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ЗмістOf combined theoretical - practical final exam
Assessment system of practically – oriented state exam during
List 2 /pathology/
List 3 / emergent states/
List 5/ medical manipulations/
Theoretical questions for graduate exam of
MINISTRY OF PUBLIC HEALTH OF UKRAINE
O.O. BOGOMOLETS NATIONAL MEDICAL UNIVERSITY
Department of obstetrics and gynecology № 1
Vice rector for Educational Affairs
Corresponding member of national Academy
of medical Sciences of Ukraine
professor ________________ O.P. Yavorovskiy
PRACTICE – ORIENTED STATE EXAM
ON OBSTETRICS AND GYNECOLOGY
For foreign students VI course medical faculty 2012 - 2013 year
By the Meeting of Scienific Council
Medical faculty № 1
____________2013, protocol ________
Faculty dean professor CHERKASOV V.G.
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.
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).
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
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 :
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 :
LIST 1 /symptoms and syndromes/
4.Abdominal pain syndrome.
5.Perineal pain syndrome.
8.General or local rash.
9.Hepatomegaly and hepatolienal syndrome.
12.Jaundice / icterus/.
23.Disseminated intravascular syndrome.
2.Fetal intrauterine hypoxia.
4.Rh-incompatibility and pregnancy.
5. Bleedings in the early stages of pregnancy.
6.Prematurity and postmaturity of pregnancy.
7.Extragenital pathology and pregnancy.
9.Premature detachment of placentae.
10.Ectopic / extrauterine/ pregnancy.
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.
2.Congenital malformations of female genitalia.
3.Benign tumors of utery and ovaries.
5.Inflammatory diseases / salpingitis,endometritis, salpingooophoritis, pelvioperitonitis, cervicitis/.
6.Malignant tumors of utery and ovaries.
8.Menstrual cycle”s disorders.
3.Acute respiratory failure.
5.Acute adrenal deficiency.
6.Acute renal deficiency.
7.Acute hepatic deficiency.
8.Acute coronary failure.
10. Acute psychosis.
11.Acute radiative lesions.
12. Electric trauma.
13. Epileptic state.
15.Stoppage of blood circulation and breathe.
18.Edema of larynx.
19. Qienkey edema.
21.Paroxysmatic rhythm”s disorders.
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.
7.Creatinine and urea of blood.
10.Common bilirubin and its fractions.
12.Blood urea acid.
13.Blood alkaline phosphotase.
16.Total blood count.
17.Serologic reactions due to infectious complications.
18.Microbiology of discharges.
20.Radiologic examination of abdominal cavity.
21.Radiologic examination of urogenital system..
22.Cytologic examination of vaginal and urethral discharges
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/.
OBSTETRICS AND GYNECOLOGY /for students 6 course only/
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.
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
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.
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.
differential diagnosis. Treatment tactics. Indications to hormonal replacement therapy.
Clinical course, diagnosis. Treatment tactics.
Examination plan of both partners. Endocrine forms of female infertility. Diagnostic procedures. Renewal methodics for reproductive function.
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.
Head of department of obsterics
and gynecology / 1 of National Medical University
Academician, professor Ventskivskiy B.
|Ministry of public health of ukraine o. O. Bogomolets national medical university||Ministry of Public Health of Ukraine M. Gorky Donetsk National Medical University|
|Ministry of Public Health of Ukraine M. Gorky Donetsk National Medical University||Ministry of Public Health of Ukraine M. Gorky Donetsk National Medical University|
|Ministry of Public Health of Ukraine M. Gorky Donetsk National Medical University||Ministry of Public Health in Ukraine Donetsk M. Gorky National Medical University|
|The ministry of public health of ukraine vinnitsia national medical university named after M. I. Pirogov||The ministry of public health of ukraine vinnitsia national medical university named after M. I. Pirogov|
|The ministry of public health of ukraine vinnitsia national medical university named after M. I. Pirogov||The ministry of public health of ukraine vinnitsia national medical university named after M. I. Pirogov|