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MINISTRY OF PUBLIC HEALTH OF UKRAINE


O.O. BOGOMOLETS NATIONAL MEDICAL UNIVERSITY


Department of obstetrics and gynecology № 1


"APPROVED"

Vice rector for Educational Affairs

Corresponding member of national Academy

of medical Sciences of Ukraine

professor ________________ O.P. Yavorovskiy

“____”________________ 2013


PROGRAM


PRACTICE – ORIENTED STATE EXAM

ON OBSTETRICS AND GYNECOLOGY


For foreign students VI course medical faculty 2012 - 2013 year


“APPROVED“


By the Meeting of Scienific Council

Medical faculty № 1

____________2013, protocol ________


Faculty dean professor CHERKASOV V.G.


“APPROVED“ “APPROVED“

By the Methodical meeting at the By the Central methodical committee

department of obstetrics and gynecology № 1 on Surgical disciplines

___________2013, protocol __________ ________________2013, protocol ______


Head of the department Head of the Central methodical

of obstetrics and gynecology № 1 committee on surgical disciplines

Corresponding member of National Academy

of Medical Sciences of Ukraine

Professor_________________Ventskivskiy B.M. Professor _________________ Burka A.O.


THE PLAN

^ OF COMBINED THEORETICAL - PRACTICAL FINAL EXAM

ON OBSTETRICS AND GYNECOLOGY ON SPECIALITY

“ CLINICAL CARE “


Exam on OBSTETRICS and GYNECOLOGY is carried on clinical base of department of obstetrics and gynecology № 3 at clinical obstetric hospital № 3 (Kuchera str., 7).


Exam starts at 08.00 a.m. and consists of 2 stages .


The first stage - working procedures like a practical physician. In present of the members of STATE EXAMINATION COMISSION final – year student must demonstrate following practical and clinical skills : interrogation of patient, identification, determination of the chief complaints, social history, family history, special obstetric and gynecological anamnesis. Student must perform general objective methods of investigation, to evaluate condition of intrauterine fetus (in case of pregnant woman investigation).


Based on objective data, student must determine leading clinical symptom or syndrome (LIST № 1), identify diagnosis, recommend laboratory or / and instrumental examination, perform differential diagnostics, recommend treatment tactic (operative, conservative), recommend the diet regime, determine preventive measures for ambulatory observation (LIST № 2). In case of pregnant patient examination, student must determine her general status, estimate pregnancy term, determine tactic of delivery, in case of postnatal patient - evaluate degree of uterine involution, type of lochia, lactational status.


The second stage - working procedures like a clinician. Student must know how to solve situational practical tasks on intensive medical care (LIST № 3). Based on laboratory and instrumental data student must evaluate additional information according to previous diagnosis (LIST № 4), must take medical procedures and manipulations using phantoms, additional training materials as well ( LIST № 5).


^ Assessment system of practically – oriented state exam during

the state certification of medical faculties graduates 2012


Evaluation results of the practically – oriented state exam in each discipline are brought to such Protocols ( sample attached ) :


- Protocol 1 (the first part of exam assessment);

- Protocol 2 ( the second part of exam assessment);

- Protocol 3 (evaluation of overall results of a practically-oriented state

exam);


The result of every practically-oriented state exam is determined :

- in points ( maximum score - 200 );

- by evaluation on the traditional scale ( 5 – “excellent “, 4 – “good”,

3 – “satisfactory”, 2 – “ poor”);

- by evaluation of ECTS ( “A”, “B”, “C”,” “D”, “E”, “FX”).


Points are put on the basis fixed in individual Protocols 1,2, and in Protocol 3 for the examination and evaluation according to the following scale :


  • 200 - 180 - “5’’, A

  • 179 - 160 - “4”, B

  • 159 - 140 - “ 4”, C

  • 139 - 120 - “3”, D

  • 119 - 100 - “3”, E

  • below 100 points - “ 2 “, FX


The maximum score in points for each task provided in Protocols 1,2, defined as follows: for clinical disciplines 200 points are divided into 25 tasks and is equal to 8 points.


Performing of common tasks of activities and skills that are checked during the SCE and entered in Protocol 1,2, is estimated for clinical disciplines as :


  • 8 points - done;

  • 6 points - written with minor errors;

  • 4 points - made of blunders;

  • 0 points - failed .


LIST 1 /symptoms and syndromes/


1.Anemia.

2.Arterial hypertension.

3.Arterial hypotension.

4.Abdominal pain syndrome.

5.Perineal pain syndrome.

6.Fever.

7.Haemorrhagic syndrome.

8.General or local rash.

9.Hepatomegaly and hepatolienal syndrome.

10. Headache.

11.Dysmenorrhea.

12.Jaundice / icterus/.

13.Dyspnea.

14.Asphyxia.

15.Dizziness.

16.Constipation.

17.Cough.

18.Intestinal dyspepsia.

19.Metrorrhagic syndrome.

20.Edema syndrome..

21.Nephrotic syndrome.

22.Urinary syndrome.

23.Disseminated intravascular syndrome.

.

24.Convulsions.

25..Cachexia.


^ LIST 2 /PATHOLOGY/

OBSTETRICS


1.Multiple pregnancy.

2.Fetal intrauterine hypoxia.

3.Gestoses.

4.Rh-incompatibility and pregnancy.

5. Bleedings in the early stages of pregnancy.

6.Prematurity and postmaturity of pregnancy.

7.Extragenital pathology and pregnancy.

8.Placenta previa.

9.Premature detachment of placentae.

10.Ectopic / extrauterine/ pregnancy.

11.Fetoplacental deficiency.

12.Labor pains abnormalities.

13.Female pelvis anomalies.

14.Acute fetal hypoxia.

15.Bleedings in labor.

16.Malpositions of fetus.

17.Traumatical lacerations of utery and labor ways.

18.Postnatal septic complications.

19.Bleedings after labor.


GYNECOLOGY


1.Infertility.

2.Congenital malformations of female genitalia.

3.Benign tumors of utery and ovaries.

4.Endometriosis.

5.Inflammatory diseases / salpingitis,endometritis, salpingooophoritis, pelvioperitonitis, cervicitis/.

6.Malignant tumors of utery and ovaries.

7.Neuroendocrine syndromes.

8.Menstrual cycle”s disorders.


^ LIST 3 / EMERGENT STATES/


1.Postnatal asphyxia.

2.Hypertensive crisis.

3.Acute respiratory failure.

4.Acute ischuria.

5.Acute adrenal deficiency.

6.Acute renal deficiency.

7.Acute hepatic deficiency.

8.Acute coronary failure.

9.Acute intoxication.

10. Acute psychosis.

11.Acute radiative lesions.

12. Electric trauma.

13. Epileptic state.

14.External bleedings.

15.Stoppage of blood circulation and breathe.

16.Collapce.

17. Comas.

18.Edema of larynx.

19. Qienkey edema.

20.Unconcious state.

21.Paroxysmatic rhythm”s disorders.

22.Supercooling.

23.Convulsion”s syndrome.

24.Heat apoplexy.

25.Drowned state.

26.Physiological delivery.

27. Shocks.


LIST 4 /additional laboratory and functional methods of investigation/.


1.Analysis of ascites liquor.

2.Urinanalysis by Zimnickiy.

3.Urinanalysis by Nechiporenko.

4.Urinanalysis for diastase level.

5.Proteinogram.

6.Blood glucose.

7.Creatinine and urea of blood.

8.Blood electrolytes.

9.Blood transamynases.

10.Common bilirubin and its fractions.

11.Coagulogram.

12.Blood urea acid.

13.Blood alkaline phosphotase.

14.Histomorphological methods.

15.Stool analysis.

16.Total blood count.

17.Serologic reactions due to infectious complications.

18.Microbiology of discharges.

19.Total urinanalysis.

20.Radiologic examination of abdominal cavity.

21.Radiologic examination of urogenital system..

22.Cytologic examination of vaginal and urethral discharges


^ LIST 5/ MEDICAL MANIPULATIONS/


1.To make artificial respiration and closed chest massage.

2.To fix a tongue.

3.To stop external bleeding.

4.To make primary cleansing of wound.

5.To make gastric lavage and enteroclysis.

6.To make an injection of medication.

7.To measure arterial pressure.

8.To make catheteterization of urinary bladder.

9.To make manual aid for prevention of perineal trauma at physiological delivery.

10.To make primary cleansing of newborn.

11.To make manual examination of rectum.

12.To determine a blood group and Rh-typing.

13.To make blood transfusion and its components.

14.To make bimanual examination,visual examination of cervix utery by means of gynecological speculums.

.


PRACTICAL SKILLS /Recommendations of department of obstetrics and gynecology № 1, National medical university, Kiev, Ukraine/


1.To make manual methods by Leopold.

2.To make auscultation of fetal heart beating.

3.To measure diameters of female pelvis.

4.To evaluate cardiotocogram.

5.To determine signs of placentae detachment.

6.To make manual separation of placentae.

7.To make external massage of utery after labor.

8.To make combine external and internal massage of utery after labor.

9.To make culdocentesis.

10. To make taking away discharges from cervix, vagina and urethra for bacterioscopy and cytology.

11.Know how to consult a patient for adequate way of contraception

/recommendations for family planning/.


^ THEORETICAL QUESTIONS FOR GRADUATE EXAM OF

OBSTETRICS AND GYNECOLOGY /for students 6 course only/



  1. Founders of world obstetrics and gynecology. Main actions of his works.

  2. Structure and working principles of obstetric hospital.

  3. Organisation of obstetric service for combine residence mother and newborn.

  4. Structure and working principles of prenatal care monitoring /ambulatory service/. Observation of “high risk” pregnants.Prophylaxy of obstetric and perinatal pathology.

  5. Organisation and cooperation of ambulatory service, obstetric hospital and postnatal ambulatory service.

  6. Hygiene and nutrition of pregnants. Importance of nutritional factors in prophilaxy of obstetric and perinatal pathology / fetal macrosomia, gestosis, fetal hypotrophy, anemia etc./

  7. Female genitals anatomy in point obstetrics. External and internal genitalia.

  8. Clinical and topographic anatomy of female internal genitalia.

  9. Blood supply, innervation and lymphatic system of female genitalia.

  10. Neurohumoral regulation of menstrual cycle. Changes in female organism due to menstruation.

  11. Anatomical and physiological changes of female depends on age.

  12. Fertilization. Fetal egg development at different stages of embryogenesis. Critical periods of fetal egg development.

  13. Changes in the maternal organism during pregnancy /hemodinamic,

hemostasis, endocrine system, genitalia, mammary glands/.

14.Changes in the maternal organism before labor. Definition of “cervix maturity’.

15.Amniotic fluid: biological structure, metabolism, influence on fetus.

Amniocentesis, amnioscopy.

16.Structure and functions of placenta. Fetoplacental complex and its peculiarities. Diagnostic procedures for evaluation of fetoplacental activity in different stages of pregnancy.

17.Early pregnancy diagnostics. Hormonal and immunologic tests.Instrumental diagnostics.

18.External obstetric examination. Definition of attitude, lie, position, type of position and presentation of fetus.

19.Ultrasound diagnostics in obstetrics. Determination of fetus condition and placental functions. Biophysical fetal profile.

20. Late pregnancy diagnostics. Methods, diagnostic procedures.

21. Female pelvis and its significance in obstetrics. True pelvis, planes and diameters. External and internal measurement of pelvis. Determination of true conjugate.

22.Muscles of pelvic floor. Female perineum and its significance in obstetrics.

23.Fetus as delivery object. Mature fetal head structure, its dimensions and circumferencies. Mature fetus height and weight. Fetal maturity signs.

24. Attitude of fetal head to obstetric inlet: determination by external and internal examination.

25. Causes of labor activity beginning. Changes in maternal organisms before and in labor. Modern methods of registration of labor activity.

26.Delivery biomechanism of anterior and posterior vertex presentation.

27.Clinical course and management of the first delivery stage. Determination of labor act phases.

28. Modern methods of delivery pain analgesia.Psychoprophylactic training of pregnants. Influence of medications on fetus. Nonmedicamentous obstetric anesthetic techniques.

29.Clinical course and management of the second delivery stage. Maneuvers of perineum protection.

30.Clinical course and management of the third delivery stage. Signs of placenta detachment.External methods of placenta detachment.Evaluation of bloody loss in labor.

31.Premature and mature newborn condition assessment / Apgar, Silvermane scales/ Primary inspection of newborn. Prophylaxy of postnatal septic complications.

32.Physiological puerperial period. Changes in maternal organism after labor/ genitalia, mammary glands etc/.Breastfeeding, regimes for newborn.

Care of mother and newborn.

33. Special gymnastics in pregnancy and postpartum period. Types, recommendations.

34.Pelvic / breech/ presentation. Classification. Reasons, incidence. Delivery biomechanism.

35.Diagnosis of pelvic presentation. Pregnancy management. Correcting gymnastics.

36.Clinical course and management of labor in pelvic presentation. Manual aids at complete, incomplete and feet presentations / Zovjanoff 1,2, classical manual aid/. Indications to cesarean section at pelvic presentation.

37.Multiple gestation. Incidence, reasons. Observation of pregnants, clinlcal course and management of labor. Possible complications.

38.Deflexing fetal head presentations. Peculiarities of labor act at different stages of deflexing presentations. Indications to operative delivery way.

39.Malpositions in pregnancy and labor. Causes, diagnostic procedures. Clinical course and management of pregnancy and labor. Classical combined version.

40.Neglected transversal lie position of fetus in labor. Causes, clinical

tactics.

41.Presentation and prolapse of umbilical cord, arms and feets. Diagfnosis, clinical tactics.

42.Labor activity anomalies. Etiology, pathogenesis. Classification.Labor activity weakness. Modern methods of correction.Medicamentous correction of labor activity anomalies, indications.

43.Discoordinated labor activity. Clinic, diagnosis, labor management,correction, prophilaxy.

44.Noncarrying of pregnancy in different terms. Spontaneous abortion.

Reasons, clinic,diagnosis. Stages of spontaneous abortion. Medicamentous and surgical treatment.

45. Artificial abortion. Methods of induced abortion in earliest terms of pregnancy. Contraindications for induced abortion.

46.Methods of induced abortion in latest terms of pregnancy. Indications.

47.Infected abortion. Clinic, diagnosis, treatment. Complications. Septic schock. Clinic, diagnosis, treatment.

48. Prematurity of pregnancy. Causes, clinic and diagnosis of preterm labor. Treament of threatened preterm labor. Clinical tactics.

49. Postmaturity of pregnancy. Determination of postmaturity and prolonged pregnancy. Causes, diagnosis. Peculiarities of labor management in postmaturity. Influence of postmaturity on fetus.

50.Rh-incompatibility ,ABO-isosensitisation and pregnancy. Clinical course and management of pregnancy. Pathogenesis of hemolytic fetal disease, diagnosis, treatment.Indications to preterm delivery.

51.Hemolytic newborn disease. Pathogenesis, clinic, diagnosis. Treatment.

Indications to substituting blood transfusion. Prophylaxy of immunologic complications.

52.Early gestosis. Classification, pathogenesis. Clinical course of nausea and vomiting. Treatment. Indications to interruption of pregnancy.

53. Late gestosis. Etiology, pathogenesis,classification. Clinic and diagnosis of different forms/ edema, preeclampsia, eclampsia/. Possible complications. HELLP- syndrome. Complex treatment of late gestosis. Indications to interruption of pregnancy. Influence of late gestosis on fetus.

54.Gestosis and extragenital pathology of pregnants. Clinical course gestosis associated with extragenital pathology. Procedures of earliest diagnosis of late gestosis. Influence of medicamentous therapy on fetus.

55.Placental presentation. Etioilogy, classification. Clinic, diagnosis. Clinical course and management of pregnancy and labor depends on different stages of placental presentation.

56.Premature detachment of normally located placenta /abruption of placenta/. Etiology, pathogenesis, clinic, diagnosis. Treatment. Possible complications, its prophylaxy.

57.Bleedings in third period of labor. Causes, clinic, diagnosis. Treatment.

58.Hypotonic bleedings. Etiology, pathogenesis, clinic, diagnosis. Methods of treatment. Indications to surgical treatment.

59.Disseminated intravascular coagulated syndrome / DIC- syndrome/ in obstetrics. Causes, pathogenesis /dead fetus,abruption of placenta,embolia by amniotic fluid, endometritis in labor/. Coagulopatic bleedings in obstetrics. Treatment, prophylaxy.

60.Hemorrhagic schock in obstetrics. Clinic, diagnosis. Methods of treatment. Organization of therapeutic care in cases of massive obstetric bleedings.

61. Contracted pelvis. Classification. Different types of contracted pelvis:

Characteristics, diagnostic criteria/ pelvis justo minor, simple flat pelvis, flat rachitic/. Delivery biomechanism different types of contracted pelvis. Diagnosis. Clinical course and management of labor. Determination of anatomically- and clinically contracted pelvis. Diagnosis of clinically- contracted pelvis.

62. Embolia by amniotic fluid. Etiology, pathogenesis. Clinic, diagnosis. Treament, prophylaxy.

63.Pathology of amniotic surfaces. Molar pregnancy / hydatidiform mole/, its types clinic, diagnosis. Treatment. Rehabilitation of patients with molar pregnancy in anamnesis. Possible complications.

64. Acute and chronic hydramnion. Etiology, pathogenesis. Clinic,treatment.

Peculiarities of labor act, possible complications, prophylaxy.

65. Clinical course and management of pregnancy associated with extra-

genital pathology. Peculiarities of prenatal care and observation at obstetric hospital.

66.Pregnancy associated with cardiovascular pathology: clinical course and management of pregnancy and labor. Possible complications. Indications to interruption of pregnancy.

67.Urogenital pathology and pregnancy. Clinical course, management. Complications. Indications to interruption of pregnancy.

68. Pregnancy associated with diabetus mellitus: clinical course and management of pregnancy and labor. Influence of diabetus mellitus on fetus. Possible complications. Indications to interruption of pregnancy.

69. Pregnancy associated with hemopoietic and hemoplastic pathology:

/anemia, leykemia/. Possible complications at pregnancy and labor. Indications to interruption of pregnancy.

70.Pregnancy associated with acute and chronic infections/ respiratory infections, rubella, tuberculosis, AIDS/. TORCH – infections. Influence of infections on fetus. Clinical course and management of pregnancy and labor. Intrauterine infected status. Indications to interruption of pregnancy.

71. Pregnancy associated with syphilis /lues/. Clinical course and management of pregnancy and labor, influence on fetus.

72. Pregnancy associated with acute and chronic gonorrhea. Clinical course and management of pregnancy and labor. Prophylaxy of newborn”s gonoblennorhea.

73. Pregnancy associated with tumors of utery and ovaries. Clinical course and management of pregnancy and labor.

74. Pregnancy associated with acute surgical pathology / acute appendicitis,pancreatitis, cholecystitis, intestinal obstruction/. Peculiarities of pregnancy and labor management.

75.Perinatology – determination. Main stages of fetal development. Influence of negative factors on fetus / bad habbits, professional factors, radiation, chemical agents/.

76. Influence of parents bad habbits to fetal development ( alcohol, drugs ).

77. Influence of negative ecologic factors to fetal development.

78.Influence of medications using by pregnants on fetal condition. List of medications, which are not recommends in pregnancy. Why?

79. Pregnancy associated with macrosomia : diagnostic procedures, causes, clinical course and management of pregnancy and labor. Possible complications.

80. Fetoplacental deficiency. Etiology, pathogenesis. Diagnostic procedures.Intrauterine fetal retardation syndrome / IFRS/. Classification, diagnosis, clinical findings. Treatment. Delivery ways.

81. Pregnancy with pathological clinical course. Indications and methods for interruption of pregnancy.

82.Obstetric forceps. Conditions, indications, contraindications.Operation technique/ outlet forceps, cavity forceps/. Analgesia. Vacuum fetus extraction in modern obstetrics.

83. Extraction of fetus by pelvic pole. Indications, technics.

84.Embriotomies / fetal destroying operations/, its role in modern obstetrics.Operations – craniotomia, cranioclasia, decapitation, cleydotomia. Indications, conditions, technique. Analgesia, possible complications, prophylaxy.

85.Cesarean section. Indications, conditions, technique, analgesia. Types of operations. Complications for mother and fetus. Peculiarities of peritonitis after cesarean section.

86. Ectopic / extrauterine / pregnancy. Classification, causes. Clinic and diagnosis of progressing and violated ectopic pregnancy. Treatment. Rehabilitation of patients with ectopic pregnancy in anamnesis.

87.Obstetric traumatism. Vulva, vagina, perineum ruptures. Cervical ruptures. Diagnosis, treatment, possible complications. Rupture of utery. Classification.. Etiology. Clinic of complete and incomplete rupture of utery. Diagnosis. Obstetric tactic. Prophylaxy.

88.Acute and chronic fetal distress syndrome. Etiology, pathogenesis, diagnosis, clinic. Treatment tactics. Possible complications of hypoxic disorders.

89.Newborn asphyxia. Etiology, pathogenesis,diagnosis, clinic. Modern intensive care tactics. Medicamentous correction of biochemical disorders. Possible distant complications of newborn”s asphyxia.

90.Physiological puerperal period : clinical course and management. Postnatal care and feeding of newborns. Importance of breast-feeding. Stimulation and block of lactation. Observation for mammary glands. Prophylaxy of newborn”s septic complications.

91. Breastfeeding of newborns. Stimulation and block of lactation. Care of mammary glands.

92. Adaptation period of newborns. Possible complications.

93.Labor traumatism of newborns / cephalhematoma, intracranial hemorrhages, fractures of clavicle and extremities/.Clinic, diagnosis. Intrauterine and postnatal developmental defects.

94.Endometritis in labor. Causes,clinic, diagnosis. Complications for mother and fetus. Treatment and delivery ways. Prophylaxy.

95.Postnatal septic complications. Classification. Clinical course on different stages. Diagnostic procedures. Intensive therapy of poswtnatal septic complications.

96. Postpartum endometritis. Causes, classification, diagnostics, clinic. Intensive therapy.

97.Lactational mastitis. Causes, clinic, diagnosis. Treatment tactics /therapeutic and surgical/.

98.Ambulatory care of pregnant patients. Methods of observation. Screening of possible complications. Methods of preparing to labor of “high-risk” pregnant patients.

91.Perinatal mortality, its components. Structure of perinatal mortality at current time. Ways of decreasing of perinatal mortality.

92.Family planning, indications, contraindications, methods. Contraceptive medications and devices. Classification, mechanism of action, effects. Modern contraceptive methods, its influence on female organism. Possible complications.

93.Ambulatory gynecologic care of patients. Organization of ambulatory service for young girls. Prophylaxy of possible complications.

94.Examination of gynecological patients: gynecologic anamnesis, objective methods, additional procedures, functional and instrumental methods.

95. Modern methods of examination of female genitalia.

96.Modern methods of examination of female reproductive system / hypothalamic area, pituitary glands, ovaries, utery/.

97.X-ray examination and ultrasound diagnostics of female genitalia, indications, importance in diagnostics.

98.Lymphography and lymphoinfusion as diagnostic procedures in gynecology.

99.Endoscopic /colposcopy, hysteroscopy, laparoscopy/ and cytologic procedures in diagnosis of gynecologic pathology.

100.Biopsy, diagnostic curettage , its importance in diagnosis of gynecologic pathology. Indications, analgesia, possible complications.

101.Modern methods of examination of ovaries functional activity.


102.Methods of hormonal diagnostics in gynecology.


103.Laboratory and instrumental methods of examination in gynecology.

Bacteriology and bacterioscopy, its importance in diagnostics of inflammatory pelvis disease.


104.Etiology of inflammatory pelvic disease : modern view. Sexual transmitted diseases - determination, clinical forms, peculiarities of clinic and diagnostics. Main activators of inflammatory processes /nonspecific,

specific, trichomonas vaginalis, candida. Chlamidia trachomatis,mycoplasma, viral infections./ Bacterial vaginosis - agents, clinic, diagnosis, treatment, prophylaxy.


105.Acute inflammatory of female external genitalia / vulvitis, vaginitis, bartolinitis, acute condilomas/. Etiology, clinic, diagnosis, treatment.


106.Urogenital trichomoniasis. Clinical course. Diagnosis, treatment, possible vaccination.


107.Urogenital chlamidiosis. Clinical course. Diagnosis, treatment.


  1. Micotic lesions of female genitalia. Clinic, diagnosis, treatment.


109.Virus lesions of female genitalia. Clinic, diagnosis, treatment.


110.AIDS. Etiology, clinic, diagnosis, treatment tactics, prophylaxy.


111.Acute inflammatory processes of female internal genitalia / endocervicitis, endometritis, adnexitis, pelvioperitonitis/. Clinical course . diagnosis, differential diagnosis, treatment. Indications to surgical treatment, types of operations. Prophylaxy.


112.Chronic inflammatory processes of female internal genitalia . Clinic, diagnosis. Treatment tactics in cases of chronic inflammatory of genitalia.

Methods of rehabilitation. Role of physiotherapeutic procedures in treatment.


113. Gonorrhea. Etiology, classification. Clinical course in acute and chronic stages. Peculiarities of clinic in different periods /childhood, pregnancy, climacteric period/. Diagnosis, treatment tactics of differeny clinical forms. Indications to surgical treatment. Treatment criteria. Rehabilitation.


114. Tuberculosis of female genitalia. Etiology, pathogenesis, clinic, diagnosis. Treatment tactics. Rehabilitation of reproductive fuhction.


115. Disorders of menstrual cycle and reproductive function – classification. Characteristics of different clinical forms.


  1. Amenorrhea – classification, stages, clinical forms. Etiology, clinic /uterine, ovarian, pituitary, hypothalamic/. Diagnosis. Modern treatment tactics. Combination hormonal replacement therapy and nonhormonal methods.




  1. Disfunctional uterine bleedings at ovulatory menstrual cycle. Etiology, clinic. Functional diagnostic tests. Treatment tactics.




  1. Anovulatory dysfunctional bleedings. Classification, etiology, pathogenesis. Clinical peculiarities in different periods / juvenile, reproductive, climacteric/.




  1. Juvenile dysfunctional bleedings. Clinical course. Diagnostic procedures. Treatment tactics of menstrual correction.




  1. Disfunctional bleedings in reproductive period. Clinical course. Diagnostic procedures, differential diagnosis. Treatment tactics. Surgical and hormonal hemostasis – indications, possible complications. Renewal of reproductive function, rehabilitation.




  1. Climacteric dysfunctional bleedings. Clinical course. Diagnosis,

differential diagnosis. Treatment tactics. Indications to hormonal replacement therapy.


  1. Neuroendocrine syndromes in gynecology/ postovaryectomy, premenstrual, climacteric/. Etiology, pathogenesis, clinical forms.

Clinical course, diagnosis. Treatment tactics.


  1. Genital endometriosis. Modern theories of development. Classification. Clinic external and internal endometriosis. Diagnostic procedures. Modern treatment tactics. Indications to surgical treatment. Importance of laparoscopic surgery in diagnosis and treatment.

  2. Infertile couple. Causes of female and male infertility, classification.

Examination plan of both partners. Endocrine forms of female infertility. Diagnostic procedures. Renewal methodics for reproductive function.


  1. Role of inflammatory processes in infertility development. Diagnostic procedures in cases of infertility due to inflammatory. Renewal methodics for reproductive function.

  2. Artificial fertilization. Insemination . In-vitro fertilization. Medical and legal aspects.

  3. “Acute abdominal pain syndrome” in gynecology. Diagnostic procedures, differential diagnosis. Treatment tactics.

  4. Congenital anomalies and displacements of female genitalia. Etiology, classification, diagnostic procedures. Methods of correction.

  5. Benign tumors of uterus. Etiology, pathogenesis. Classification. Clinical findings at different forms of uterine fibroids, complications.

Treatment tactics. Indications to surgical and conservative treatment.


130.Benign tumors of ovaries. Classification. Clinic, diagnostic procedures. Cysts of ovaries. Classification, clinic, diagnosis.

Treatment tactics. Possible complications. Indications to oprerative treatment. Peculiarities of operative procedures on ovaries.


  1. Background and precancerous cohditions of cervix. Classification. Clinic, diagnosis. Modern methods of treatment. Indications to operative treatment. Vaccination.

  2. Precancerous conditions of endometrium / hyperplastic processes/ Etiology, classification, clinic, diagnosis. Modern methods of treatment.

  3. Precancerous conditions of ovaries. “High- risk” patients, suspected for development of ovarian cancer. Diagnostic procedures. Treatment tactics.

  4. Cervical cancer. Etiology, pathogenesis. Classification. Clinic, clinical groups. Diagnostic procedures. Modern treatment methods. Peculiarities of surgical treatment.

  5. Endometrial cancer. Etiology, pathogenesis. Classification. Clinic, clinical groups. Diagnostic procedures. Modern treatment tactics. Hormonal replacement therapy in treatment of patients .

  6. Cytotrophoblastic disease. Chorioncarcinoma. Etiology, clinical course. Diagnosis. Modern treatment tactics.. Rehabilitation of reproductive function.

  7. Ovarian cancer. Classification. Clinical course. Diagnosis. Modern treatment tactics. Polychemotherapy, hormonal replacement therapy.

  8. Chemotherapy of oncologic patients. Indications. Radiative therapy of oncologic patients. Indications. Methods. Possible complications. Prophylaxy.

  9. Preoperative procedures. Examination plan of patients before gynecologic operations. Peculiarities of examination before abdominal and plastic operations.

  10. Operative procedures at ovaries and fallopian tubes. Types of operations. Indications. Operative technique.

  11. Hysterectomy /supravaginal amputation and extirpation of utery/. Indications. Operative technique.

  12. Surgical treatment of uterine fibroids. Types of operations. Indications. Operative technique. Peculiarities of operative treatment at reproductive period.

  13. Postoperative care of patients after gynecologic operations. Peculiarities of care after abdominal and plastic operations. Possible complications. Prophylactic procedures.Peculiarities of care elderly patients and patients with concomitant extragenital pathology. Prophylaxy of tromboembolic complications.



Head of department of obsterics

and gynecology / 1 of National Medical University

/Ukraine, Kiev/,

Academician, professor Ventskivskiy B.

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Ministry of public health of ukraine o. O. Bogomolets national medical university iconThe ministry of public health of ukraine vinnitsia national medical university named after M. I. Pirogov

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