with acne and hirstuism what is the cause? – PCOS ✅
..
Patient with PCOS ( poly cystic ovary ) wants to get pregnant, how to manage her?
A-OCPs ‫ رﻛﺰوا ¼ﺎﻟﺴﺆال‬، ‫ﺪ ان ﺗﺤﻤﻞ‬Éö‫ﻫﺬا ﻟﻮ ﻗﺎل ))ﻻﺗ‬
B-Metformin, weight loss, and Danazol C-Metformin, weight loss, and Clomiphene ✅✅

🌹PCOS ( poly cystic ovary ) wants to get pregnant, treat by Metformin, weight loss, and
Clomiphene 🌹
🌹PCOS ( poly cystic ovary ) not want to get pregnant = OCP ( esteogen and progestron )
…
🌹PCOS symptoms what to test for? glucose and lipid profile🌹
..
🌹pt with irregular menses and acne and hair in face her wt 60kg:Pcos🌹
..
🌹A women in reproductive years , complains of infertility, hirsutism and acne . most probable
diagnosis : A. PCOS ✅ B. asherman syndrome
..
🌹17 yrs female, no menstruation , high testosterone , Normal breast development
coarse pubic hair
A. Mayer Rokitansky Kuster Hauser syndrome B. complete androgen insensitivity ✅
C. congenital hypothyroidism
.....

1Adenomyosis
🍓 px presents with heavy menstrual bleeding with clots. Para 5 . Has had previous myomectomy.
On abdominal exami nation, uterus not palpable. On pelvi examination, uterus is bulky. Diagnosis?
A. Endometriosis B. Leiomyoma C. Adenomyosis✅✅ D. Endometrial cancer

Adenomyosis is the invasion of endometrial glands into the myometrium. This usually occurs in
women between the ages of 35 and 50. Risk factors for adenomyosis are endometriosis and
uterine fibroids. It presents with dysmenorrhea + menorrhagia.
Adenomyosis is a clinical diagnosis. On physical examination the uterus is large,
globular, and boggy. MRI is the most accurate test. Hysterectomy is the only definitive
treatment.
.........

🍓Pt with heavy bleeding and history of uterine surgery utrus is bulky= Adenomiosis

🌹42 years with 2ndry dysmenorrhea and heavy menses, on pv u found symmetrical uterine
enlargement. = adenomyosis🌹

🌹Pregnant with hx of myomectomy Came with lower abd pain and tenderness and bulky uterus
on exam What is the most likely the cause?
A. fibriod B.adenomyosis ✅✅

🌹adenomyosis case of 42 y women, Sx : dysmenorrhea, menorrhagia, Clinically :

large uterus best investigation = 1) MRI
.....
🌹55 years old come with heavy painful menstrual bleeding in each cycle With previous hx of
myomectomy 12 y ago , on examination : symmetrical uterus no other signs no US finding Most
likely dx : A. endometrial hypertrophy B. uterine fibroid C. endometriosis D. adenomyosis
…
🌹 dysmenorrhea + menorrhagia + O/E tender and large uterus .what's the dx?
A. Leiomyoma B. Endometriosis c-: Adenomyosis
.....
🌹40years old women have hx of dysmenorrhea and excess bleeding per examine...abdomen
tender and bulky uterus .. A. adenomysis✅ B. endometriosis
…..
OB case. Placenta implanted deep into uterine wall. Diagnosis?
- Placent' accret' (superfici'l myometrium)
- Placenta increta (deep myometrium)✅
- Plqcenta percreta (serosa)
….
🌹 case of a previous surgery pregnant the placenta into uterus.?
A. accreta B. increta ✅C. pancreta
….

1Molar pregnancy
pt with choriocarcinoma (scenario) : having uterus size more than GA+ hemoptysis. Next?
:A-Biopsy the mass B-admit for D&E✅ C-admit for staging and chemo D-admit for hysterectomy
..
🌹case of Choriocarcinoma with very very very high bhcg with hemoptysis ask about first thing to
do ? A.evacuation B.radio C.chemo D. chest x Ray ✅ (is common practice to use chest x-ray
for the detection of pulmonary metastasis.)
…
🌹Pregnant female 10 weeks came with vaginal blew + abdominal pain on examination gartational
age 11 -12 weeks , what is the cause ? Molar pregnant(*Bc fundal hight is more than the actual
geatational age)
🌹Pregnant woman develop SOB, x Ray shows snow appearances what is the dx? amniotic fluid
PE. == N.B:complication for molar pregnancy

🌹Complication of Dilatation and evacuation in Female underwent this procedure for

complete mole? A- Amniotic embolism✅ B- Hypothyroidism C- Pneumonia

🍒Case of snow storm appearance of uterus on ultrasound, council the patient on:
A- this condition is highly malignant✅🍒 B- risk of infertility must be addressed C- husband something..

🌹Snow storm appearance on US Dx? Complete hydatidiform mole .

A case pregnancy Present with severe vomiting and nausea , examination uterus large for the
pregnancy age . Very high HCG = hydatidiform mole

Us showing snowstorm appearance ..Bhcg = 80,000

A-complete hydatiforme mole ✅✅ ‫ ﻣﻜﺮر‬B--incomplete hydatiforme mole
Case of Molar pregnancy, asking about the Mx?
A- Medical B- Surgical C- evacuation✅‫ﻒ اﻟﺮﺣﻢ‬Œ‫ ﺗﻨﻈ‬ìn m ‫ﻌ‬Ž D- observation

🍓Pregnant came with abdominal pain i think 8 weeks , with heavy bleeding, pass some tissue, on
vaginal examination you find some part of tissue and cervical os opening, uterine examination was
bulke, abdominal was tender and more than 8 weeks, What is the diagnosis ?
A. complet B. incomplete C. thertined D. complete molar ✅✅ > hyperemesis gravidarum
..
🌹pregnant female 8 weeks, vaginal bleed and lose of pregnancy tissue and close cervical os?
Complete abortion.
......
🌹 Pregnant came to ER in her 18 weeks, comes with bleeding, cervix is open
and some products passed out? A- therenated B- missed C- Incomplete✅
…
🌹Photo showing US with molar pregnancy. what are the complications of
D and C = Uterine rupture
..
🌹Molar pregnancy case treated by dilatation and suction. What is the most
common early complication? A. Perforation B. pneumonia C. amniotic fluid embolism
…
common complication after uterine Evacuation? A. Perforation B. Infection C. Bleeding D. Abscess
..
🌹case of women with bilateral tubo-ovarian abscess
A. CT guided drainage B. Laparoscopic drain C. laparotomy D. antibiotics
…\
🌹Female with bilateral tubo ovarian abscess came with very sever abdominal
pain , what is appropriate mx :
A. IV ABX ✅initially B. CT guided draining C. laparotomy
….
🌹Vulvar mass on 5 o’clock location with itching and redness patient is feverish ask what’s the dx?
A. vulvar abscess B. bartholin duct abscess
…

37y, female, was breastfeeding 5 months go, now came as pregnant again but she didn’t now
when that happen What’s the benefits method to measure her gestational age ?
A. US at 18 months B.US at first trimester as soon as possible✅
…- Side effect of evacuation of pregnant women 14
a-Amniotic emboli b-Uterus perforation✅✅
‫ ﻟﻤﺎ اﺳﻮي‬ìn m ‫ﻌ‬Ž evacuation Ô
m “ ‫ﺼ‬Éö‫ﻒ ﻻزم ﻧﻜﻮن ﺣ‬Œ‫ﻒ ﻟﻠﺮﺣﻢ ﻻزم ﻟﻤﺎ ﻧﻤﺴﻚ اﻟﻤﻌﺪات ﺣﻘﺖ اﻟﺘﻨﻈ‬Œ‫ ﻫﻮ ﻣﺜﻞ ﺗﻨﻈ‬Â‫ا‬
n
‫ﻪ ﺛﻘﺐ‬Œ‫ﺤﺼﻞ ﻓ‬É‫ ـ ـﻎ اﻟﺮﺣﻢ ﻧﺠﺮﺣﻪ و‬Éö‫ﻪ اﺛﻨﺎء اﻟﺘﻔ‬Ç‫ﺘ‬ý‫ ﻻن اﻟﻤﻌﺪات ﺣﺎادة ف ﻧ‬، ‫ ﻻ ﻧﻌﻤﻞ ﺛﻘﺐ ¼ﺎﻟﺮﺣﻢ‬ìµ‫ﺎدة ﺣ‬É‫ ﻣﺎﻧﺪﺧﻞ ز‬،
. . . .. . .

1Placenta previa + increata

-Management of a case of placenta previa at 34w2d , presented with bleeding
*if Less than 34w:* mother and fetus are stable > admission & conservative.
*Scheduled CS:* if the mother stable *after fetal lung maturity at 36 weeks gestation.
....
case of placenta previa with painless mild bleeding at 34 w , next step ? admmision
..
🌹 Painless vaginal bleeding in a 34 weeks pregnant ( I think it’s placenta Previa case )
A_Admit her B. CS C. 6teroid
…
🌹 Pregnant 32 weeks GA presented with mild painless vaginal bleeding few hours ago (placenta
previa) appropriate management?
A. immediate c/s B. biophysical C. amniocentesis to assess fetal maturity D. expectant
management ✅
…
🌹Placenta in implanted in the uterine wall, what is that:
A. Placenta previa B. Placenta accrete C. Placenta increta ✅D. Placenta recreta
.....
🌹Placenta is implanted in the uterine wall, what is that:
A. Placenta previa B. Placenta accreta C. Placenta increta ✅D. Placenta recreta
Answer is: C if in the muscular layer; if not, accreta.
…

1placenta abruption
What are the signs & symptoms of placental abruption? ‫ﻞ ﻋﺎم‬Ë‫ﺸ‬Ê ‫˜ﺬە اﻻﻋﺮاض‬
_Vaginal bleeding (although about 20% of cases will have no bleeding)
_Uterine tenderness.
_Rapid contractions.
_Abdominal pain.
_Fetal heart rate abnormalities

🍓Pain+Bleeding = placenta Abrubtion

🍓Painless + Bleeding = Placenta praveia

🌹pt with painful bleeding and hx of smoking= Placental abruption .

🌹pregnant fall from stairs and she had severe pain minimal bleeding now she has
contractions every 10 minutes cervix was closed what she has?
A. vasa previa B. placenta abruption✅ C. placenta previa D. latent phase
.....
Placental abruption and fetal distress and ph 6 wt improve mortality now ?
A. mild hypothermia✅ B. IVF C. electrolytes
….
🌹painful vagnial bledding diagnosis ? Placental abruption ✅ B. Low lying Placenta C. Vasa Previa
. ‫ = ﯾﻌﻧﻲ ﺗﻣزق = ﯾﻛوون ﻣؤؤؤﻟم ﻻن ﺗﻣزق ﻓﯾﮭﺎ ﺗﻘطﯾﻊ واﻟم‬abruption = ‫ﻣن اﺳﻣﮭﺎ‬

….
🍓 Pregnant with DIC and placenta abruption with sever bleeding and pain what is the most
appropriate thing to do : A. give her Blood transfusions B. call multidisciplinary team✅✅

.....
🌹placental abruption: rapid response team and multidisciplinary

🍒 🍒What to do with a patient with placenta abruption with hypotension and vitally unstable?
Call rapid response team with multidisciplinary intervention...🍒

Severely hypotensive lady with abruption what to do to save her life:

A. Blood transfusion her. ✅ B.rESPONSE team. Answer is: A initially, definitive B

🌹Lady with placental abruption BP 84\40 HR140 with sever bleeding what to do?
A. multidisciplinary team and RRT B. 2 packs of FFP
C. admit to ICU D. there were no IVFs
…

🌹A primgravida (at 28 weeks?) and a heavy smoker presented with severe

vaginal bleeding and abdominal pain. Most likely cause is
A. Rupture of fetal artery B. Uterine rupture C. Vasa previa D. Placental abruption
…

37 years old pregnant female came with sever plasentia abruption +DIC+ Intrauterine fetal demise
Cx diltation 6cm What u should to do?
A)obsarvation B)augmentation of labur C)CS ✅ D)hestroctomy
D-Defer all vaccines
:‫ﻓﻲ ﺛﻼث ﺣﺎﻻت وھم‬CS ‫ ﻧﻠﺗﺟﺎ ﻟﻠﻘﯾﺻري‬plasentia abruption ‫ﻓﻲ ﺣﺎﻻت‬
1_contraindicantion to vaginal delivary
2_ unstable fetus
3_unstable mother ‫ ﻣﺴﺘﻘﺮ‬gh‫ﺣﺎﻟﺔ اﻻم ﺣﺮﺟﺔ وﻏ‬
fetus stable :‫ ﻓﻲ ﺣﺎﻟﺔ‬vaginal delivary ‫وﻧﻠﺗﺟﺎ ﻟﻠوﻻدة اﻟطﺑﯾﻌﻲ‬
 Cs‫ اذا‬. ‫ ﺣﺎﻟﺗﮭﺎ ﻏﯾر ﻣﺳﺗﻘرة‬DIC ‫وھﻧﺎ ﻣن اﻟﺳﯾﺎﻧرﯾوا اﻻم ﺣﺻل ﻟﮭﺎ‬
DIC = Disseminated intravascular coagulation.
How does placental abruption cause DIC? Because of this, most abruptions are caused by
bleeding from the arterial supply, not the venous supply. Production of thrombin via massive
bleeding causes the uterus to contract and leads to DIC. The accumulating blood pushes between
the layers of the decidua, pushing the uterine wall and placenta apart.
Disseminated intravascular coagulation (DIC) begins with excessive clotting. The excessive clotting
is usually stimulated by a substance that enters the blood as part of a disease (such as an infection
or certain cancers) or as a complication of childbirth, retention of a dead fetus, or surgery.
‫ = ﻣﻌﻧﺎھﺎ ﺣﺻل ﺧﻠل ﻣﺎ ﻓﻲ اﻟﺟﺳم ھذا اﻟﺧﻠل أدى اﻟﻰ ﺧروج ﻋواﻣل ﺗﺧﺛر اﻟدم ﺑﺷﻛل ﻛﺑﯾر ف‬DIC ‫اول ﺷﻲء ﺑﺷﻛل ﻣﺧﺗﺻر ﺟدا‬
‫ ﺗوﻓر‬. ‫ ﻣﺛل اﻟﺳﯾﻧﺎرﯾوا ھذا‬fetus death .‫ ﻣن اﻻﺳﺑﺎب اﻟﻲ ﺗؤدي اﻟﯾﮭﺎ‬، ‫ادت اﻟﻰ ﺣﺻول ﺗﺧﺛرات ﻓﻲ اﻣﺎﻛن ﻋدﯾدة ﻓﻲ اﻟﺷراﯾﯾن‬
.‫ ﻻن ﺣﺎﻟﺔ اﻻم ﻏﯾر ﻣﺳﺗﻘرة ﻓطﺑﻌﺎ‬، ‫ وﯾﺳﺎﻟوا ﻛﯾف ﻧطﻠﻊ اﻟﺟﻧﯾن ﻣﻧﮭﺎ‬DIC ‫اﻟﺟﻧﯾن ﻓﻲ ﺑطﻧﮭﺎ وﺣﺻل ﻟﮭﺎ‬

..
🌹pregnant unbooked present with painless vaginal bleeding .. fundal high 34 weeks what first
thing to do live far away and has difficulty in trasport?
‫·ﺔ ﻣﻮاﺻﻼت‬r‫" وﻋﻨﺪﻫﺎ ﺻﻌ‬m ‫ﺪ ﻋﻦ اﻟﻤﺴ!ﺸ‬Œ‫ﺸﺔ ¼ﻌ‬Ó‫ ﻋﺎ‬ÿ n
a) Admit to ward ✅✅
µ m
b) Us ‫ﺎﻧﺖ ﺗﻘﺪر‬i ‫ ﻟﻮ‬، "m ‫ ﻟﻠﻤﺴ!ﺸ‬$ m
n æ Œ‫ اﺣﻨﺎ ﻣﺎ اﺧ’ﻧﺎە ﻻن ﺗﻘﻮل ﻣﺎ ﺗﻘﺪر ﺗ‬، "‫ﺖ وﻣﺎﺗﻘﺪر ﺗﺮوح ﻟﻠﻤﺴ!ﺸ‬Œ‫ وﺗﺮﺟﻊ ﻟﻠﺒ‬، ‫ﺔ‬Ž‫ﺪا‬Ç‫ اﻟ‬ln ánŒ‫ﻄﻠﻊ ﻃﺒ‬Ž ‫ﻣﻤﻜﻦ‬
‫ﺪ ﻓﻨﻨﻮﻣﻬﺎ وﻧﺮاﻗﺐ ﺣﺎﻟﺘﻬﺎ وﻧﻌﻤﻞ ﻟﻬﺎ ﻓﺤﻮﺻﺎت اﻓﻀﻞ‬Œ‫ ¼ﻌ‬ÿ µ
n ‫ﺲ‬ç ، ‫ﺘﻔﻴﻨﺎ ¼ﺎﻻﻟ’اﺳﺎوﻧﺪ‬%‫ﻋﺎدي ﻛﻨﺎ ا‬
…
🌹Patient 34 GA, came after hx of fall at home with abdominal tenderness and noticed reduced
fetal movement, 4cm cervix and 80 effacement. Fetal heart rate 150, and moderate abnormal
utrine contractions every 3 to 4 minutes. Whats diagnosis?
A.Abruptio placentae B.Latent phase labor C.Vasa previa
…
🌹Pregnant with massive bleeding from abruptio placentae. Treatment to save her life?
A.admitted to ICU with obstetric team B.Admitted with different spacilized team
C. 2 peripheral IV cannula and blood transfusion ✅ ‫ﻒ ﺳﺎﻓﻴﻨﺞ‬‰‫ﻗﺎل ﻻ‬

1gyne
🌹Pt 23 marriage compline of suprapupic pain and red itchy vulva what the diagnosis
A. cystitis B. honeymoon syndrome✅
…
🌹Case of Meigs syndrome .asking the definitive test? A. Histopathology ✅B. Pelvic ultrasound

🌹Female diabetic hypertensive obese .. I think history suggested endometrial hyperplasia .. what
is the most appropriate thing to do to reach diagnosis ? A. Pelvic ultrasound B. Endometrial biopsy
….
🌹Pt nullipara had severe menorrhagia , Hb: 10 presented to ER what to give :
A. Medroxyprogesterone B. Mixed estrogen C. Blood transfusion
…
🌹 pt lower abdominal pain on right side mainly Ultrasound showed cyst in ovary 9×9 with
calcification?
A. methotrexate B. Dilatation and curettage C. open surgery or laparotomy ✅
🌹pt young age used cream on valva and developed itching =. allergic dermatitis
..
13 old female painless bleeding Once weakly? A-Reacurance (period)
…
🌹 17 year old female, medically free, gymnast in her class, developed breasts later and never
menstruated, on examination she is tanner stage 5 but no menstruation, diagnosis ?
A. hypothalamic hypogonadism B. imperforate hymen✅ C. gonadal agenesis
….
🌹pt with irregular menses LMP since 6week first test: Pregnancy test 🌹
🌹pt with irregular cycle, hx of amenorrhea for 3 month complain of vaginal spotting trying to
conceive for 3 years : A. Order pregnancy test ✔
…
🍓 Para 5 patient whose LMP was 7 months ago. Presented with desire to conceive Management?
A. Pregnancy test✅ B. Pelvic scan C. Endometrial biopsy D. Serum FSH and LH
…
🌹22 yr female, complaining lower abdominal pain during the first menstrual period and breast
tenderness related to menstruation. Physical examination normal. She wants to get pregnant in
the future which screening test she should do?
A. Breast US B. papanicolaou test C. HPV
…

9 months years older girl with asymmetrical breast enlargements with you will ask next?
A.ACTH level B.MRI brain C.CT D. Pelvic US ✅ ‫ ﻫﺬا ﺣﻞ ﺟﻠﻮري‬، ‫ﺪﻣﻦ اﻟﺤﻞ‬%‫ﻟﻢ ﻧﺘﺎ‬
….
💐6 year girl with vulvar itching and bleeding what you think == Itching, bleeding, offensive smell
>foreign body 🌹
….

🌹Urge incontinence principle management?

A_Medical B- Surgical C- Medical and surgical D- Bladder training and physio🌹
….
🌹Urge incontinence ttt? Kegel exercise
…
🌹Pt with leaks when sneeze, cough, laugh and leak with urge bathroom also, dx
A. Mixed incontinence
…
🌹 What prevents uterus from prolapse? A- Round B- broad C- uterosacral ligament✅
....
🌹While examining the knee, tibia Above/anterior to foment what ligament is injured?
A. Anterior B. posterior C. tibial,..
…
inhibition of which of the following is the primary action of oral contraceptives?
Suppressing the release of gonadotropins
…
🌹 pt with galactorrhea and irregular menses first test=. prolactine ✅✅🌹
…
13 years girl with galactorrhea , Which hormone or test u have to check:
A. FSH B. LH C. prolactin✅
…
🍒Female Case scenario of hyperprolactinemia Amenorrhea for months, breast milk
discharge...etc Lab
shows high prolactin. Next appropriate step is imaging of ?
A. Sella turcica MRI‫✅ و‬B. kidney
…
🍒Patient unable to conceive for 3 years, her periods are every 45 days. Patient is also complaining
of recurrent headaches for the last few months. Labs show elevated TSH and elevated Prolactin
levels. How would you manage the patient: A. Order MRI✅ B. Start Cabergoline C. Start Thyroxin
…

🍒Pt pregnant and don’t know the last menstrual ,cycle who you will know the date of delivery by
investigation ? US🍒
..
🍒15years female present with pain at beginning of cycle normal body examination = Primary
dysmenorrhea 🍒
…
🍒🍒Couple has 3 children and want tubal ligation. The wife is in midcycle. What
should you tell the wife? Do it after menstruation 🍒🍒
A. Do it immediately B. Do it with menstruation C. Do it after menstruation ✅
..
🍒Pregnant 7 weeks and unbooked what's next? Confirm gestational age🍒🍒
unbooked Pregnant = ‫ﺎد‬Œ‫ اﻟﻌ‬ln m ‫ ﻣﺎ ﺗﺘﺎﺑﻊ ﺣﻤﻠﻬﺎ ا¼ﺪا‬Ân‫ﻣﻌﻨﺎﻫﺎ اﻟﺤﺎﻣﻞ ا‬
un-booked women were those who have no prenatal care at all throughout the pregnancy,
..
🍒Turner presented by amenorrhea next ? A- TSH B- FSH✅ C- prolactin D- Estrogen
َ ُ‫ = 🎂 ﻓ‬FSH ‫رﺑط = ﺗورﻧﯾر = ﺗورﺗﺔ‬
🍰🎂🍒‫ﺳْﺢ= ﻟﻣﺎ ﻧﺣﺗﺎج ﻓﺳﺣﺔ ﻋن ﻧﻔﺳﮭﺎ وﺗرﻓﯾﮫ ﻧﺟﯾب ﺗورﺗﺔ‬
🍓Associated with Turner syndrome? = Coarctation aorta
‫ﻂ‬œ‫ = ر‬turn = ‫ﺴﺪد اﻟﻬﺪف‬Õ ´Ô‫ ﺣ‬Ç
_ h ‫ﻤ‬‰ ‫ﺸﻦ =ﻛﻮرة ﻻزم ﺗﺮﻣﻴﻬﺎ ¼ﺴﺎر‬²‫ﻌ_´ ﻣﻨﻌﻄﻒ =ﻛﻮرا‬‰ .
`
🌹 Probability of turner syndrome in next pregnancy. 30 ✅B- 40 C- 50 D- 60🌹
…
🌹 15 y/o girl in short stature, webbed neck ... etc, Dx:
A. Chromosomal disorder✅ B. Androgenic disorder C. Hormonal disorder
..
🌹G3p0A2 5 weeks presented with spotting on examination open os and no active bleed . history
showed 2 abortions at 2nd trimester last one with D&C diagnosed as incompetent cervix. ur
diagnosis now? A. asherman syndrome B. incompetent cervix C. chromosomal abnormalities
….
🌹 2nd trimester screening test for down syndrome.= Down quadruple test
…
Female pregnant, what of the following true regarding Elevated hCG?
A.High hcg indicator of ectopic pregnancy B.High hcg in second trimester indicator of pregnancy.
C.High hcg in second trimester is the most sensitive marker of Down syndrome. ✅
D.High hcg can cause elevation of TRH which cause hyperthyroidism.
…
🍒Married 2 months ago and wants to confirm if pregnant? Serum BHCG🍒💐
..
🌹Young girl with symptoms of primary dysmenorrhea treatment? NSAID🌹
…
16 y complain abdominal pain in menstruation from day 1till day 3 . = is NSAID
…
🌹 A women with symptoms of dysmenorrhea, she took NSAID but needs
stronger treatment, her symptoms not significantly affecting daily activity?OCP 2nd line
..
Female has painful period she use NSAID she want stronger medication what to advice her?
Exercise and relaxation.
…
🌹19 year old girl c/o dysmenorrhea she starts on NSAID , there is an improvement in symptoms
but the patient need more satisfy... what’s your management:
A. . Mgso4 B. . Tocolytics C.Patient supports and educate self care✅
…
🍒Pt with menorrhagia what to give= OCP 🍒
…
🌹An adnexal mass was felt in healthy female with normal pelvic examination,
no pregnancy, had her menstruation 2 weeks? A- Follicular cyst,✅✅🌹 B- Corpus luteum cyst
..
🍒Infertility, high prolactin level? prolactinoma🍒
..
🍓Woman with normal vitals and laps without any complaints except Some white vaginal
discharge with normal PH nigative wiff test no growth on culture?
A- BV= B-normal physiological discharge✅ C-Tricomonas D-clamydia
..
🍓Woman with normal vitals and laps without any complaints except Some white vaginal
discharge with normal PH nigative wiff test no growth on culture?
A- BV B-normal physiological discharge✅ C-Tricomonas D-clamydia
..
…..
🍓women had sicker disease child , which test to do before her second marriage?-Hb
electrophoresis for husband ✅
…
🍓When the Ovulation occur in relation to the LH peak:
A. 36 hours before LH peak B. 36 hours after LH peak✅
C. At the same time of LH peak
…
🌹Ovulation..which well incease:
A. LH well incease 36h after Ovulation ✅ B. LH well incease 24h before Ovulation
C.Esterodiol well incease 36h before Ovulation D.LH well decreas 24h before Ovulation
…
🌹20 years old female have cycling pain and can't do her activities normally and absent from
school, she used analgesics and didn't improve what is your advice
A. Lifestyle modification ✅ B. Diazepam
….
🌹Pregnant women eat at nights and had heartburn symptoms during bed rest what is the
management? Lifestyle modification
..
Female 28 y.o complaining of dysmenorrhea and dyspareuia pelvic ultrasound done and showes a
hypoechoic mass (ground glass) what statement
is true? A-highly malignant B-partner need to be treated C-antibiotes should be given
D-future fertility is a concern✅
‫ وﻣن ﻣﺿﺎﻋﻔﺎت اﻟﻣﻌروﻓﺔ ﻟل‬endomatriosis ‫ ھذا ﻏﺎﻟﺑﺎ‬hypoechoic mass ( ground glass ‫ ﻻن ﻗﺎل‬، ‫ﻟﯾﮫ اﺧﺗرﻧﺎ ھذا‬
. infertillity ‫ اﻧﮭﺎ ﺗﻌﻣل‬endomatriosis
.. . . . . . .
179.Pregnant with massive bleeding from abruptio placentae. Treatment to save her
life?
A- admitted to ICU with obstetric team
B- Admitted with different spacilized team
C- 2 peripheral IV cannula and blood transfusion✅✅
…
🌹Pregnent has abruptio placente what is the acid base balance of fetus Asphyxia..
A- Res acidosis.. B- Metabolic acidosis Pethidine cause mixed acido
…
🌹Pregnant with severe abruptio placenta +DIC + IFD + cervical 6cm ..what most appreciate next
step? A. C/s B. augmente the labor Answer is: Stabilize the pt ( transfusion )
….
 CTG
🌹women that taks OCPs before the marriage and after that her husband asked
her to stop it because he want to have a baby but she refused what is ur action ?
A. support her. B. support the husband
C. mutual consent for use ocp “or like this and I choose it”
…
🌹Pregnant lady was working all day and came due to decreased fetal movement. No abdominal
pain, no vaginal bleeding. Everything is okay. What to do next?
A. non-stress test✅ B. biophysical profile C. vibroacoustic stimulation
…
🌹CTG pic of early deceleration head compression
…
🌹women in labor on oxy, MGSO, epidural had variable decelerations What’s the cause
A. oxytocin B.magnisum sulphate✅ C. Epidural D.head positioning
…
🌹pt came G3P1102 in the 32th week with abdominal pain and vaginal bleeding CTG done which
show late deceleration what the acid-base status of the baby now?
A- Asphyxia B- respiratory acidosis C- metabolic acidosis✅ D- IUGR
…
🌹What is the absolute Contradiction for EVC: CTG variable deceleration 🌹
..
🌹G4P3 pregnant lady in labor with fetal presentation breech and want to do ECV , Her 1st delivery
was CS followed by 2 successful VBAC, pelvic exam was 1-2 cm dilated cervix, ultrasound: amniotic
fluid 4 and CTG as in the picture Which one in the scenario is contraindicated for ECV?
A. CTG findings B. Ultrasound findings✅Oligohydramnios C. Hx of previous cs
…
🌹CTG:late deceleration cause? uteroplacental insufficiency
.....
🌹CTG:variable deceleration cause? cord compression🌹
…
🌹Uterus Compress inferior Vena cava will cause? Hypotension🌹

🌹Pregnant female primi in labour for couple of hours, 6cm dilated , 80% effacement, 0 station,
was managed with oxytocin and ruptured membrane for 20 hours. CTG showed late deceleration
(pic) What is the appropriate next step: A.amnioinfusion B.ampicillin C.C/S D. stop oxytocin ✅🌹
if uterine hyper contractions
…
🌹 Preganat in labour gaive hime oxctycine all parameter was good and fully dilated after 30m
suden ctg with decreased contraction and absent:
A. Stop oxytocin ✅B. Emergency cs C. Lateral position
….
pregnant women’ in labor having Anastasia and everything is ok but the fetus have bradycardia
what to do ? A. Stop Anastasia ✅ B. Give oxytocin C.Cs
…
Pt hypotensive and normal contraction and ctg pic show fetal bradycardia: = Epidural anaesthesia
…
🌹DM pregnant lady 38 weeks in active labor and having DKA profile and fetus in distress (I think
they showed a CTG or labs that is suggested of bradycardia) what to do:
A.Change the mother’s position of labor B. Stop and do C/S ✅
Answer is B if category 3 heart activity
…
🍓Fetal bradycardia A. Stop oxytocin B. Change mom position✅
‫ﻂ‬Œ‫ﺸ‬Ä ’“‫ﺴ‬Ó ‫ﻪ ﻳﺮﺟﻊ‬Ç‫ﻤﻜﻦ ﻗﻠ‬Ž (n ‫* ﻏ“’ي ﺟﻠﻮﺳﻚ ﺗﺤﺮ‬n ‫ء =ﻗﻮ‬+ m
n ¼ ‫ﻪ‬Ç‫ﻀﺎت ﻗﻠ‬Ç‫ ﻧ‬Ô“‫ر·ﻂ =ﺟﻨ‬
🌹DM pregnant lady 38 weeks in active labor and having DKA profile and fetus in distress ( CTG
that is suggested of bradycardia) what to do:
A.Change the mother’s position of labor✅ B.Stop and do C/S 🌹
….

🌹Causes of reduced variability: Mgso4 🌹

…

🌹Sign of fetal distress in CTG ?

A. less contraction ✅ B.Early deceleration C.Late deceleration D.good contraction
…
🌹CTG showing weak to no uterine contractions of a case of a pregnant in labor cervix dilated 4 cm
and effaced 70% and fetus in +2 station, choices:
A.Give tocolytics B.Stop oxytocin D. Wait and check progress in 2 hours ✅
…
🌹Female in labor 2 stage 3 hours now, all normal, What to do: wait 2. Hours 🌹
…
🌹Confirm labor by a : A. ratio, or by B. examining in 2 hours
…
🌹CTG showing decreased variability and choices were what causes the CTG change: = MgSo4 🌹
….
late deceleration reflects?
A- metabolic acidosis. B- respiratory acidosis. C- asphyxia
Answer: C and this will cause metabolic acidosis in the fetus
🌹late deceleration reflects = asphyxia🌹
‫ﺎ =اﺳﻒ ﺗﺎﺧﺮت‬Œ‫ = اﺳﻔﻜﺴ‬late
…
🍒🍒Fetal bradycardia > Vasa previa
*Vasa previa is triad of*
● Amniotomy.
●Painless vaginal bleeding.
●Fetal bradycardia. 🍒🍒

…
Third trimester Pregnant woman with vaginal bleeding, abdominal exam shows a length less than
the gestational age, CTG shows late decelerations, diagnosis?
A. Placenta previa ✅✅ B.Vasa previa
….
2 CTG pictures, one shows variable decelerations, the other shows I think early deceleration, both
questions had the exact same scenario of a lady on labour with epidural Anesthesia and Mgso4
infusion, and I think baby with extended nick, question asking about the cause of this ctg picture?
A. Mgso4 B. Epidural anesthesia C. Baby position :
🍒Drugs and CTG changes
➔ Epidural anesthesia + Fetal bradycardia = prolonged decelerations
➔ Mgso4 = decreased variability
➔ Oxytocin = late deceleration Or prolonged deceleration (if with uterine hyperstimulation) 🍒
. .. . . . .. . . . .
🍒Late declarations what the acid bace ? metabolic acidosis🍒
…
🌹Decreased fetal movement? non-stress test
…
Picture of CTG showed sinusoidal pattern, what’s the most likely cause?
A. Fetal anemia= ✅ B. uteroplacental insufficiency
…
CTG one variable deceleration about pt primigravida cervix 5cm and the fetus is in station 0 with
cephalic presenting part and this state for 4 hours even the oxytocin had been taken what is the
management for this pt?
A- stop oxytocin✅✅ B- immediate CS C- follow up D- instrumental delivery
Correct answer : A then B
…
🌹CTG show late deceleration= placental insufficiency🌹
…
CTG showing early deceleration asking what is the cause
A/Mg sulphate B/Fetal head position✅
….
CTG showing reduced variability asking what is the caus == Mg sulphate..
…
CTG show decrease variability and he is on mg sulphate cause is? MG sulphate toxicity
….
mother can't feel fetus movement .. non stress test reactive ,, biophysical profile 8 what to do ?
a) Repeat biophysical profile after 24 hours
b) Repeat biophysical profile after 1 week ✅ + reassure , ‫ اﻣﻮرە ﺗﻤﺎم اﻟﺤﻤﺪ‬ìn æ ‫ﺲ ﻣﻌﻨﺎﻫﺎ اﻟﺒﻴ‬Àr‫ﺴﻌﺔ ﻛ‬£ ‫ﻻن‬
Biophysical Profile: Test Score Results
A total score of 10 out of 10 or 8 out of 10 with normal fluid is considered normal. A score of 6 is
considered equivocal, and a score of 4 or less is abnormal.
🌹mother can't feel fetus movement .. non stress test reactive ,, biophysical profile 8 what to do
=Repeat biophysical profile after 1 week + reassure 🌹
........ .........
Pregnant lady ,41 GA in labor on epidural analgesia, mg sulfate for pre-eclampsia and oxytocin,
CTG showd prolonged deceleration and the mother was hypotensive, most likely cause of the
CTG finding?
Mg sulfate
Oxytocin
Epidural analgesia ✅
🌹mother withvpre-eclampsia + hypotensive +on epidural analgesia+ cuases of prolonged
deceleration CTG = Epidural analgesia 🌹
.....
CTG reduced variability Cause? mgso4 G=mg
…
🍓Flat intrauterine fetal heart. What should you do: Stop MGS4
…
🌹30 years old female pregnant 39 GA she is in 1st stage of labor suddenly in CTG there is
deceleration of fetal heart
A. Sotp oxytocin✅ B. Stope epidural anesthesia C. Infusion oxytocin
‫ﻂ‬œ‫ = ر‬fetal heart = ‫ﺨﻮف‬‰ ‫ء‬Ù –
` = X ‫ا•ﻌﺪ ﻋﻨﻪ ووﻗﻔﻪ‬.
....
.......
🍓Ctg with fetal bradycardia, After PROM and polyhydramnios cause :
B. cord prolapse✅ C. placental insufficiency
…
CTG pic shows “Late deceleration”= Dx: Uteroplacental insufficiency
‫ﻣﻊ‬: = (( late )) ‫ طﯾب ﻧﺣﺎول ﻧرﺑطﮭم‬، Uteroplacental insufficienc ‫ ھو‬Late deceleration ‫اﺣد اﻻﺳﺑﺎب اﻟﻲ ﺗﻌﻣل‬
insufficin .‫( اﻟﻣرءة ﻓﻲ اﻟوﻻدة ﻛل ﻣﺎزاد ﺧطر ﻋدم وﺻول اﻻوﻛﺳﺟﯾن ﻟﻠﺟﻧﯾن‬late ) ‫(ﻛل ﻣﺎ ﺗﺎﺧر‬insufficin placenta)
.......
CTG pic shows “Early deceleration”= Dx: Head compression
head )‫( ھو )اﻟرأس‬Early )) ‫ اول ﻣﺎ ﯾوﻟد اﻟﺟﻧﯾن اول ﺷﻲء ﯾطﻠﻊ‬Head = ‫ = ﻣﻊ‬Early ‫رﺑط‬
.. . . . .
🍒 Picture of late deceleration what so expect ? abruptio placenta
‫ ﺑﻼﺳﯾﻧﺗﺎ‬Late = ‫… رﺑط =اﺧر ﺷﻲء ﯾطﻠﻊ ﻣن اﻟرﺣم‬
…
🍓 Ctg show sinusoidal : Anemia🍓
…
🌹Pregnant 1st visit at 10 weeks what is the most important to be done on 1st visit
A. ultrasound to see sac B. cbc for anemia
…
🌹Sinusoidal ctg pic whats cuse ?
A. Iron deficiency B. Head compression C. Cord prolapse D. Placinta insufficiency
Fetal anemia/ SINUSOIDAL

Preterm rupture membrane

🌹Tricky q with preterm premature rupture 31+5 days with ctg sever variable decelaratlon what
nexy ? A-mgso4 B- tocolytics and steroid ✅
Standard treatment for pPROM includes antenatal corticosteroid medicines, which are used to
speed up fetal lung maturity
…
🍒 premature rupture of membranes 32 = Give IV Abx and steroid 🍒
.....
🍓Preterm rupture of membrane management?
A. tocolytic B. corticosteroids ✅‫ ﻣﻔﺮوض ﻛﻤﺎن اﻧﺘﯿﺒﯿﻮﺗﻚ‬C. surfactant D. antibiotics
…
🌹WHEN TO GIVE IV AB FOR PROM=More than 18 hrs of membrane rupture or less than 34 wks
…
🍒 Premature rupture of membranes ( ,nitrazine test was positive what other way to know to
know its amniotic fluids ?? Ferning test✅
ferning and nitrazine methods for detecting the presence of amniotic fluid following ruptured
amniotic membranes have employed samples from vaginal pooling🍒🍒
......
pregnant at 38 weeks hx of rupture of membrane 24 hours ago.. what to do ?
a) Induction of labour (IOL) ✅ b) CS There was no IV antibiotic in choices.
…
🌹Prior history of 2 Premature delivery came at 20-22 week for check up visit, cervical was 30
mm length. What is your management? A- immediate cerclage B- progesterone only ✅
...
🌹Pregnant 32 weeks had premature labour, so started on MgSa 2 days ago, now the respiratory
rate is 8/min and other critical side effects. What to do?
A. Oxytocin B. Steroid C. Stop MgS✅ D. Switch to terbutaline
........ ..

1Blood disease
🌹Pregnant has iron deficiency anemia and she’s taking medication for it now complaining of
fatigue They attached her labs All were normal except mcv was
low what’s the diagnosis?
A. iron deficiency B. pregnancy induced hypothyroidism C. thalassemia
…
Patient 30 yo female smoker on OCP for 6 years gonna do ovarian cystectomy and during the
surgery developed hypotension tachycardia hypoxia dX ? A. PE B. Hemorrhage shock C. Septic
..
🌹PT with IUFD came with shortness of breath And other symptoms but no mentioned any
bleeding or something like that ,Pt high ,Ptt high, Fibrinogen low ask about dx= Embryonic
pulmonary embolisms

🌹 mother of sickler ask about next pregnancy: paternal serum electrophoresis

…
🌹Old lady with uterine fundal mass they did surgery,what lymphatic drainage should be resected:
A. Superficial inguinal B. Deep inguinal C. Internal iliac D. Para-aortic
…
🌹What to give 29yo pt before pregnancy: A. Iron B. Folate✅ C. Multivitamins
 ‫ﺔ‬Œ‫ﻴ“’ة داﺧﻞ اﻟﺨﻠ‬-‫ﻓﻠﻮﺗﺎت =ﻓﺘﺎت ﻛﺜ‬
🌹40 year female primigravida with Hx & DVT. RX? A- Heparin✅ B- Enoxaparin🌹

🌹 Pt pregnant 10 wks primigravida, and have hx of previous DVT , management:

A. no need for anticoagulant B. heparin C. enoxaparin D. aspirin

🍓40 yrs primegravida healthy with previous DVT hx What to do now?

A. Asprirn B. Enoxaparin ✅ C. Heparin D. No anticoagulant

19 y/o female married on OCPs develop sing of DVT in the lower limb (lower extremity pain and
swelling), what is the cause? OCPs ✅ ✔
…
-🌹 Patient C/O missed period for 2 month and Rt leg edema What important question? hx of using
OCP🌹
….
🌹case female pregnant Still born at 38 wks everything normal then discharge but
after 3 days come back with bleeding from every site injection Which best investigation?DIC4
Fibrin product.
…
🍓Pregnant came complaining of dyspnea and abdominal pain i think with very high
PT, aPTT, low fibrinogen = A. DIC ✅ B. Autoimmune TTP
…
🌹Pt pregnant with fetal death and DIC management.
A-medical B-expectations C-urgent surgery cs D-induce labour ✅
…
🌹20 years old pregnant presents with loss of fetal movement after that she developed decrease
in urine output with ground glass appearance of the lung by x-ray Hb and platelet are low , ppt
and pt prolonged , fibrinogen low Ask about the diagnosis :
A. Autoimmune thrombocytopenia B. DIC ( PT +PTT = High ) + plattlet low C. Amniotic fluid
embolism
….

1Abortion
🌹19 year old lady with history of 3 of 1st trimester loss, PTT eleveated, Anticardiolipin elevated,
what is the diagnosis? Antiphospholipid syndrome

🌹 A female had three miscarriages and pulmonary embolism?

Antiphospholipid syndrome . 🌹
…
🍓recurrent thromboembolic events, spontancous abortions Ddx?
Antiphospholipid Antibody Syndrome
…
🌹Patient with bilateral deep DVT and recreant fetal demise
A. Protein c B. Protein s C. Antiphospholipid syndrome✅
......
🌹 First trimester miscarriage at 5 week with history of 2nd trimester abortion twice
duo to cervical incompetence, cause now:
A.Cervical incompetence->2nd B- Chromosomal abnormality ->1st ->11week
…..
🌹Pregnant completely healthy no abdominal pain or contraction presented to ER with spot of
bleeding upon PV examination the OS were closed. Dx. ?
A. normal pregnancy ✅ B. Threatened abortion C. Incomplete abortion

…
🌹Cervix open + products on uterus = incomplete Abortion
…
🌹Pregnant came to ER in her 18 weeks, comes with bleeding, cervix is open and some products
passed out? A.therenated B.missed C. Incomplete ✅
…
🌹Pregnant lady came with bleeding, passing of tissue and open Os (dilated). Type of abortion?
A. Incomplete abortion ✅ C. Complete abortion (os close), D. Threatened abortion
…
🌹Case of incomplete abortion. After D/c she has hx of no mense . Which layer of
endometrium is damaged? A. Spongy B. Basalis C. Compact D. Functional

🌹Lady came with incomplete abortion, she's for surgery, she refused the surgery and her husband
agreed. What you will do? Respect her wishes ✅
…
🌹Incomplete abortion management, severe bleeding =
A. fluids + D and C B. fluids + expectant management C. fluids + uterus massage
…
🌹Pregnant at 20 week complain of vaginal bleeding os closed ultra sound no fetus = complete
abortion

🍒Female with recurrent abortions, aPTT elevated? Antiphospholipid syndrome🌹🌹

..
🍒bleeding per vagina, is partially open, tissue passage ? A.Inventiable B. incomplete abortion ✅
…
🌹 pt pregnant come with severe bleeding and component in cervix what next management = iv
fluid and D&C ( this case of incomplete miscarriage.) 🌹
…
Pregnant lasy had abortion at 9 week she had sever vaginal bleeding, abdominal part, *pass the
fetus* and the cervical os is open with tissue what you will do:
A. Iv fliud with expectant manay B. Iv fliud with evacuation and curettage✅
....
🍒Bleeding per vagina, os closed? Threatened abortion
‫ﻜﻮن‬Ž ‫ﺤﺼﻞ اﺟﻬﺎض ﻟﺬﻟﻚ‬Ž ‫ﻪ اﻧﻪ ﻣﻤﻜﻦ‬Œ‫ﺒ‬ý‫ﻦ ﻣﺠﺮد ﺗ‬/‫ﺔ اﺟﻬﺎض ﻟ‬Ž‫ﺤﺼﻞ اﺟﻬﺎض وﻻ ¼ﺪا‬Ž‫ ﻣﺎ‬، ‫ﻣﻦ اﺳﻤﻬﺎ اﺟﻬﺎض ﻣﻬﺪد او ﻣﻨﺬر‬
OS = CLOSE 🍒
...
🍒A scenario about threatened abortion, how to manage? Bed rest 🍒
..
🌹Pregnant 8 weeks pregnant, came complaining of bleeding per vagina, examination shows
closed healthy looking cervix with minimal brownish discharge US done shows crown rump length
of 7 What is your action ? A. bed rest ✅ B. D&C
..
pt with several weeks of amenorrhea came with vaginal bleeding and BHCG was positive os
close What is the Dx? Threatened bortion
..
Case of pregnant lady 8 weeks gestation, her crown rump length is 7 weeks, she presented with
vaginal bleeding and brown discharge, how will u manage:
Evacuation. observe✅. Misoprostol
-Most likely threatened abortion ( occura before 20 week of gastantion )
…
Pt c/o of bleeding and she at 8wk gestational age on ex os closed and there is brownish color
appear during pv, the abdomen is soft, not tender or guarding and she denies passage of few
tissue By u/s you found gestational age 7wks = A.molor pregnancy B. threatened abortion ✅
C.ectopic pregnancy
…
🌹1st trimester, Os closed and speculum revealed heavy bleeding. Type of abortion? A.
Threatened abortion 🌹
…
🌹Pt with 8 weeks gestation her os open , vaginal bleeding and abdominal pain Dx:-
A- threatened B- incomplete C-inevitable
…
🍓woman, has hx of miscarriage , Now she's GA of 7 weeks , she came to ER with vaginal spotting.
Vaginal exam shows brownish discharge and no active bleeding and OS is closed. Patient denied
any hx of passing tissue. Everything else is normal What's your diagnosis:
A. Threatened✅ B. Normal pregnancy C. Incomplete D. Inevitable
............
🌹pergnant with vaainal bleed didn't see product oÿ conception on inspection POC seen at cervix
what type oÿ abortion: A. inevitable.

1cs
🌹 Case of breach indicated for CS when to give Antibiotics ? in preoperative preparation
…
🍓Pregnant maybe 32 weeks, hypertensive already took magnisium but had seizure. How will you
manage? A. Steroids В. Mg C. Immediate CS✅✅
…
🍓IUFD with history of CS what to do ?
A. SVD trial first then CS B. CS due to previous CS C. ask her opinion✅ D. ask her husband opinion
.......
🌹When to start abx administration in CS? A.after cord clamp B.postoperative C. preoperative ✅
…
🌹pregnant with mild bleeding, Us: placenta previa.= CS🌹
…
F, 2nd stage of labour, face presentation? A- CS✅ B- oxytocin
…
🍓34weeks GA pregnant she had uterine contractions every -mins the cervix dilated 3cm and the
membranes intact ,the fetus lying transverse and has normal FHR, she had vaginal bleeding on us
the placenta attached to the posterior fundus but with retroplacental isolucent, what you will do:
A. Give her tocolytic B. Give her oxytocin C. Cs✅✅ D. Amniotomy
….
🍓 Picture of CTG showing late decelerations and in the history the mother is in active labor and
cervix is 6 cm dilated for a long time on oxytocin. There are *signs of fetal distress* what to do:
Answer is Stop oxytocin first then Go to C section .
…
🌹placenta previa and she has contractions, what to do? Cs🌹
…

1Vaginal delivery
🍒🍒Occipito-anterior > Vaginal delivery🍒
🍒🍒Occipito-posterior > CS🍒🍒

🌹a 30 year old multiparous fully dilated and is pushing but then gets exhausted.child is at -3 and is
cephalic and stable. What is the Mx? SC

🌹Pregnant lady in 33 weeks, fundal hight found 30 weeks, US revealed unciable fetus
IUFD, how would council her about mode of delivery? spontenous delivery

Pregnant 8 weeks pregnant, came complaining of bleeding per vagina, examination shows closed
healthy looking cervix with minimal brownish discharge
US done shows crown rump length of 7 What is your action ?
A. admit for observation B. Reassurance✅ C. Admit for Surgical intervention
…
🍓Case of mother in early pregnancy with herniation of fetal tissue cervical dilation of 1.5 cm no
bleeding or clot or pain A. Abortion B. cervical incontinence✅
…
🌹Case of female with previous 2 preterm labor, now she is in 20 weeks of gestation and her
cervix opened 30 mm ,what you will do?
A- Immediate Cervical Cerclage n. B- Give tocolytic & wait C- Observation
D- progesterone supplement ✅
…
Pg with deceleration and epidural anesthesia and oxytocin develops mild bleeding and decrease
contraction ? A. Stop oxy and cS ✅ B.Stop epidural C.Increase oxy
.....
🌹 Primigravida in stage 2 of labour for 3 hours, she took an epidural analgesia, what to do next?
A. Augmentation oxytocin B. Observe C. C/S
…

🌹 lady in labor,CTG is reassuring with contraction of good quality, then sudden stoppage of
contraction and ctg changes of fetal distress. what is the management?
A. Urgent C section B. give oxytocin C. IV fluid D. change position
....
🌹IUFD (Demise) + DIC, cervix is dilated 6cm with labor?
A. CS B. laparotomy C. Hysterectomy D. deliver normally (or oxytocin/augmented). ✅

🌹Patient in labor with 5 cm cervix- after 5 hours still no change, fetal head +1 , ctg is reassuring
and shows good uterine contraction. What is the management?
A. Sc terbutaline B. instrumental C. recheck after 2 hrs D. C section
…
🍓Case of labor effecamnte 50% cervical dilation 2 cm ctg reassure mother vitally stable , how to
coniform the situation;
A. TV sonogram
B. Every 2 hrs Pelvic exam to access for further dilation of the cervix✅✅

CTG one variable deceleration about pt primigraveda cervix 5cm and the fatus
is in station 0 with cephalic presenting part and this state for 4 hours even the
oxytocin had been taken what is the management for this pt?
A- stop oxytocin✅ B- immediate CS C- follow up D- instrumental delivery
…
🌹Q gives datails about pt term for delivery , cervix open effaced what should be given :
A- iv oxytocin B- cervical repining
.......
🌹G5P4, she's fully effaced, cervical ripening, station -3, fully dilated. Your action?
A. Instrumental delivery B. Cesarean section C. Re-evaluate after 2 hours ✅
....
...
🌹Pregnant lady with 6cm and 80 effacement , ruptured members and head
station+1, what is the labor stage? Second
....
In pregnant lady 39 wk with effacement 90% and cervix dilation 2 cm, what is your
most appropriate action? A. IOL B. CS C. expectant management
...
🌹Pt in labor room cx 6cm effacement 70% for 4 hours CTG Fetal accelerations and no maternal
contraction management? A. Re-examining after 2hours B. Give oxytocin ✅ C. Cs
...
🌹 post date 42 week , closed cervix hard and non effacement , fetal heart was
all normal, contraction were normal , posterior of face felt ( in exam or
us??) , when start prostaglandin gel to induce labour , Fetal heart drop to
80 and contraction last only 2 min , what is next important to consider:
A. preparation for cs B. assessment for cord prolapse ✅
......
🌹Pt in labor room cx 6cm effacement 70% for 4 hours CTG Fetal accelerations and no maternal
contraction mangment? A-Re-examining after 2hours B-Give oxytocin C-Cs
,,,,
🍓Pregnant 39 weeks presented to the outpatient department with abdominal pain on
examination her os is closed, no effacement. no bleeding, dx?
A. false labor✅ B. Active labor
………………………..

🌹 A lady came on 20th day postpartum. She delivered a full term baby 3.45 KG by instrumental
vaginal delivery. She is now complaining of yellowish white vaginal discharge, odorless, non-itchy,
no pain or discomfort. Cervix is pink and nontender. Discharge analysis was +ve for leukocytes and
epithelial cells. What is the most appropriate next step?
A. Urine dipstick analysis B. Discharge culture C. Reassure D. Metronidazole

🌹 Patient after spontenus vaginal dilivary and episiotomy with 1 hour, found to have blue
swelling in the vagina, what is the best management ?
A. Packing B. Aspiration C. Observe D. Surgical ( if large)
N.B: In other recall It was severe pain and measured as 8*10cm
🍊vaginal hematoma = small = with rest, ice, compression, and elevation (RICE).
if large (surgeical drain)
…..
🌹 episiotomy swelling (I don’t remember the size but is large )and pain (no sitz bath in choices)="
Surgical evacuation
…
🌹Most predictive for pregnancy complication ?
A. Abdominal pain B. Vaginal bleeding ✅✅ C.Ankle edema
…
59. Lady feel vaginal fullness increase when standing long period when urinate need to push with
her hand diagnosis: A) cystocele✅✅ B) enterocele. c) rectocele
…
🌹Multipara female feel mass: A-Cystocel✅ B-Rectocele
.....
🌹A 42 YO female P6036 complaining of vaginal fullness and heaviness increased through the day.
She uses manual pressure to empty her bladder completely. She has stress incontinence.
Diagnosis? A. cystocele B. rectocele C. enterocele D. periodoncia
…
🌹female after uterus prolapse surgery have the urine from vagina what is dx?vesicovaginal
fistula🌹
…
🌹Female 3 months post SVD , after one month she complain about having stool
inc. and passing flatus from the vagina : A. recto vaginal fistula . B. perineum tear .
…..
🌹Urine leak during urination only? urethrovaginal
Continues leak? Vesicovaginal

🌹 Pt in labor and do for her spinal anesthesia which part of perineum will stell sensitive =. retcum
..
🌹27 yo lady c/o urine come out from the virginal , during micturition?
A. Urethroviginal fistula B. Ureterovaginal fistula . Vesicovaginal fistula.
…
🌹 Patient after spontenus vaginal dilivary and episiotomy with 1 hour, found to have blue
swelling in the vagina, what is the best management ?
A. Packing B. Aspiration C. Observe D. Surgical ( if large)
N.B: In other recall It was severe pain and measured as 8*10cm
...
🍒🍒 pt in labor and planning to do lateral episiotomy.. ask about the advantage of it? Less
perineal tear🍒🍒
...
🌹2nd degree laceration and another in the vaginal wall u cant suture due to the perfuse bleeding
from above
A- 10 ut oxytocin. B- Prostaglandin C- Explore the uterus and examine it✅🌹
/…..
🍊vaginal hematoma = small = with rest, ice, compression, and elevation (RICE).
if large (surgeical drain)
....
Patient after delivery need to lateral episiotomy after six hours developed swelling in that area
blue in colour and tenderness = aspiration
…
What’s the most important thing to check before instrumental delivery ?
1-Breech 2- placenta abruption 3- head pelvic disproportion ‫ﻧﻔﺲ ﻣﺼﻄﻠﺢ‬
(Cephalopelvic Disproportion)✅
‫ ˜ﺬا‬instrumental delivery ‫ﺻﻮرﺗﻪ‬

m “ ‫ﺴﺎﻋﺪﻧﺎ اﻃﻠﻊ اﻟﺠﻨ‬Ó ‫ ﻣﻌﺪات اﺳﺘﻌﻤﻠﻬﺎ ﻋﺸﺎن‬forceps .

‫ﻪ ¼ﺎﻟﺮاس واﺷﻔﻄﻪ او‬Ç‫ﻜﻮن ﻗﻮي ارﻛ‬Ž ‫ﻜﻮن ¼ﺎﺳﺘﺨﺪام اﻟﺸﻔﺎط ﻫﻮاء‬Ž‫ﺎ‬Ž. Ô
‫ﺔ ﻟﻠﺤﻮض‬Ç‫ﺴ‬ý‫ﺔ اﻟﺮاس ¼ﺎﻟ‬Œ‫ﺪ ﻣﻦ وﺿﻌ‬%‫ﻞ ﻣﺎ اﺳﺘﻌﻤﻠﻪ اﺗﺎ‬Ç‫ﻗ‬
…
🌹patient in labour, cervix fully dilated, fully effaced, presenting part at +2 station for 3 hours?
ventouse delivery ‫ﺴﻤﻮﻧﻪ اﻟﺸﻔﺎط‬Ó ‫ ﻫﻮ‬Ân‫ا‬
…
🌹Pregnant women during vaginal delivery, what can make her has fourth degree perineal tear ?
A.Unrestrained legs and squatting position
B.Unrestrained legs and sitting on chair
C. Restrained legs and use of forceps and other metallic instrument ✅✅
..
🍓Perineal tear caused by?
A. Restrained leg with stirrups B. Unrestrained legs with squatting position
There was no forceps in the options
🍏🍏🍏🍏
🌹 Fully dilated for 2 hours abdominal examination 4/5 head, fully dilated and effeced +2 station,
prior cs strong contractions early deceleration what to do?
A.Wait another 2h B.Oxitocin C.Cs D. Ventous ✅ E.Forceps
…
🍇pregnant women with CS before 2 yrs In labour ( fully dilated , fully effaced , +3 station , strong 4
contraction in 10 minute ) for 2 or 4 hour!?
A. ventose✅ B. reevaluate after 2 h

…..
🌹 When exam pregnant you feel nose,mouth.= Face presentation🌹
....
🍒Best presentation of twins regard vaginal delivery?
Cephalic cephalic✅🍒🍒 Breach breach Breach cephalic Transfers cephalic
…
🌹 Twin pregnancy which is favorable for SVD =
A. breach breach B. breach cephalic C. cephalic cephalic ✅
…
🌹fetus with breach presentation flexing hip and knees:
A- Frank breech. B- Complete breech✅ C- Incomplete breech🌹
….
🌹US of pregnant shows breech position, both legs and hip flexed, asking about breech =
Complete breech🌹
…
Description of fetus position all his extremities were flexed? A. frank breech B. complete✅
…
🌹Pregnant with bicornuate uterus and fetal heart can be detected at the level of maternal
umbilicus what could be the fetal presentation? A-face B-brow C-breech ✅D-shoulder
…
🌹A description of complete breech and asks what type is it? (all limbs flexed)
….
🌹 (I cannot remember if the female has bicorniate uterus or not) Pregnant in 39
weeks, in labor Global soft is the presentation part, fetal heartbeat inthe umbilicus..fetal
presentation:
A. Brow presentation B. Face presentation C. Complete breech D. cephalic presentation
…
🌹 Pregnant 34 at labour in examination showed transverse presentation she want
to know if she can do ECV Ultrasound shows bicorniate uterus with normal
fetus What is the contraindication for ECV ? A. Bicornuate uterus B. Breech presentation
…..
Pregnant .. Leopold maneuver 1st and 2nd finding: soft not hard .. fetal heart beat at umbilicus
presentation: A- Face B- Brow C- Shoulder D- Breech✅
….

….
🌹fetal heart beat at umbilicus presentation: = Breech 🌹
…
🌹Fetus A breach fetus B cephalic , previous C/S , what is the indication for C/S now ?
A. previous CS B. presentation✅
.....
🌹During pelvic examination for a lady in labor, 6cm cervical dilation, you felt the eyes and a hole,
what ia the fetal presentation? Face
.....
🌹 31yrs 37wks ROM in labor examination reveled breach presentation, ctg reactive PV CX 2 cm ,
50 % effaced, mid anterior CX, your management:
A. CS✅ B. oxytocin C. Vag.Prostaglandi D. iv antibiotics
….
🌹weeks pregnant came with breech presentation what is your next step?
Flu 36 weeks + ECV🌹

Patient had hysterectomy.. came back later complaining of urine coming through vagina during
urination.. location of fistula? Urethrovaginal fistula ‫ﻣﻦ اﺳﻤﻬﺎ‬
...
Woman after vaginal delivery, develo ped stool incontinence+passing gas
through vagina diagnosis A. Anovaginal fistula ‫ﻣﻦ اﺳﻤﻬﺎ‬
…
🍓Elderly female after hysterectomy, She is on complete iv nutrition, Urine out
put 35ml/hr .What prevents her from going home?
A. Low urine output✅ B. Delay in oral nutrition
🍏🍏🍏🍏

….
🍓female with symptoms of bartholin gland inflammation and ask you the dx: = bartholin cysts
.........
Something in the vestibule in young patient? A. bartholin cyst
.....
🌹 0'clock lesion fluid-filled mobile, and some pus discharge:
A. Hyrdentis suppurativa B. Bartholin Duct abscess ✅

Ovarian Torsion
Symptom of ovarian torstion :
1_ sudden onset pain 2_ Nausea and vomiting
3_unilateral lower abdominal pain that worsens intermittently over many hours
4_pelvic mass at presentation 5_unilateral, tender adnexal mass
....
Case of young lady with sudden severe right lower abd pain 9/10 and N/V and a mass was
felt,dx? (US or CT shows large mass ):-
-ruptured ovarian cyst -ovarian torsion✅✅ -appedicitis
..
Young lady right lower abd pain intermittent (lasts 10-15min)with nausea and vomiting on
exam right lower quad fullness was felt,dx?
Ovarian torsion ✅ Appendicitis
..
female with fever, tenderness, abdominal pain, dx? A- Cervicitis B- Salpingitis ✅
…
🌹Unmarried young lady, 20 yr old, with bilateral abdominal pain, she is a waitress at a resort,
very vague sexual history, no bleeding, no significant and examination….no fever, missed last
month periods. diagnosis?
A. ovarian torsion ‫ ﺟﺎﻧﺐ واﺣﺪ‬ln m ‫ ﻋﺎدة‬B. salpingitis ✅
multiple sexual partners or ‫ ﯾﻛون ﻋﻧدھﺎ ھﯾﺳﺗوري ﺑﺎل‬، ‫ ﻻن ﻣن اﻋراﺿﮭﺎ اﻟم ﻓﻲ ﺟﺎﻧﺑﯾن اﻟﺑطن‬، ‫اﺻﺢ ﺟواب‬
unprotected sex
C.ruptured ectopic pregnancy ‫ﺲ ¼ﺎﻟﻢ‬ç $ n æ Ž‫ ﻣﺎ‬، ‫ﺔ ﻧﺰﻟﺖ‬Ér‫ﺎن ﻋﻼﻣﺎﺗﻬﺎ اﻟﺤﻴ‬i
D. endometritis and adnexal masses
,,,,,,,,
🌹 Pt with suprapubic pain and cervical examination showed tenderness in fornix,
associated with profuse discharge: most likely dx: A. cervicitis B. salpingitis
....
🌹Suprapubic pain : acute salpingitis
.....
Girl with lower abdominal pain and discharge on O/E suprapubic tenderness
diagnosis: A. Cervecitis B. Salpingitis✅
Salpingitis > painful
Cervecitis > painless
…
Young lady newly married came with history of right lower quadrant pain and
tenderness pregnancy test negative what is your diagnosis= ovarian torsion✅✅
..
🍒 Pregnant patient presents with ovarian torsion, refused to do the surgery, what is your action ?
Explore, explain then document🍒
…
🍒Pregnant with bilateral ovarian torsion & refuse surgery what to do ?
A. Respect her ✅ B.Consent from husband C.Do it without consent it is emergency
..
🌹Pt with sudden acute pain us showed mass in ovary what is the dx? Ovarian torsion.
…
Female presented with sudden acute onset o abdominal pain . US show mass in the ovary. What’s
the diagnosis A. Rupture of ovarian cyst B. Ovarian torsion✅✅
….
1)_ 50-Young lady right lower abd pain intermittent (lasts 10-15min) with nausea and vomiting on
exam right lower quad fullness was felt,dx?
A-Ovarian torsion ✅✅ B-Appendicitis
‫ ﻻن اﻻﺛﻧﯾن ﯾﺗﺷﺎﺑﮭوا ﺑﺎﻻﻋراض ﻟﻛن اذا ﻟﻘﯾﺗوا ھذه اﻟﺟﻣﻠﺔ‬ovrian torstion ‫ﻓﯾﮫ ﻛﻠﻣﺔ ھﻧﺎ ﺗﻔرق ﻟﻲ ﺑﯾن اﻟﺗﮭﺎب اﻟزاﺋدة و‬
ovarian torstion‫ اﺧﺗﺎروا ﻋﻠﻰ طول‬pelvic mass ‫او‬unilateral, tender adnexal mass
…
🌹 Female pregnant with known history of infertility, presents with ovarian
torsion, her husband wants to sign the consent but she refuses, who is supposed to sign the
consent? A. husband B. doctor C. patient
…

1Leiomyosarcoma ( uterine fibroid )

🌹49 years female has submucosal fibroid. She didn't complete her family yet. How manage?
A. laparoscopic myomectomy B. hysteroscopic resection✅
…
🌹Female complain of fibroid size 5x6 mild no bleeding or symptom how manage she follaw up by
ultrasound and do complete red cell count every two month= follow every 6 nmonth. (F=6)
…
🌹Fibroid, asymptomatic, 6x5 what you will do?
A. Myomectomy B. Hysterectomy C. Follow up in 2 months D. Follow up in I year ✅
…
🌹Fibroid commonest in: African race
..
🌹Amniotic fluid lack Increase of fibroid size = leiomyosarcoma 🌹
…
🌹pt asymptomatic with 5 cm serous fibroid ttt = follow up. 🌹
…
🌹 pt with bleeding, US showed fibroid and pt wish to maintain her infertility how to manage? Lap
myomectomy🌹
…
🍓Elderly female with previous history of myomectomy and PCO, Now complain of
vaginal bleeding, Diagnosis? A. Fibroid B. Endometriosis C. Endometrial hyperplasia ✅
Fibroid increases in size postmenopause >consider leiomyosarcoma
..
59 yrs old female came for check up she stated that she had her routine gynecological check up 12
years ago when she was still pre menopausal and it showed fibroid it was small( I don't remember
the size) and it wasn't treated. Now when you examined her the fibroid increased in the size and
you found endometrial thickening( I forget the exact sizes) what is the most likely diagnosis:
A/Leiomyoma B/Leiomyosarcoma✅ C/Metastasis from ovarian cancer
D/Endometrial cancer
Uterine fibroids, also known as uterine leiomyomas or fibroids , when fibroids become very large
must be remove because it has chance to transform to
( uterine leiomyosarcoma )
_
‫ﻠﻤﺔ‬i ‫ ﻟﻤﺎ ﻗﺎل‬endometrial thickening + very large fibroid ‫ ﻃﻮل `^ اﻧﻪ ﻣﻤﻜﻦ‬Ý‫ ﻓﻜﺮوا ﻋ‬fibroid Þ‫ﺗﺤﻮل ا‬
sarcoma .
# past Hx of fibroid = then become very large and endometrial thickening = leiomyosarcoma.
……
Female has fibroid 2*3 become 5*6 , endometrial thickens 5 mm
-Endometrial ca -leyomyosarcoma✅✅
. ‫ ﻓﻛروا ﻓﻲ ﺳﺎرﻛوﻣﺎ‬endometrial thick ‫ ﺗﻐﯾر ﺷﻛﻠﮭﺎ وﺳﺎرت ﻛﺑﯾﯾرة و ﺧﺎﺻﺔ‬fibroid ‫ﻗﻠﻧﺎ ﺳﺎﺑﻘﺎ اي ﻣرة ﺗﺷوﻓوا‬
…..
48 years old female came with abnormal uterine bleeding. TVU shows subserous fibroid and
endometrial thickness is 14 mm. Dx?
A. Fibrosarcoma B. Myosarcoma✅✅ C. Fibromyoma
….

🌹female came with abnormal uterine bleeding. TVU shows subserous fibroid and endometrial
thickness is 14 mm. = leiomyosarcoma or (( myosarcoma)).🌷
‫ رﻛزوا ﻻن اﻟﺳؤوال ھذا ﺗﻛرر ﻟﻛن اﻻﺧﺗﯾﺎرات ھﻧﺎ ﻏﯾروھﺎ ﺣطوا ﺑدل‬leiomyosarcoma ‫ ھﻲ ﻣن اﺣد اﻧواﻋﮭﺎ‬myosarcoma ‫🍬ﻟﻠﻌﻠم‬
‫ ﻓﻣن اﺳﻣﮭﺎ‬Myometriam s ‫ ﺣﺻل ﻓﻲ طﺑﻘﺔ‬tumor ‫ ﻻن ھذا ﻣﻌﻧﺎھﺎ‬liomyosarcoms ‫ وھﻲ ﻧﻔﺳﮭﺎ‬myosarcoma ‫ﻻﯾوﺳﺎرﻛوﻣﺎ ﻛﺗﺑوا‬
myo_sarcoma .

1Ectopic pregnancy
🌷Female with fever and Supra pubic pain with vaginal discharge Acute Salpingitis🌹
…
F c/o lower abdomen pain, and tenderness, purulent watery vaginal discharge, Ddx? A- Cervicitis
B _ salpingitis✅✅ ( inflammtion of fallopian tube )
.‫ ﺳﺎﻟﺑﻲ = ﺳﻠﺑﻲ ﻣﻊ ﻛرﯾﮫ‬salpingitis = ‫ = ﯾﻌﻧﻲ ﻗﯾﺢ = ﻛرﯾﮫ = ﻣﻊ‬purulent ‫رﺑط‬
…

🌹female in reproductive age , come by an ambulance (RTA ) What 1st thing have to do?
check for pregnancy ✅
…
🌹Ectopic pregnancy 1- 3 cm and Bhcg 2600-medical treatment= methotrexate
..
Ectopic pregnancy is a defect in which process: Implantation ✅
…
🌹Ectopic pregnancy, medical treatment or surgery? ‫ﺔ‬É‫ﺤﺪد ﻟﻚ ﻫﻞ راح ﻧﻌﺎﻟﺠﻬﺎ ﺟﺮاﺣﺔ وﻻ ادو‬Œ‫ ﺑ‬Ân‫ﺶ ا‬Ó‫ا‬
A- the house distance B- hbcg 4000 C- size 3 cm D- vital stable ✅
…
🌹 Patient underwent Salpingostomy, came with increasing Bhcg, What’s next step?
methotrexate
Methotrexate, formerly known as amethopterin, is a chemotherapy agent and immune system
suppressant. It is used to treat cancer, autoimmune diseases, ectopic pregnancy, and for medical
abortions. T
…
Vague abdominal pain amenorrhea for 2 months past hx of perforated appendicitis 14 year ago
came HCG 1800 Management ?
A. Surgical intervention after stabilizing B. Gs review for acute abdominal
C. Strong analgesic D. Methotrexate✅
…
Ectopic with Bhcg 2500 and one week later 6000 whats next step in management?
A. Medical B. salpingectomy C. salpingotomy✅ =
removal of a Fallopian tube. This may be done to treat an ectopic pregnancy or cance
..
🍒ectopic pregnancy BHCG 3000 , medically treated. on follow up BHCG is rising ,next step?
(nothing about the stability of the pt)
A. medical treatment B. salpingostomy✅✅ C. salpingectomy
‫ اﻟﻲ ﻣﻌﻧﺎھﺎ ﻧﺷﯾل ﻛل‬salpingectomy ‫ ﻋﺷﺎن ﻧﺧﺗﺎر‬Rupture ‫ اﻟﺣﺎﻟﺔ ﻟﯾﺳت‬، ‫اول ﺷﻲء ﻣﺎ ﻧﻔﻊ ﻣﻌﮭﺎ اﻻدوﯾﺔ ﻓﻧﻧﺗﻘل ﻟﻠﺟراﺣﺔ‬
‫ وﻣﻌﻧﺎھﺎ ﻧطﻠﻊ اﻟﺟﻧﯾن ﻣن‬S ‫ ﺑﺣرف‬salpensotomy ‫ ﻓﻧﺧﺗﺎر‬، ruptur ‫ﯾﻌﻧﻲ ﻟﯾﮫ اﺷﯾﻠﮫ وھو ﻣﺎﺳﺎر ﻟﮫ‬fallupian tube
.‫ﺑدون ﻣﺎ ﻧﺷﯾل اﻟﺗﯾوب ﻧﻔﺳﮫ‬Fallubian tube
an ectopic pregnancy progresses, the fallopian tubes are unable to contain the growing embryo
and may rupture. A ruptured ectopic pregnancy is considered a medical emergency as it can cause
significant hemorrhaging (excessive bleeding). If an ectopic pregnancy is diagnosed early (i.e.,
before rupture has occurred), it may be possible to manage medicinally; the drug methotrexate
targets rapidly dividing fetal cells, preventing the fetus from developing further. If medicinal
management is not possible or has failed, surgical intervention may be necessary. A salpingostomy
may then be performed to remove the pregnancy.
If fallopian tube hasn’t ruptured and your pregnancy hasn’t progressed very far, your givev
injection of methotrexate
If fallopian tube is damaged like bleeding heavily or ruptured need emergency surgery with
asalpingectomy
….
🍒Patient 6 wks amenorrhea complain od lower abd pain and nausea Bhcg 2500 In Fallopian
tube mass 3 cm # treatment + # diagnosis = Ectopic pregnancy = treat by = Medical therapy (
methroxat ) 🍒
…
🌹Ectopic pregnancy 6 wks less than 3.5 cm pt stable with mild pl mx?
A- .Methotrexate✅ B- Serial BHCG. C- Laparoscopic. D- Expectant mx.

🍒Ectopic hcg 3000? Methotrexate🍒

..
stable ectopic pregnancy but live far.= admitte her
…
🌹pt with ectopic pregnancy what is best question before managment of the pt?
A- accessability to hospital. ✅🌹
….
💐Ectopic pregnancy bhcg 3500 hypotension tachypnea , management
A.Methotrexate B.Laparoscopy C. Laparotomy slpingectomy ✅
Np:- BHCG Less than 5000 =methotrexate
BHCG more than 5000 = surgery ..if stable laparoscopic..if unstable laparotomy 💐
….
🌹female with right lower quadrant pain some came with +ve pregnancy what is the diagnosis?.
A.Acute appendicitis B.ovarian torsion C. ectopic pregnancy ✅
..
🌹Married lady came to the ER with right lower pain that started 6 hours ago, she’s drowsy and
bowel sounds are sluggish: A. ruptured ovarian cyst ✅ B.Ectopic pregnancy
They didn’t mention anything about labs (hCG etc) or U/S…
….
🌹Ectopic pregnancy her husband not in the city: Surgical 🌹
..
🌹 patient with ss of ectopic pregnancy and came with bleeding. What is the source
of her BLEEDING? A_tubes✅ B. -ovaries.
…
🌹 patient had salpingostomy due to ectopic pregnancy, after that her b hcg
plateaued. Mx? A.methotrexate ✅ B. -laparotomy.
,./
🌹Ectopic pregnancy most important to ask about: accessibility to hospital.
…
🌹Ectopic pregnancy hcg 2500 on methotrexate after that hcg is 6000 treatment?
A-Methotrexate B-Salpingostomy ✅ C-Salpingectomy
.......
🌹Patient with ectopic pregnancy, her husband is in a military mission, she lives 80Km away fron
hospital, brought by her neighbor, US showed unviable fetus, abscent heart rate, 4cm fetus, BHCG
is 5000, what is the indication for surgical intervension?
A. BHCG B. Fetal heart C. Fetal size D. Social history✅
..
🌹Ectopic pregnancy managed surgical how to follow up the B HCG? It was 3500 after the
surgery.= Weekly measurements of B HCG until undetectable.
…
Case of ectopic pregnancy treated by Salpingostomy. On regular follow up her BHCG was
decreasing until the last three
visits the BHCG results plateaued. BHCG was 3200 on the last visit (normal is less than 5000). How
would you manage thecase:?
A. Consider giving Methotrexate✅ B. Start OCP C. Surgical intervention D. Reassure
…
Women diagnosed as ectopic pregnancy asks what is the predisposing factor:
A. Previous tubal pregnancy B. PID✅
…
🌹 Commonnest Contraindication intrauterine device?
A. Abnormal bleeding B. Pelvic inflamatory dis C. Ectopic pregnancy previous iud D. Endometritis
…
🌹 Case ectopic pregnancy ( history given) mother refusing OR hcg 3500 size of sac 3 non viable no
signs of rupture. what will u do=
A. explain that failure is high B. treat medically but sign consent C. laparoscopy D. laparotomy
…
🌹another case history given goes with ectopic with signs of rupture with free fluid asking about
treatment? laparotomy salpingectomy
…
Pt with ectopic bhcg 200+ treated with methotrexate came in few week with sever pain and
bhcg 6000 what to do?
If stable = laparoscopy , unstable = laparotomy.
…
pregnet smoker what will help her stop ? - behavioural therapy ✅
‫ﺾ‬Éö‫ اﻟﻤ‬6m Ž ‫ﺾ اﻧﻪ ﻣﻤﻜﻦ دە‬Éö‫ﻒ اﻟﻤ‬Œ‫ء ﻫﻮ ﺗﺜﻘ‬Ö× m
n ‫ ﻣﺎﻟﻪ ﻋﻼج اﻓﻀﻞ‬Ô“‫ﻟﻠﻦ اﻟﺘﺪﺧ‬
Lady her husband comes to you she want IUD insertion but husband wants her to get pregnant
refuses insertion... What to do?? A.contraciption decision is mutual.
….
- Baby was diagnosed with intrauterine fetal death using only US :
Further investigation Inform the mother ✅. C/S
….
_ Pregnant ( idon't remeber weeks ) after intercourse she had vignal spoting diagnose as complete
abortion ? They blame self which action ?
- Identify there emotions and show empathy
- Identify the emotion And empathy and prepare management plan ✅
…
Pregnant 20+ weeks with a twisted ovarian cyst you explain she needs a laprotomy to save the
baby's life and she refuses what to so?
- accept her refusal - ignore her and proceed with the surgery - take permission from her
husband ✅ - call the ethical commitee
…
Patient came to your clinic regarding consent for hysterectomy. What will you do?
A. Document B. Explain✅
…
🌹 24 yrs primigravida. Married 6 months ago, hx of irregular menses, at ER complaining lower
Abd pain, scanty vag. Bleeding, by us uterus empty, rt adnexal mass 2,5 cm, bhcg 2500, bp 120/70,
P 78 RR 14. Management: A. surgical B. medical✅ C. medical plus surgical
….

1polyp
🌷 - Picture of single cervical polyp with history of minimal bleeding what is correct?
A- Excision in clinic✅✅ B- Follow up after few months C- Admission and more investigation

….
🌹AUB, hystroscopy done (picture: soft tissue projection inside something?
A. Subserous myoma B. Endometrial polyps ✅
…
🌹55 yo man diagnosed with acromegaly what investigation will be required in the future? A. TTE
B. colonoscopy
‫ ﻻن ال‬acromegaly ‫„ﺪ ﻣﻦ ﺧﻄﺮ ﺣﺪوث‬à‫ﻳ‬
colonic polyps and colorectal cancer
....


Asherman
female C/O amenorreha for several months with hx of C&D procedure what is
name of this syndrom? A-Asherman ✅✅ B-Sheehan
D & C ‫ ف اذا ﺷوﻓﺗوا‬، dilation and curettage = (D&C ‫اﻟﻣﺗﻼزﻣﺔ ھذه ﻣﺎ ﺗﯾﺟﻲ اﻻ ﺑﺳﺑب اﻧﻲ ﻋﻣﻠت ﻓﻲ اﻟرﺣم ﻗﺑل ﻛذا‬
‫ ﻻ ﺗﻔﻛرون اﺑداااااا ب اي ﺷﯾس ﻏﯾر ﻣﺗﻼزﻣﺔ ﺷﺎرﻣﺎن‬amenorreha ‫وﻗﺎﻟك اﺷﺗﻛت ﻣن‬
Asherman syndrome is the formation of scar tissue in the uterine cavity come with women who
have had dilation and curettage (D&C) after pregnancy complications.
….
🌹Case of Pregnancy, did D&C, after 1 year got amenorrhea , what the diagnosis ?
- Asherman syndrome✅✅🌹
…
🌹amenorreha for several months with hx of C&D procedure = Asherman🌷
…
🍇Pregnant 5 weeks gestation with heavy bleeding and clots , hx of 5 previous abortions all her
Previous abortions were at 2nd trimester , she had multible D&C, what causes her current
bleeding: A. asherman✅ B. cervical incompetence C. chromosomal defect
..
🌹Pregnant in 5 weeks came with v. bleeding and she has history of 3 abortions d.t cervical incom.
and hx of D.C Ask about the cuz of current abortion
A. incompetence B. Asherman syndrome✅ C. Chromosomal
🌹Pregnant 5 weeks gestation with heavy bleeding and clots , hx of 5 previous abortions all her
Previous abortions were at 2nd trimester , she had multlble D&C, what causes her current
bleeding: A- Aisherman ✅ B- cervical incompetence C- chromosomal defect
‫ﻠﻤﺔ‬i ë‫ﻠﻤﺔ اﺷ“’ﻣﺎن =دوروا ﻋ‬i ‫ﺸﻮﻓﻮن‬£ ‫ اول ﻣﺎ‬Dand c ‫ﺴ¾ﺐ‬ç ‫ اﻻ‬$
n æ Œ‫ ﻫﺬە اﻟﻤﺘﻼزﻣﺔ ﻣﺎﺗ‬d&c
.........

UTI pregnancy
Management of UTI in pregnancy..

🌹One case of pregnant with UTI in urinalysis but pt asymptotic = Treat even if asymptomatic ‫ﻻزم‬
‫ﻌﻤﻞ اﺟﻬﺎض‬Œ‫🌹ﻋﻼج ﻻن ﺑ‬
..
🍒Female with uti , renal US reveals multiple Cyst through renal parenchyma different in size =
Poly cystic kidney 🍒
..
💐Abdominal pain with menstruation Us :multiple cyst variation in size diagnosis = A. Fibrocyst
B.Fibroadenoma
…
🌹Pregnant woman with recurrent UTI for 3rd time during current pregnancy, what to do:
Cystoscopy or ureteroscopy ✅ B. Urinanalysis D pelvic ultrasound .
…
🌹 Pregnant with recurrent UTI what to do?
A. X ray B. US C. ureteroscopy D.cystoscopy and RFT’s
…
🍒Pregnant UTI first trimester ttt? Nitrofurantoin 🍒
…
🌹female at 38 week with UTI what is ttt? A. Nitrufurtonin (for first trimester ) B. cephalexin(for
third trimester )
…
🌹UTI in 28 week pregnancy = A. cipro B. nitro✅ C. ceftri
…
🌹 Pregnant 1st and 2nd trimester have UTI Cystitis What treatment to give :
A. Nitroforgen B. Ceftriaxone C. Cefotaxime
…
- Pregnant w/t Asymptomatic UTI ..(not mention any weeks or anything) Tx:
A- Nitro ✅ B- Cipro C- Cephalon D- Augmentin 🌹Asymptomatic UTI = Nitrofurantoin🌹
…
🌹APregnant with UTI not determined which trimester, what is the best abx :
A. augmentin B. nitrofurantoin✅
…
🌹Pregnant patient in 3rd trimester with uti, what to give?
Nitrofurantoin B. ciprofloxacin C. trimethoprim/sulfamethoxazole D Cephalexin or amoxicillin
….
🌹Lactating with UTI what abx to give : Nitrofurantoin ✅
…
🌹Pregnancy with UTI culture sensitivity to : A. cipro B. nitro ✅ C. txm/sulfa
…
🌹 pt 3rd day post OP he have gram -ve bacteremia, how it reaches blood ?
A. Translocation B. From the gut C. UTI✅

1Ethic
......
🌹Pregnant woman from another country and different language, she is now in the 22th week I
think, she has history of previous 2 abortions, she developed now S&S of labour, she came to ER
anxious and afraid to lose hisd third pregnancy, what will u do:
A. Not appropriate to show that you understood her feeling because language is different
B. Show that you understood her feeling✅ C. 3rd option I forogt but it was least one to be correct
D. Call help from clleages

Patient had IUFD diagnosis confirmed by US. What is your next step in management?
A. Tell patient✅ B. Tell relatives C. Advance preparation D. Do more investigations
…
🍎Question about early identification of disease, what type of prevention was it?
2ry screening
‫ء ﺛﺎﻧﻮي ﺗﻮە ﻣﺎﺣﺼﻞ‬Ö×
n ‫ﺔ =ﻻ ﻫﺬا‬Ž‫ﺴﻮي ﻟﻪ ﺣﻤﺎ‬Ä ‫ﺤﺼﻞ اﻟﻤﺮض ﻧﻔﻄﺮ‬Ž‫ﻞ ﻣﺎ‬Ç‫ ر·ﻂ =ﻗ‬.
.....
🌹screening the mother for HBs what type of prevention? A. 1ry B. 2ry C. 3ry D. primordial
…
🍎Wife refused who got the right to decide?
Patient
......
🍎Old pt you diagnose her with atrophic vaginitis but didn't seem convinced she told
you she wanted another consultation
A. Tell her ur sure that us not necessary
B. Write report and refer✅
C. Refuse
….
🌹 Pt admit for tonsillectomy but surgery prolonged bc bleeding, the surgery successfully done ,
after pt ask why surgery prolonged?
A. reassure pt and don’t tell him about bleeding
B. tell another doctor to see him
C. ethics committee
D. reassure pt and tell him what happened ✅
.......
🌹medical physician refuse to resuscitate her premature baby? Respect her wish. 🌹
.......
🌹intern concern about side of renal transplant? inform the surgeon .🌹
......
🌹ethic csae about serrugaty and the doctor know that it’s not allowed at his hospital but doesn’t
know about SA role? till them that it’s not allowed at his hospital. 🌹
..............
🌹You attended the surgery theater as an intern, ( some renal surgery ) and the surgent was
preparing to do the surgery on the right side, but you knew from the history that the diseased
kidney is the left one. What should you do?
A- call the chef intern
B- tell the surgent ✅
C - do nothing
...........
🌹Patient old with end stages cancer disease complining of sever pain and his children ask you
to give him stronger pain killers you respect theirs wishes but you told them that the pain killers
may fasten the death of there father question in this case what the doctor do ?
principles of double effects 🌹
…
Pregnant unbooked G3p2 came to ANC visit and she gave you report about her socioeconomical
state she cannot handle anything and she don’t want her baby due to ... long scenario U/s report
Baby well with good fetal heart rate, GA 16+4 weeks What is your plan ?
A.prepare her for abortion B.tell her husband about it and take consent C.refuse✅✅ D.refer
her
…..
Women take contraceptive and husband don’t want it and want to have baby but wife refuse,
your action: A.show empathy B.support wife choice C. support husband choice ✅
D.contraceptive requires mutual consent
…..
🌹 34 years P4G3 GA 32 she is not came to ANC visit never, what the cause?
A- visit is expensive B- Ignorance✅ C- scaring from visit
…..
🌹If she refuses the surgery: ethical committee 🌹
…..
A woman brought with the police with bruises how to deal with her condition:
A.Call a. Social service of the hospital
B.Not examines her without her husband
C. Enter to her with a large smile and begin examination
D. tries to console her, she knows the cause of the bruising, and then begins the examination ✅
…
🌹Patient admitted with stroke hemiplegia on 2nd day start to having 1st degree bed sores the
physicin verbally tell the nurse to change patient position every 1 hr to avoid bed sores . Nurse
forget to write this . 3 days later patient had fever on examination he had infected grade 3 bed
sores . Where is the defect :
Communication between the doctor and the nurse inadequate way
........

🌹women got pregnant after trying 10 years, now she is 10 week pregnant, she has abdomen pain
and vaginal bleed, she went to the ER , the dr said the was not fetal heart sound and this is
abortion ( they were shocked ) what the doctor should do ?
A. Sympathy ‫ﺗﻌﺎﻃﻒ ﻣﻌﻬﺎ ﺣﻞ ﺟﻠﻮري‬
B. Admission after evacuation as post-partum care
C. Search for cause of abortion🤔
.......
🌹 Pregnant pt follow up appointment came after reading on the internet they said smoking
doesn't cause congenital heart disease , what to do ? Explain🌹

🌹The mother refused the cs that is will save the baby.

A.Refer the pt B.Repect her wish C.Take the husband concent ( not sure)
D.Do vaginal delevary E.Do cs against her wish
N.B: If she refuses to sign the consent only you can take her husband consent, but if she refuses
the surgery you cannot force her. But since her husband has rights you have to report to ethical
committe and they will deal with husband’s rights. in other recall last choice was call hospital
ethical part ✅ 🌹

🌹A 50 year-old female presents with complaints of anxiety. Two months ago during a meeting at
her job, she became very anxious, sweaty, and short of breath. She had to leave the meeting in
order to calm down. Since then, she has avoided the meeting room out of fear that she will have a
recurrence of the symptoms. What is the most likely diagnosis?
A. Panic disorder B. Specific anxiety disorder ✅🌹 C.Post-traumatic stress disorde D. Generalized
anxiety disorder
….
🌹 case of a female came after 3 months of delivery, saying she used to suffer with low mood,
irritability during the first 2 weeks of delivery but symptoms resolved now completely....what
condition did she suffer from...?
A- postpartum psychosis B- pp blues ✅ ‫ ﺣﻞ ﺟﻠﻮري‬C- pp depression D- pp hallucinations 🌹
..
🌹Pregnant wants to quit smoking best way = Cognitive behavioral therapy🌹
…
🌹 Pregnant want to stop smoking, which IV drug is indicated
A- bupropion B.varnaline C.cognitive behavior ✅
….
🌹Smoking during pregnancy A.nicotine replacement B. behavioral support ✅🌹
….
🍒Female patient wants contraceptive pills and she insisted to tale it without telling
her husband. What the doctor should do?
A. Refuse✅✅ ( Dont choice Tell husband)
B. Tell the husband‫ﻣﺎﻟﻨﺎ ﻧﺪﺧﻞ ﻧﻘﻮم ﻧ½ﻠﻢ زوﺟﻬﺎ ﻧﻘﻮﻟﻪ ﺗﺮى زوﺟﺘﻚ ﺗﺤﺘﺎج ﺗﺎﺧﺬ اﻟﺪواء‬
C. Give the patient as she requested
D. Tell her the intrauterine device is better as the husband will not see it
…
Female patient who is in forties had 5 children and now pregnant in 12 weeks with
Rheumatoid arthritis and wants to terminate the pregnancy. What should the
doctor do?
A. Tell her the fetus is still small and can be terminated
B. Do the termination
C. convince her that the rheumatoid arthritis doesn't affect the pregnancy✅
…
Female patients come to the doctor's office with signs of abuse. She told you the
abuse was from her husband and told you not to tell her husband. What should
you do?
A. Threatens the husband by police ‫ﻚ اﻟוﻃﺔ‬Œ‫ﻧﻬﺪد زوﺟﻬﺎ ﻧﻘﻮﻟﻪ ﺗﺮى ﺑﻨﻌﻠﻢ ﻋﻠ‬
B. Tell the police ‫ ✅ اﺻﺤﻬﻢ ˜ﺬا‬C. Do what the patient said to you
D. Give the patient your number to tell if this happens again in future ‫ﺎ‬Œ‫ ﻋﻠ‬ln µ ‫ واﻗﻮﻟﻬﺎ د‬Ân‫اﻋﻄﻴﻬﺎ رﻗﻢ ﺟﻮا‬
‫ﺔ‬Œ‫ﻟﻮ أذاك ﻣﺮة ﺛﺎﻧ‬
NB: Examine , document , then report ‫ھذا اﺻﺢ ﺟواب ﻟو ﻟﻘﯾﺗوه اﺧﺗﺎروه‬
….
Female patient who is in forties and pregnant wants abortion and threatens you
that she will attempt sucide if you not abort the pregnancy. What should you do?
A. Do the abortion
B. Give her herbal remedies that help in abortion
C. Admit her to psychology support to convince her✅✅
D. Get her out of your clinic
...
🌹smoker with fetal desmia cries that her smoking killed her fetus
A- Tell her... B- Say the cause not yet clear✅
…
🌹Case of pregnant smokers: Low birth weight
 Ethics
🍎Patient for surgery but has a persistent cough for 6 months and you didn't book
him for surgery, he is angry and threatened to report you if you didn't book him for
surgery:
A. do the surgery to get his respect
B. Report him to hospital social worker
C. Consult a physician
D. Report him to the administration✅
N.B: Referral to another doctor in other recall
........
🍎Consultant told resident to write piperacillin Tazobactam and pharmacist said px had? Penicillin
allergy. What should the resident do? Refused to write gently✅
........
🍎A child with multiple bruises brought by parents. What should Dr. do?
A. Question parents about it
B. Refer the child
C. Inform child protection services✅
............
🍎An ethical scenario in which parents brought their child for health check. Child
has not had any vaccination because px's don't believe in it. What should you do?
A. Accept their decision
B. Refer them to social services,
C. Refer them to another Physician
D. Counsel them about benefits of
immunization and correct their misconceptions✅
.....
🍎A pregnant woman within labour with fetal distress. You counselled her for surgery but she is
refusing bluntly. What is the appropriate action?
A. Refer to another hospital,
B. Inform the hospital ethics committee✅
C. Get consent from husband,
.......
🍎A woman came for routine ANC and smokes about half a pack of cigarette daily.
She had 2 normal children previously and doesn't believe smoking is harmful in
pregnancy. How do you manage?
A. Accept her beliefs,
B. Refer her to mental health services,
C. Counsel that her child is at risk of intrauterine growth restriction,✅
D. Counsel about nicotine replacement in pregnancy
.......
🍎Scenario of an elderly with an advanced cancer. Anaesthetist thinks operation not
advised but surgeon wants to operate. What should you do?
A. Take a high risk consent✅
B. The surgeon should operate with another anaesthetist,
C. Inform hospital ethics committee,
D. Refer patient to another facility.
.....
 Ethics:
🌹Meningitis suspected pt's SON refuse iv antibiotic to be given to his father what to do?
A. Respect the son's decision.
B. Ask patient opinion ✅
...
🌹 elderly with end-stage cancer in unbearable pain his family ask u to give him what to do?
Answer is: Give him (principle of double effect) stronger pain killer: what type of desicegion
making doctor use?
A. Decision of majority
B. Decision of children ✅🌹
C. Decision of benefits
.....
🌹couples with infertility ask about serogate pregnancy which not allowed in ur hospital and u are
not sure wither allowed in saudi or not?
A. Warn them might not be allowed in ksa. ✅
B. appointment to check yourself and then tell them.
C. Referral to colleague who can help to do it. 🌹
....
🌹dr prescripe medication to the pt but the pharmacist thinks that the pt is allergic to it but dr
insust what should u do?
A. write it then ssk doctor to sign it.
B. refuse to give medication. ✅🌹
.....
gyn explain to the pt that HRT will not help her menpousal symptom at this stage but the pt insist
to have it what should dr do?
A. Dont give it to her (refuse). ✅
B. give her.
C. refer he.
.........
🌹A woman came to the clinic with her husband due to infertility problems. Results are back that
her husband is HIV positive:
A. Inform husband. ✅🌹
B. inform wife.
C. ignore results.
.......
Elderly pt with lower abd pain and couldnt urinate for many ( dont remember days or hours) .=
Foley catheter
......
🌹Very old pt in ICU with carcinoma and other trouble in breath.. surgeon want to do sm surgery
to improve breathing but sure if the pt will survive during the surgery.. what to do?
A. let the pt sign very high consent ✅🌹
B. No need to do it cuz there is no sure improve ment
....
🌹Pt with fetal congenital heart need intubation and resuscitation .. mother one of the hospital
physician and refuse intubation and resuscitation .. what to do??
A. respect mother wish
B. Refer to another colleague
C. Do the intubation ✅🌹‫ﻣﺎﻟﻬﺎ ﺣﻖ‬
D. Call hospital committee
......
🌹40 year old, he had to undergo amputation and refuses, what will you do?
A. assess his mental capacity
B. let him sign against medical advice ✅
C. force him into OR
.......
🌹girl came to ER with child abuse, what the prove of abuse? hymen injury at 6clock
….
🌹 Female 3 years abused ? Uncontrol stool and urine
..
🌹Pregnant lady came to the hospital with broken arm caused by husband abuse. Which of the
following is the most likely time for increased intimate partner violence?
A. After retirement✅ B. During pregnancy C. At family visits D. Holiday

ETHICS
🌹Smoker mom on 30 weeks on US examination there was no fetal heart.
She was so annoyed and started blaming herself , what should you tell her?
A. Smoking is the main risk factor of IUFD
B. Calm down we still going to investigate the reason
....
Paitent with irrigular cycle and take ocp before marriage, after marriage the husband want baby
but she refused ?
a-Mutural consent on ocp1✅ Ô m “ ‫ﻻزم ﻣﻮاﻓﻘﺔ اﻟﻄﺮﻓ‬
b-Be with women ‫😂 ﻧﻮﻗﻒ ﻣﻊ اﻻم‬
c-With husband ‫😂 وﻻ ﻧﻮﻗﻒ ﻣﻊ اﻻب‬
d-Show empathy ‫" ﻣﻌﻬﻢ‬n m ‫وﻻ اﻇﻬﺮ ﺗﻌﺎﻃ‬
. .. . . . .

🌹 A 6 years old girl brought by her mother to the clinic, she is malnourished and in poor hygiene,
the mother say it’s too hard because she is looking after the kids and they have low socioeconomic
state, your action:
A. report mother to child protection services
B. use only close questions??
C. encourage mother to use her own words??
D.call social worker
....
Ethics
3 years old asthmatic child, mother is concerned as they are not leaving the house much as they
have to use the nebulizer and it needs power source, what
to advice?
A. the mother is right
B. Find a portable nebulizer
C. Educate about inhaler use and stop nebulizer
....
🌹 In a consultation with a patient he keeps asking you to explain his illness and
you wish to collect information to get better insight on the disease
A. you interrupt him gently and ask him closed question.
B. you tell him to be quite because there many patients waiting.
C. you address his thoughts.
....
🌹Asthmatic child ( 7 year ) always came to ER and father was smoker and every
time the doctor advised him to quit smoking but he not listening and careless ,
child right now complain severe attack , what you will do ?
A. Talk the father about that habit
B. Tell hospital committee
C. Treat the child and forget that situation
....
🌹 Couple want to do surrogacy‫ اﻻرﺣﺎم‬gh‫ ﺗﺄﺟ‬came to you and you don't know if it’s allowed in
Saudi. what should you do?
A. Give them an appointment in a few weeks and educate yourself on the topic
...
🌹33 weeks pregnant woman came for a regular antenatal clinic visit an ultrasound was done
before she stepped into your office the results sure are a
non-viable pregnancy intrauterine fetal. what is the best option for this patient
how will you break the news to this patient?
A. tell her your baby died
B. show emotion and empathy while explaining the finding
C. Be strong show no emotion
....
....
🌹Doctor brings all these together; diagnosis, plan and parents thoughts ..etc.
what the doctor did?
A. Summarization B. Reflection
C. Paraphrasing
‫ﺺ‬Œ‫ﻼن واﻻﻓ½ﺎر =اﻟﺘﻠﺨ‬Ç‫ﺺ واﻟ‬Œ‫ﻞ اﻟ!ﺸﺨ‬i ‫اﻟﺪﻛﺘﻮر ﺟﻤﻊ‬
....
🌹 Elderly in ICU, wrote on his clothes “ i want to die in peace”, patient collapsed
doctors didn’t resuscitate him and he passed away, pt son is angry he said that
his father was not capable to take decision, what to till him?
A. respect pt choice
B. Pt couldn’t do it anyway
C. Doctors don’t resuscitate braindead patients
...
🌹Sexually active woman delivered a baby out of wedlock at a hospital she abandons the baby a
pediatric surgeon examines the baby and finds out that baby has an inguinal hernia and would
like to perform surgery what should he do it next
A. Consult the ethics committee at the hospital
B. perform the surgery
C. not perform the surgery
....
🌹 Pt talking to surgeon about his condition & he want to explain his perception of why he is ill,
and surgeon wants to get more information from history :
A. wait until he finishes his thought
B. interrupt politely & ask close ended questions
....
🌹 Child presenting with asthma exacerbation, father smokes in home, told many times not to
smoke but he doesnt care and doesn't want to listen. What do you do:
A. Call child care services.
B. Explain why its important not to smoke at home.
C. Call medical ethical committee of the hospital
...
🌹 Pt dx as RA and for steroid she is afraid what to do?
A. stress the importance of tx and give her time to decide
B. tell her it have non serious SE
....
🌹Doctor trying to take a medical history from a patient, but the patient wants to
talk about his perception of the disease and how he got it:
A. let him finish his thought
B. politely stop him and use close Qs
...

1psycatric
- Female come to ER with prusis multiple area Which indicate domestic violence ‫ا‬
‫ﺔ‬Œ‫ ؟ اﻟﺰوﺟﺔ اﻟﺜﺎﻧ‬Ân’m m ‫ اﻟﻌﻨﻒ اﻟﻤ‬Â‫ ﻳﺆدي ا‬Ân‫ﺶ ا‬Ó‫ا‬:)
a-Second marriage ✅✅
b-Tobacco
🌹domestic violence ‫ ا‬Þ̀g_ _ ‫ =ﻋﻨﻒ ﻣ‬Second marriage🌹

. . . . . ..
🌹 Female with severe depression , recently improved on paroxetine for 2 months and now she is
pregnant , what is the appropriate action ?
A. Stop paroxetine due to avoid prematurity
B. Continue paroxetine C. Stop paroxetine due to fetal damage
…
Mother after given birth see snakes in her baby and shake him 50 time
A. Hallucination B. Delusion C. Post partum psychosis✅

22 years female known case of severe depression. she is controlled on paroxetine. Now, she is
pregnant. What to do:
A. Stop paroxetine because of fetal malformation
B. Continue paroxetine and control her depression✅
‫’وك‬æ‫ر·ﻂ =ﺣﺎﻣﻞ =¼ﺎروك =ﻣ‬
.........
🌹Female with menses decreases work, increases absence and ER visits what she has:
A. swing mood ✅ B. Anexity C. irritability
🌹PMS: Swing mood 🌹
🌹PMDD: Irritability 🌹
.....
🍓17 years female came with change in behavior before every menstrual cycle(something like this)
A. irritability✅ B. Mood swing
…..
🌹 Mother bring her 13 years old how has history of recently menarche, She reportes
that her daughter recently being irritated, and had mood swings, disorder is dx?
A. *Mood disorder*✅ B. Behavior disorder C. Substance abuse D. Anxiety disorder
…
🌹Mother bring her 13 years old how has history of recently menarche, She reportes
that her daughter recently being irritated, and had mood swings, Which of the following is
disorder is dx? Mood disorder*

🍒Pms and asks what help you in the diagnosis:

A. Clinical symptoms✅ B. Another with mood swing as the answer
…
🍓PMS = Clinically diagnosed🍓
…
Patient with nervousness irritability and low mood and Postpartum period what to give:
A. intradermal progestogen patch
B. SSRIs ✅✅✅ ‫ﺔ‬Œ‫ﻻن اﻋﺮاض ﻧﻔﺴ‬
C.Progesterone only pills
D.Other contraceptive methods other than the OCP
…
🌹Patient with recently depressed after being promoted to manager, what to do?
A. TCA B. SSRI C. Psychotherapy
.....
A women with disabling symptoms of menstruation that affect daily activity= SSRIs
…
🌹Female pregnant 30 weeks, her husband punched her in the face and abdomen then she hit the
floor. Examination all normal. What best next step?
A.Immediate CS B.Confirm what happened ✅ C.Reassure and discharge D.Follow up
…
.....
🌹Postpartum Mother delivered her baby 1 week ago and she that snakes in her child's bed and
she checks her baby every time.
A. delirium B. DelusionC. Postpartum psychosis✅
….
🌹12 year obese girl brought by her mother concern about irregular menestrual bleeding and
increase weight for 5 months, acne, otherwise normal.. during examination the girl was
uncomfotable, uncooperative.... n .. what of the following doctor should consider in the
discussion: A. Behavior✅ B. Mood C. Anxiety
…

.....
🌹Pt with skin lesion in her labia, picture provided, lesion slowly growing (my
description: small round, erythematous base, with dark elevated surface)‫اﻟﺼﻮرة‬
:Dx , ‫ﺷ>ﯿﻬﻪ وﻟ@ﺴﺖ ﻣﻄﺎ¼ﻘﺔ‬
A. basal cell carcinoma
...
🌹Left ureter agenesis

...
🌹Mealanoma

🌹 Nuchal trans in us? A. Nl with cardiac disease B. Nl with neural defect

December
🌹 Young women G2p1 is smoker, no chronic disease and now she is complaining of nothing, her first
pregnancy is ok, what is the risk for her current pregnancy? A. IUGR. B. Forget others
…
🌹 Female use paroxetine with history of suicidal attempts and depressions pregnant what to do = .
Continue B. Decrease dose C. Discontinue
(N.B having suicidal attempts or ideation This indicates severe depression
Take the risk of cardiac anomalies from paroxetin but you will avoid suicide which will
end up with mother and fetal death)
…
🌹 Bilateral tubo ovarian abscess management?
A. Laparotomy B. laparoscopic drainage C. US guided drainage D. IV abx
….
🌹 What of the following gives the highest yield in a patient coming for
prenatal visit?
A. General appearance B. Pelvis rectal digital exam C. Inspection of vagina D. speculum exam
….
🌹 Female on active delivery. Full effacement and 7 cm dilatation +3 station.
Doctor noticed cord protruded out of the vagina. Fetal HR 120. What to do?
A. CS. B. Follow after 2 hrs. C. Ventouse delivery. D. Continue vaginal delivery
Answer is A because it is (cord prolapse)
….
🌹 Highest causing factor of endometrial cancer:
A. late menarche. B. early menopause. C. DM. D. progesterone tumor
Answer is Early menarche and late menopause are the risks, they are reversing it here
Progesterone is a protective factor for endometrial Ca, DM is a risk
….
🌹 60 y post menopause come with lump on the vulva and complain of itching
and after the itching bleeding on PE the mass was pea like , what is the Dx?
A. SCC. B. Bartholin cyst C. Bartholin adenosis or adenoma
Answer is A It’s the most common vulvar carcinoma + the most common presentation is
itching, Bartholin usually asymptomatic or it will cause pain, tenderness presentation will
be like abscess, SCC usually present as small mass
…..
🌹 pregnant with 33 week gestation presented with headache protein urine +3,
Bp 150/100 , asking what to do ?
A. Immediate C/S. B. delay for a week and give steroid. C. admitted for observation
N. B: Severe preeclampsia in preterm usually they admit her > Mgso4 and BP control +
steroids
Then they discuss delivery since she is preterm
Even if blood pressure 1000/500
1st avoid CS
2nd: If she is preterm > Mgso4, Steroids, BP control
Then discuss delivery
But if she is full term > Mgso4, BP control > infuse her with oxytocin for delivery +
Mgso4
…..
Ectopic pregnancy bhcg 3500 hypotension tachypnea , management
A. Methotrexate B. Laparoscopy C. Laparotomy salpingectomy
….
precious baby after 10 years infertility and the patient cervix open 4 cm
effacement 50% and the presenting part was soft globular at -2 station
A. Oxytocin. B. CS. C. Prostaglandin
N.B Firm and round signifies cephalic, soft and/or non-round suggests breech. If breech
presentation is suspected, the fetal head can be often be palpated in the upper uterus.
It is breech > CS
She's in labor no point of PG
Didn't mention contractions so no point of oxytocin
And too late to give tocolytics (plus it’s contraindicated >4cm dilated)
…..
Cervical polyp pic found accidentally? A. Excision now B. Admit and work up C. Reassure
….
Female came to be pregnant k/c ulcerative colitis before 3 ys on mesalamine
drug Recurrent attack last one before 3 m
A. Dealy pregnant for 3 m B. Delay pregnant for years C. She cant pregnant now coz she is sick and baby
not complete
Answer is:In general any chronic disease try to control the disease first before pregnancy
(stabilize the mother first)
Generally speaking, women whose ulcerative colitis or Crohn's disease is in remission can
become pregnant as easily as other women of the same age. However, women with active IBD
may have more difficulty becoming pregnant. Conceiving during a disease flare is not advised.
…..
female pt with stress incontinence.. Which type from the following is similar
A. Cystocele. B. Urethrocele. C. Rectocele
what is the reliable method to confirm amniotic fluid leaks other than something
paper ? Answer is Ferning test. ( paper test = Nitrazine test)
….
Vaginal trichomoniasis tx for husband = A. metronidazole B. tetracycline C. no treatment
…..
7th child vaginal delivery, 4 kg baby placental in place , bleeding 800 ml cause
A. primary pph B. secondary pph C. iatrogenic pph D. tertiary pph
….
Female in 40th with AUB ،hx of PCOS not treated suspecting polyp confirmed by
ultrasound + endometrial thickness next
A. Hysteroscopy polypectomy. B. No endometrial biopsy in choices
….
Female 3 months post SVD , after one month she complain about having stool inc.
and passing flatus from the vagina : A. recto vaginal fistula B. perineum tear
….
Female her previous pregnancy is stillbirth and now she wants to pregnant and
ask the doctor about all the vaccines that she is needed before consumption and
reduce the stillbirth ? A. rubella B. varicella C. influenza
…
One question about post episiotomy with tear grade 2 , she is on oxytocin 20 infusion and you want to
repair the tear but there is bleeding from above obscuring this , uterus is soft , what to do ?
A. Manual exploration B. Methylergonovine C. Increase oxytocin
….
Highest test of value (something like that) of fetal growth , mom was at 10 w GA ?
A. CRL B. BPD C. Femur length
….
● Endometrial biopsy , prerequisite?
A. Admission. B. Anesthesia clearance. C. Verbal consent D. Operation room preparation
….
● Female with Painful Mass bulged lateral and inferior of pubic tubercle , Dx ?
A. Femoral hernia B. Indirect inguinal hernia C. Direct inguinal hernia
…
● Female with infertility, prolactin high, TSH high, Cause of infertility?
A. hypothyroidism B. hyperprolactinemia C. hypopituitarism
…..
● chocolate cyst (6*7 size) management?
A. observe until size 10 B. resection with ablation to any endometrioid spot Answer is: B rt ?
Answer is: Lap cystectomy
….
● 40 y at 37 GA came with active labour following spontaneous ruptured membrane, ctg is
bradycardia: A. cord prolapse. B. placental insufficiency C. rapid fetal descent
….
65ys complain of aub and endometrial mass (15 mm) what is the best management ?
A. Total Abdominal Hysterectomy. B. Lap hysterectomy. C. Vaginal
….
● A case of concealed abruptio at 34+2 days what next ?
A. US. B. Cardiotocography. C. IOL. D. CS
…..
2 questions about pre-eclampsia, one 32wks pregnant the other 34wks has hypertension
and proteinuria, management? A. Admit and observe. B. Immediate CS. C. IOL
…..
● Unbooked pregnant female presented with abdominal pain, and bleeding she took time to
get to the hospital due to transportation, on P/E: hypertensive 170/.., CTG was done and
reassuring, the next step is
A. Biophysical profile B. C/Sx C. admit the patient D. send for lab work (they didn't spacify)
…
● 39 week, women with proteinuria Bp 140/90 , ur action ?
A. admit and observation B. Labor induction C. Follow up and observe
….
● Female presented with sharp abdominal pain for 1 week. Hx of amenorrhea for 2 months.
Smoker. Hypotension, tachycardia, bhcg: 1800, all other investigations normal.
Management:
A. administer strong analgesia B. Administer misoprostol C. Refer to surgery to rule out acute abdomen
D. Laparotomy (not sure of this option but similar)
…
Couple came for infertility for 2 years female evaluated and was normal, husband has cousin with Down
syndrome and other autistic. What to do next? A. genetic test for husband B. sperm count C. wait and
watch
…
Pt pregnant on delivery presented part with brow face and mouth what is your mx? A. Emergency CS
…
● Speculum exam show cervical mass next?
A. Pap B. Cone biopsy C. Directed biopsy
….
Melnoma on valvula? A. Malignant melanocyte B. Autoimmune antibodies agensit melanocytes
…
female pt with dvt what to give ? Heparin. B. Clexane. C. Aspirin
..
DVT prophylaxis in a pregnant women with history of DVT: A. heparin B. Enoxaparin
…
34weeks GA pregnant she had uterine contractions every -mins the cervix dilated 3cm and
the membranes intact,the fetus lying transverse and has normal FHR, she had vaginal
bleeding on us the placenta attached to the posterior fundus but with retroplacental
isolucent, what you will do:
A. Give her tocolytic B. Give her oxytocin C. Cs D. Amniotomy
…
● lady is 34 wks gestation, had a previous one C/S, on pelvic exam only the cervix was 3 cm
dilated, on US placenta was anterior and laying low. Why is ECV contraindicated in this
case: A. gestational age B. vaginal exam findings C. us findings. D. The previous c/s
….
Patient I think 51 with s & s of menopause, asking about causes of flushing ?
A. peripheral vasoconstriction in response to core body temperature
B. peripheral vasoconstriction in response to high FSH and LH
C. periphral vasodulation response to High FSH and LH

…
Pt. With amenorrhea 12 week, Fundal height 16 week, On U/S fetal small to age Dx ?
A. Placental site trophoblastic tumor. B. Hydatidform C. Choriocarcinoma D. Anembryonic sac
…
Pregnant with lower limb edema , BP(150/70): A. Diuretic B. labetalol C. continue evaluation
…
● Postpartum depression undergo psychotherapy: A. Encourage breast feeding B. Involve family member
….
● Pregnant patient with recurrent UTI what to do? A. X ray B. US C. ureteroscopy Answer is: C
….