Gynae Ospe 2012

GYANE-OBS OSPE ALL COLLEGES UNDER UHS... (2012)

Vntose 2type of cup cntraindcation fetal cmplictionz
Intractv take hstory of prsnting complain,index prgnancy,past obs history
Prenatal diagnosis wid,cordocntsis20wk amniocntsis15wk,CVS10WK for cytogenic biochemcl enzymatc dna analysis
Advice to lady who had c-section 7days back now stitches removed
Pre-eclampsia 3symptm 2fetal cmplction recur rate
Fe dficiency anemia peripherl flm causes route fe administrtion
Extrnl cphlc vrsion at wat gstationl age advntge 3contraindcatio 4risks of ds
Synto inj wat is actve mngment of 3rd stage its other uses signs of placental separation

MC ospe:
1)fetal skull diameters(pic) Ques:names of diameters
2)CTG Trace
a)FHR(b)normal ctg values(c)wt is non stress ctg?
3)scenerio(a)diagnosis:vesicovaginal fistula(b)types of fistula(c)treatmnt
4)intrective:scenerio:(a) PROM(b)managemnt
5)intrective:pics a)to idntify which type of twin preg in which pic.5pics(b)fetal n neona al complications.(c)compl of monoamniotic mono chorionic twin preg
7)scenerio(a)eclampsia(b)specific invest(c)aim of managemnt
8)(a)matrnal mortality(b)define MMR(c)causes of mortality in Pak
9)pic uv prolapse(b)types(c)name uterine ligaments
10)pic cord presntation n cord prolase(b)risk factors(c)treatmnt
11)scenerio ashrmn synd(b)investigations(c)treatmnt
12)usg n scenerio(a)diagnosis(fibroid(b)age grp(c)complications hn preg(d)2surgical options
13)intrctive pic a)ocps(b)other preparations of hormonal cntracption(c)abslute contraindications
14)pic to label types of fibroid5labels
15)pic(a)idntify colposcopy(b)wt i$ stge3 in ca crvx

Gyne/obs OSPE WMC 17/2/12

OBSERVD
1. OCP
2. Recurent abortion
3. Spina bifida
4. Hep b
5. Preclmpsia
UNOBRERVD
1. Transvers lie with arm prolapse
2.mcrosomic baby
3. TTTS
4. Bilobd placenta
5. Megalo anemia
6. 5 instrumnts thay, sub k nam or use
7. Uterus didalphus or sub septate uterus
8. Colposcopy
9.Fibroids
10. Uterine prolapsed

Qamc ospe 17.2. 2012 ctg,normal puerperium,bact.vaginosis,cuscos speculum,wriglexes 4cep,thalacemia minr counsel,shouldr presentation,pco,uterus labelling,levonorgestrel,iucd,uterine polyp,penatal mortality

FMH ospe:
Counselling of diabetic mother,
down syndrome ,
HIV,l
ast trimestr vaginal bleeding,
pt 6 wk amenorr preg test + bleeding 4 one day
Spots
Ectopic preg,
colposcopy,
endometriosis,OCPs,
Rh -ve mother,
complications of transverse lie shoulder presentation,
Fetal scalp electrode heart monitoring,
outlet forceps

UMDC OSPE 17TH FEB
SPOT 1.... diagram ov cord traction...... sings ov placental seperation...... name ov method?
SPOT2..... vacum device..... indicationz nd pre requisite
SPOT 3......... episiotomy scizr..... 2 cmplicationz
SPOT 4....... breech prezntation............ fctrz responsible.......... investigatinz
SPOT 5....... diagramz ov difernt types ov pelvis .. labeling..... plus whtz d mst favrable type
SPOT.6..........fibroidz.. a diagram which iz gvn in 10 teachrz showing difernt typez.............. b) major presnting complaints
SPOT 7........... scenerio PID.... common organism invlvd..... investigation nd treatment
SPOT 8...... ocpz......... hormonez........ side efects...... wht u vl advise d patnt 2 do in d case ov missd pilz
SPOT 9.. ayerz spacula.... indication..... wht iz CIN, classification
SPOT 10 .......... scenerio was about vaginal discharge or spoting................... 4 d/dz plus investigationz
INTERACTIVE STATIONZ 
11.... imperforate hymen diagram.... cmplicatnz plus treatment
12...... paseriez... indicatnz.... plus cmplicatnz
13....... breast feedng... beneftz... C/I etc
14.......... SCENERIO eclampsia..... investigatnz plus treatmnt...
15........... diabetez........risk factrz 2 baby............ insulin iz safe 2 use or nt? cmplicatnz...

NMC.....today's OSPE [17.2.2012]
label the picture...uterus showing Fibriods at diffent sites.
( subserosal, submucosal, intramural, peduncultad, twisted)
2. lady with decreased bleeding at periods after a D & C
what is the diagnosis...Asherman's syndrome
investigations
treatment
3. curd like vaginal discharge
Dx...Vaginal Candidiasis
organism causing??
investigation?
treamtment?
4. picture showing fetal skull diameters...label them, names?
scenerio....Dx..fibroids!
it is a diease of which agr group?
complications during pregnancy?
give two surgical treatment options?
6. patient presenting with watery discharge few days after a C-section.
Dx...Vasicovaginal fistula
types?
investigations

investigations?
treatment?
7.what is maternal mortality?
maternal mortality rate?
major causes?
ashermanns invest and treatment?

interactive stations...
8. twin pregnancy pictures....tell types shown?
complications?
complications peculiar to monochorionic monoamniotic twin P??
9. patient with b.p 160/110, proteinuria, Fits...
Dx?
investigations?
AIMS of managment?

interactive
10. picture showing colposcopy being done on a patient
name the procedure? Colposcopy.
what is the extent of cevical Ca stage 3?
11. primigravida, 33 weeks gestation, presenting with watery vaginal discharge, and labor pains..
Dx. preterm labor?
managment?
mode of delivery?
interactive
12. oral contraceptive pills.
other hormonal contraceptives?
absolute contraindicatios?
picture showing UV prolaSE
classify?
CTG graph
baseline heart rate?
baseline values?
cord prolase!
risk factors?
mangment?

WMC gyne ospe.. unobserved
1 pics of uterus didelphus and subseptate uterus; identify and rx
2 pic of colposcpy; advantages
3 ulrasound of fibroid wd h/o menorrhagia; complicatn in pregancy and surgical rx
4 pic of UV prolapse in a mutipara post menopausal lady; identify, etiology n rx
5 pic of hand prolapse; identify, comlicatns n mgt
6 pic of macrosomic baby; identify, complicatns in baby & during labour, dx in the mother, what test shud b done in postpartum period
7 pic of succeturiate lobe in placenta; comlications, mgt
8 pt wd hb 8 and increase mcv; dx, etiology, commonest cause of anemia in preg
9 instruments wd 1 use of each.. spatula, towel holding forceps, diagnstic curette, hysteroscopic curette, uterine sound
10. twin 2 twin transfusion syndrom. Pic
WMC gyne ospe observed..
1 moa, six advantages and 2 side effects of cocp's
2 g3p0 miscarriages at 8 12 14 wks; dx and inv
3 scenario wd evidence of low lying placenta; dx, types, incidence, causes, abd exam findings
4 34 wks pregnant women wd mild jaundice.. inv mgt
5 pic of spina bifida; identify, pathology, incidence, mgt

RMC GYNE OBS 17.2.12:
INTERACTIVE:
1.Rh incompatibilty scenario: dx,investigations,management
2.combined OCPS pic: identify,types of hormonal contraception,absolute contraindications of cocp
3.breast feeding: advantages to mother and baby, disadvantages of bottle feeding
4.eclampsia scenario:diagnosis, specific investigations, management
5.endometriosis scenario: dx, investigations, treatment
STATIC:
6.laproscopy pic: identify da procedure, tell methods to prevent bowel damage
7.a picture of cystourethrographay/urodynamic studies wid stress incontinence scenario: dx, wat is shown in pic, how 2 confirm ur dx, management
8.heger's dilators:what is deir use and in which procedures r dey used,2complications,how will u prevent complications
9.episiotomy scissor: identify,in which procedure it is used,types of dis procedure, complications
10.pprom scenario: dx, 2 drugs used, risk factors for pprom
11.picture showing controlled cord traction: what is going on in dis pic, what r its complications
12.twin pregnancy pic: identify,what r its complications during 2nd stage and 3rd stage, how 2 prevent 3rd stage complications
13.leakage of meconium stained liqour scenario: dx, investigations for monitoring, management
14. abdominal mass wid raised ca 125: dx,which type is common at 56yrs of age, treatment methods available [ovarian tumor]
15. bacterial vaginosis scenario: dx, investigations to confirm it..

DHq cases pih anemia oligo poly hydromnias ecclampsia perineal fistula fibroids molar preg , threatened abortion , UV prolapse 2nd degree, metarrhagia , menorrhagia , PPROM , Diabetic mothe

AIMC ospe
1. ccord cutting sissors
2. doyen retractor
3. rubin insuflator
4. ca endometrium
5. twin pregnancy n complications
6. breech at 37 weeks, manag
7. uterine anomilies
8. turnerz syndrome
9.iucd
10. shoulder presentation with cord prolapsed

AIMC obs
1. vaginal discharge
2 iu death
3 preterm labour
4 downs syndrome
5. vaginal hysterectomy

fetal scalp electrode uses and pic???
nmc ospe.....18feb....
1.scenario of placental abruption....
2.pic showing EXTERNAL CEPHALIC VERSION....ITS RISKFCTRZ AND CONTRAINDICATIONS....
3.PIC OF FETAL SKULL....LABELLING...OF FONTANELLES AND SUTURES.....
4.SCENARIO F PUERPERIAL PYREXIA...RISK FCRZ..INVESTIGATIONS....
5.PIC SHOWING COMPLETE MOLE...INVESTIGATORY WORK UP AND PERSISTENTLY INCREASED BETA HCG ...VAT U SUSPECT...?
6..INSTRUMENT...CERVICAL DILATORZ AND UTERINE CURETTE ...THEIR INDICATIONS..
7.USG SHOWING MULTIPLE CYSTS AND SCENARIO ASSISTING POLYCYSTIC OVARIAN SYNDROME..INV...?SYMPTOMS?
8.ENDOMETRIAL CA
9.FIBROID...
10.INTERACTIVE....OVARIAN CARCINOMA SCENARIO..RISKFACTOTRZ AND TUMOUR MARKER NAMES...
11.SCENARIO ....DVT...RISK FACRORZ ...SPECIFIC TO PREGNANCY...
12..PIC SHOWING ADHESIONS IN FALLAPION TUBES...SCENARIO LEADING TO PID...ORGANISMS RESPONSIBLE...?LONGTERM EFFECRS...
13..TWIN PREGNANCY PICS ..MODE OF DELIVERY WAS ASKED ..
14.SCENARIO SHOWING PRETERM LABOUR....IN 20 WEEKS...WITH PREVIOUS TWO PRE.TERM BABIES...RISK..FOR THIS ONE..? AND HOW U MANAGE AT THIS POINT?
15..CTG...INDICATIONS AND PARAMETERS VALUES...
BEST OF LUCK....4 COMING BATCHES...

cases in hfh 2???

recurrent 1st trimester abortion
Anemia
Precious pregnancy(came fr fetal surveilance)
Gestational diabetes
Mass lower abdomen(d/d)
Fibroids
Placenta praevia
Dysfunctional uterine bleeding

Protocol of pap smear?

szmc ospe...
fibroid..dx..mdcl mng..compl..
bacterial vaginosis..
sims spec,cusco spec,hegars dilatr,curette..
contraception..couns
tubal blockag..pid..interactve
amniocentesis
prolongd 3rd stag labr
eclampsia
diabetes..interactive
isoimunisation..interactive
stress incontinence..
AIMC OSPE 18TH FEB
STATIC:wrigleys forcep and keilland's forcep[uses],metallic cathether,towel clip,uterine sound,uterine curette,myoma screw[complication and indication],placenta succenturate,dermoid cyst,placental abruption,twin twin transfusion syndrome+complications of twin pregnancy in mother,hysterosalpingography picture+management of tubal blockade in young patient,molar pregnancy[late complications and follow up]

sims ospe 18 feb
interactive stations:
1.chorionic villous sampling{procedure.complications.at what tym it will b performed}
2.post date labour cervix 2 cm dilated.{uterine contractions havnt started since 4 hrz.
a.what will u do now?ans induction of labour
b.what r its contraindications
c.wat will u do if vaginal delievery not possible/
3.female in labour presented with labour.previous 2 c sections.history of blood transfusion.
a.diagnosis
b.cause in dis case
c.management
4.d&c:
a.prepration of patient
b.procedure in detail
5.22 yr female presented with ammenorrhea.n multiple cysts in ovaris
a.D/D
b.diagnosis
c.investigative procedure of choice

static stations:
1.septic abortion
a.signs
b.complications
investigations
2.ovarian ca{abdominal pain.ascites etc}
a.stage 2?
wat other complaints or symptoms can occur
3.fistulas
a.investigations
b.management
c.post op care
4.fibroids pic.label n symptoms
5.brow presentaion
a.presenting skull diameter:mentovertical
b.13 cm
c.c section
6.macrosomic baby:a.fetal complications
b.intrapartum complications
c.diagnosis of mother
d.wat test u will do after delievery n wen to check{gtt after 6 wks}
7.episiotomy definition
A.classification
b.indications
c .complications
8.amniocentesis:what info can it provide

WMC ospe 18th feb
interactive
1. An rh negative mother.. 2nd time pregnant in d 20th week ..her husband is rh positive! 
2.a lady whose husband is hiv positive.. Modes of transmission.. Risk of transfer to her
3.down's syndrome tell d invest. to a pregnant lady
4.usg of twin gestations councel
5.D & C preparation n instruments
static:
1.scenario of placental abruption invst n complications.
2.keilland's n wrigley's forcep pic identify n uses
3.septic abortion signs n complications.
4.suction canula pic.. Uses n complictnz
5.myomectomy screw pic identify n uses
6.fetal electrode fr ph monitoring pic identify ? Use? N complications
7.A lady wd a previous down syndrome baby presents in d nxt preg what r her chances of having an other affected pregnancy? Diagnostic tests available?
8.a lady presents at 32 wks wd 36 week large uterus gv d/d n management?
9.A lady presents wid fecal discharge frm her vagina n had an instrumental delivery 2 wks ago for difficult labour. Dx? Prevntion n caus
10.asherman syndrom,inv,tx

SZMC OSPE 18 feb
Observed station:
gestational diabetes
Rh incompatibility
Post term delivery...which route..C-section or vaginal delivery...wat r contraindication...
Contraceptiv
Infertility due to PID

Unobserved staion:
1-Placenta retention/prolong 3rd stage of labou...placenta is not delivered in 30 minutes...wat will u do...if this management fails wats da diagnosis n wats management....
2-episiotomy,methods,indicatins n complications
3-eclampsia,investigation n management
4-uterine fibroid,medical managemet,obstetrical comlication,
5-diagram of cystometry,scenario(diagnosis of scenario was stress incontinence),how will u confirm da diagnosis n management...
6-Instrument...Cusco speculum,sims speculum,uterine sound,uterine curette,dilator....give 1 indicaton of each n 1 complication of each...
7-Amniocentesis.....wat are indication,,,wat conditions can be diagnosed
8-Brow presentation,which diameter is being presented(mento vertex),measurement(13.5),management(C section)
9-Bacterial Vaginosis...Investigatios

FMHC ospe 18th feb

Interactive...

-UTI scenario(diagnosis, investigations and management)
-gonococal cervicitis scenario( diagnosis and management)
- abortion with discharge(spontaneous abortion going towards sepsis, diagnosis, investigations, management:::always remember in such case DiC workup is required along with other investigtions)
-downs syndrome counselling to mother at 10th week
-types of anemia in pregnancy and their diagnosis and management of scenario where a female third trimester anemic

unobserved...

-Uterus didelphys(investigations, 3gyne and 3obs complications)
-Sponge holding forceps(uses, complications)
-tubal pregnancy(diagnosis with picture,sites, medical and surgical management)
-ecv (indication, contra,)
-breech delivery (extended breech mechanism of delivery, contra to vaginal delivery).
-episiotomy picture(define, types, indications, why midline better)
-antepartm hemorrhage scenario (4 causes, management)
-xray lung..history of molar pregnancy..diagnosis was mets of choriocarcinma(diagnosis, further investigations, management)
-ventouse(indication, prerequisites)

LMDC ospe
1.management of fetal distress 9 steps
2.eclampsia
3.epidural anesthesia
4.ventouse
5.PCO
6.ectopic pregnancy
7.Molar pregnancy
8.syntocinone
9.hysteroscopy
Intereactive
1.Small for gestational age counsel
2.breast feeding counsel
3.gestational diabetes counsel
4.uv prolapse counsel
5.D & c

ecv (indication, contra,)??
ind.: tranverse lie at 36 weeks of preg.
Contraind.: placenta previa, olly/poly-hydraminos, APH History, previous C- section, multiple gestation, preeclamsia/hypertension

Uterus didelphy gyanae 3 complications and obs 3 complications???
infertility
recurrent abortions
malposition
preterm labor
usually associated with urinary tract anomlies predisposing to UTi

Nmc ospe today
1..pre eclmpsa treatment
2 ctc,normal hr,abnormal ctg
3 placena acreta,increta pancreta, treatment 4 type 3 placena previa
4 hystrosalpgram,tubal infrtl treatnet
5 ovarian ca treatment
6 extrnl cephalv vrsn,causes of brech delivry
6 fetal skul name of suture
7 uterune fibroids name labelng
8 endometrisis treatment inv
9 fibroids treatment complctns
10 preterm labour,treatment
11 twin pregnacy mod of delivry
12 molar pregncy treatment
13 perinatal mortalry,define
causes 

Qamc 18.2.2011 obsrvd ventouse delivery obs.History pelvic inlet midcavity n outlet ki boundaries n diameters n pelvic assesment counsilng at outcome of next pregnancy in recurent abortions Dialatation n curete set

bacterial vagnosis treatment. diag.
Polyhyd.2 maternal 2 fetal causes.4 complications
ovarian cyst.reasn of pain?treatment.
Intrctv..wrigley.indictnz.prerequists
kochkerz..amniotomy indictnz,contraindc.
Labour.outlet dimensn.mechanism.ischial spine dia.
Myomectmy screw.use.complictnz.what precautn when removing fibroid.
Pcos.invstg.usg finding.treatment.
Fig 2.8 tenteacherz gynae lable.
HFH Ospe
1.pcos pic of a girl wid hirsutism..dx,treatment plan
2.insufflation canulla pic..dx, two uses,two complications
3.uv prolapse pic..dx,wht is the ulcer on it called,complications,treatment
4.submucous fibroid...dx,medical treatment,most common presenting symptoms
5.peuperal sepsis...diagnosis,3 main symptoms,3 signs,treatment
6.intercative..hystrosalpingram of scarred tubes...dx(pid),organisms,treatment
7.umblical cord cutting scissors..dx,uses,structures present in the structure on which it is used(umblical veins,atery,membranes)
8.ctg showing fetal distress
9.a woman with placenta previa and unengaged fetus..how to deliver

LMDC ospe

1.bartholin cyst.... picture ....organism ....treatment
2.preterm prelabour rupture of membranes.... scenario ..2 drugs and risk factors
3.macrocytic anemia.... causes ...drugs that precipitate g6pd deficency..comonest anemia in pregnancy
4.twin pregnancy...picture di and monochorionic....complications
5.cervical polyp... pictuture... types of polyp.... symptoms 
6.robins insuffulation cannula..uses....
7.Cervical punch biopsy picture......instrument punch biopsy forcep and langenback retractor......name other such procedures(pap smear , cone biopsy)
8.fetal distress...scenario...inv...complications
interactive 
1.breast feeding advantages...disadvantages of bottle feed
2.PIH complications
3.Ca endometrium inv risk factors treatment
4.2nd trimester abortion cause cervical incompetence counsel treatment
5.placenta praevia risk factors prevalence(0.4-0.8%)

AIMC OSPE... Noninteractive 1. Ca ovary 2.Septic abortion 3.Aeurs spatula 4.Simpson forcep 5.TTTS 6.COC Pills 7.Sonic aid 8.Macrosomia INTERACTIVE.....1.AIDS 2.Vaginal candiasis 3.Recurrent abortions 4.Pre-eclempsia 5.PROM

NMC GYNAE/OBS=>OSPE-20-02-11
1. Interactive:Colposcopy[pic]=> diagnosis? what r the common presentation of CA cervix?
2. Ineteractive: Infertility=> define? tests?
3. Amniocentesis, cordocentesis, CVS[pic]=> label the pic? date of CVS?
4. Neonatal death define? neonatal death rate? cause?
5. CA Endometrium[pic]=> common presentation? investigation?
6. fibroids pic=> label
7. fetal skull label[sagital suture[pic]. (coronal suture, frontal suture, anterior fontenela, parietal bone eminence)Uterine 
8. Interacitve: Rectovaginal fistula(scenario)=> dx? causes? degrees? treatment?
9. Interactive: Twin pregnancy[USG]=> diagnosis? investigation? 
10. Ring pessary, shelf pessary[pic]=> identify? uses? complications?
11. Uterine atony[scenario]=> complications? treatment?
12. PCOS[scenario]=> diagnosis? investigation? medical and surgical treatment?
SCENARIO>>>Female with cyclical pain(abdominal), bleeding etc from lugs(cyclical haemoptysis), infertility(subfertility), hirsutism, insuline resistance ETC
Diagnosis>>> Diagnostic laproscopy is gold stamdard investigation, others USG, MRI
Rx>>>>MEDICAL= Analgesics, COCPs, Danazol/Gastrinon, Progestogens analogues, GnRH Antagonists
SURGICAL= Conservative & Definitive

NMC-20-02-11:
1. Interactive:Colposcopy[pic]=> diagnosis? what r the common presentation of CA cervix?
2. Ineteractive: Infertility=> define? tests?
3. Amniocentesis, cordocentesis, CVS[pic]=> label the pic? date of CVS?
4. Neonatal death defin...e? neonatal death rate? cause?
5. CA Endometrium[pic]=> common presentation? investigation?
6. fibroids pic=> label
7. fetal skull label[sagital suture[pic]. (coronal suture, frontal suture, anterior fontenela, parietal bone eminence)Uterine
8. Interacitve: Rectovaginal fistula(scenario)=> dx? causes? degrees? treatment?
9. Interactive: Twin pregnancy[USG]=> diagnosis? investigation?
10. Ring pessary, shelf pessary[pic]=> identify? uses? complications?
11. Uterine atony[scenario]=> complications? treatment?
12. PCOS[scenario]=> diagnosis? investigation? medical and surgical treatment?

RMC OSPE
Interactive
Male infertility -oligospermia
Shoulder Dystocia
Endometrial CA
Perinatal Mortality rate 
PPH

Unobserved
consective 1st trimester miscarriges
PCO
Colposcopy
Placental abruption
Ring pesseries
Wrigley`s 
Fibroid
Twin pregnancy -USG- complications
Amniocentesis Diagram ..

A 35yr old labourer has just bak to lhr.he is complaining of burning micturationn urtheral discharge. on examintion frank pus coming from uretheral meatus? blood test r normal. wht r urs diagnosis?
t can be uti, std, urethritis, cystitis, pyonephrosis, prostatitis, epididimitis

Sargodha medical kolg surgery OSpe 10-02-12

1.proximal third of ulna fractre 
managment? definate treatment ? cmplication
2.double j pelvi ureteric stent on x ray abdomen
how we will place it?
advantage? cmplicaionz?
wht will hold it in its position?
3.extradural hematoma ct scan 
managment?definite treatment?
4.gas under diaphragm x ray.
wht investigation,diagnosis,finding?
5 steps of managment?
5. barium follow through n there was obstruction,
tell the managment?
6.ETT
uses?
functions of its parts n their name ?
7. plane dissecting forcep .
uses? emergency use?
how sterlized?
8. cleft lif.
wht other area u will see?
wht procedure u wll do?
at wht age it will be corrected?
9. percutaneous transhepatic cholaangiogram 
arrow pionted at billary dilataion n stone.
wht major structure abnormality present , dilated CBD.
wht other one use then its diagnostic use .
observed
10. colostomy n illostomy bag.
its function .how attached ? cmplicationz?
11. proctoscopy with injection scleretherapy ,
5 percent phenol wth almond oil is used . uses?


PMC
Observed
dummy breech delivry
pipelle idntfy uses how its used n advntges
tubal ligation counselling
kickcount counselling
episiotmy incisions idntfy indictns cmplictns, advntg hw mediolateral btr
Unobserved
1.a scenrio gvn ful detail about a pt wd delyd labour 3cm dilatation on 0/+1 o.p diameter labr pains n cntractns adequate wts d management optns
whch 1 wl u opt y justify
2.Semen analysis parametrs given wts d report says n wht points wl u ask on hstry to rule out male infrtly fctr
3.pretrm labr scenario management investg 
4.pph scenrio wts d cause in it,imediate resuctatn investg
5.pt wd dysmenrhea wt wl u ask on hstry wht sgns wl u find n gv 4 d/d
6.cin /crvcl cncr cnfrmatn techniques managemnt prevention
scenario 7.trachomoniasis how its trnsfr reasn fr recurrenc cnfrmatn
8.female A -ve wts d management if husbnd A-, wt if husband A+,at wht tym o dlvry antiD gvn ,how mny unts ?