Compiled by class of 2013

Components of Gyn/Obs Viva

2 Long Cases 60marks each

Two Table vivas 10marks each
Osce 40marks

Units are assigned randomly.You are told about your units on day of viva.

First you'll be aloted 2 long cases,one from gyne and one from obs. Half hour is
given for each. PG'S help available. Then your viva for long case, then 2 very short
table vivas. Mine was unit 2 and 4.Everybody was asking superficial questions. Just
focus on definitions, investigations and treatment. Last men toacs hoga.

Toacs
3 resting stations
4 interactive stations(copy, dummy, D&C and vantouse)
16 writing stations
each station carries 5 marks
3 minutes/station

Station1 Why steroids given in preterm labour(for fetal lung maturity)? what's the
risk(Pul. oedema in mother, fetal bradycardia)?dose(24 mg)?route(I/M)?
HVSstands for? in which cndition v do this? organisms? comnt on cultur snsitivty
reprt

station2
specimen of placenta. placental functions?abnormal forms? wht hormones does it
produce?

molar pregnancy picidentify? tumor mrkers? surgcl trtmnt? clincl presntation?

station3
episiotomy scizzor. what structures does it cut?types of episiotomy?which suture is
used?
cusco speculumidentify? other names? uses?

station4
pt. with primary amenorrhoea with webbed neck, wide carrying angle. Dx? what
would her gonads be like?other causes of primary amnorhea.
pre eclampsia scenario:diagnosis? investigations?

5
pap smear report, which organ is it takn from?which instrument used?significance?
iron def anemia scenario:
diagnosis? what u wil ask in history? investigations? managment?

6
hydrocephalus baby(photo). what problems could arise in delivery? whch drug used
to prevent it in nxt pregnancy?(follic acid) dose? (5mg daily)

fibroids scenario:diagnosis? d/d? srgcl mngmnt? medcl mngmnt?

7
macrosomic baby(photo) what problams could arise in labour?in delivery?in early
neonatal period?

breach typescriteria for vaginal delievery?complications?

9

what's preterm labour?causes?

pre mature ruptur of membdiagnosis? tests? managmnt?

10
twin pregnancy types?complications fetal and maternal? what r indications of csection in twin.
mgso4 ampule:identify? uses?

11
primary PPH. causes? management?

12
threatened abortion scenario. managemnt (reassurance, avoid coitus, bed
rest,monitoring) other types of miscarriages?

ectopic preg scnario:

diagnosis? tests? managmnt?
13
copper-t. contraindications?complicationsocp:identify? mode of action?
contraindications?

14
Prostaglandin E2 vaginal tablets. What's the use in obs? (induction) complications?
routes?partogram:when will u make it?what info it will tel u abt labour?

15
suction cannula. indications?complications?pinard fetoscpe:identify?and 2 more
scenarios with it

16
can't remember.

Best of luck!!
.

1.unit 2...Long case external listened to the history n examination in detail ( mass
abdomen case)n asked a bit too...asked diagnosis...may b she wanted differential m
not sure... long case sir Arshad Chohan (case pv leaking) causes of premature
rupture of membranes, complications of premature birth, asked def of vertex,
attitude,some other questions....in this case if managed conservatively what ll b
complication? how to test chorioamniotis (fever) what to see in blood
(leukoctosis).Table viva external uv prolapse ki investigations (clinical only...rest are
only to rule out other causes etc may b treatment plan) y would u like to do c/s
urine? (to rule out uti as a cause of urinary symptoms) Table viva mam Samia ...
presentation of ectopic pregnancy...causes of it(iucd is not a cause according to
mam)...causes of post menstrual bleeding?, cervical erosion?,presentation of
fibroids?...i think thats it

2.unit 3 gynae Long case mass abdomen , mam ayesha malik asked about d/d ,
investigation, treatment, ultrasound findings of solid/cystic, benign/malignant. unit3
external asks about history, history should be complete, pih definition,
complications, questions from history.Table viva mam tabinda , infertility, types,
causes of secondary infertility.Table viva external ecclampsia definition, treatment

3. mam samia ask short hstory and then management...Long case UV prolapse...ask
about pelvic floor support,nerve supply,managemnt of prolapse....table viva prof
chohan...how wl u assess ovulation in female...external table viva...define
vertex,malpresentation,breech delivery wt ur hosptal do?ecv or c sec in breech?

4.Unit 4 Long case Dr samia. Post menopausal bleeding. Listened to summary of

history and examination. Differential diagnosis. Investigations done.After all
investigations she wanted to hear examination under anesthesia. Risk factors for
endometrial carcinoma. Stage 3 cervical CA treatment. stage 2 endometrial Ca

treatment. list all the ovarian tumors. Most common benign ovarian tumors in
reproductive age group. Treatment of them. Long case external. state case
( diabetic and hypertensive patient) management plan. How will you plan the
delivery.
Table viva Dr chohan. Investigations done for ovulation. state two which are recent.
Table viva external. What is PPH. what is puerperium? compliactions which develop
in third stage of labour. what is puerperal pyrexia? causes ( did not accept mastitis).
treatment.

5.Long case dr. tayyaba: UV prolapse causes, treatemnt options in patient ( 65 years
old),45 years old. why it is common in pakistan? complications, ulcers etc.. ( in short
typical questions regarding UV prolapse) . long case obs.. unit 5 external: c-section
complications, indications, classical c-section, trial of labour in previous 1? when u
will not consider normal labour in any case in previous 1 even? short case mam
samia: APH, PPH, types of previa/? short case gynae: post menopausal bleeding
causes??table viva external with ma'm tabinda: define PIH, she doesn't agree to the
bookish defination we tell her... parameters for PIH diagnosis, treatment of anemia,
parameters for different type of modalities of treatments in case of anemia...
investigations
If Ma'am Tabinda asks for definition of APH ,don't repeat the one written in
Chohan.She gets flared up at it.Follow the definition of Ten teachers : It's the vaginal
bleeding occurring at any time from 24th week of gestation till ' before the birth of
baby'

6.long case dr. aisha malik:case UV prolapse she checked the complete history.. age
of ur patient? risk factors in ur patient regarding UV Prolapse? can u tell by ur
history which degree of prolapse is there in this pateint? is this reducible? define 1st
degree, 2nd degree, 3rd degree prolapse? in this scenario what will u do to ur
patient? name other repairs.. complications of manchester repair? rind pessary? its
complications? y won't u place ring pessary in this pateint... long case obs with
external in unit 3: prev. 2 c-sections, again she listened to the complete history ...
for what reason we have admitted this patient? when will u do her c-section? tell me
the date on which u"ll do elective c-section... why not later, why not on EDD we
usually calculate? what r the risks?? y not before 38 weeks?? what r the benefits of
this median time we use for c-section.. what is fetal distress??normal fetal heart
rate... table viva dr. tabinda:define endometriosis, its sites, choclate cyst? how is it
formed? medical treatment of endometriosis? mechanism of action of danazol...
7.long case

ma'm tabinda: prolonged pregnancy : do PA, findings, def of engagemnt of head,

how will u manag the case, start with investigations n then treatment, primi main
what specific investigations u will do( we ll rule out cpd)
ext: UV prolapse: diagnosis, investigations, why she had developed urinary
complaints n how will u manage it ?
table viva : ma'm aisha: breech delivery complications? ext: IUCD complications
toacs in unit 1: no help at all

8.long case was of hydrocephalus(obs)..gyne..uv prolapse..in unit 2..sir arshad

chohan doesnt daviate from his book..so simple viva..kelly suture for
incontinenc..supports of utrs..names of cardinal ligament..extrna askd..prophlaxis of
hydrocephalus..does it compatible with life..hw it can affect labour..table viva in
unit1..mam tabinda was chill..engagement definition..n causes of non engagement..
extrnal..invasive mole treatment..pid..candidiasis..n risk factors for it..y occur in
pregnency..osce in unit 1..mujhy mushkil lgi,,help b km e thi..

9.Long Case (Unit 5):

Obs: Elective C Section......Ma'm Tayyaba Waseem - Indication of C section in this
patient, Indication of C section in first pregnancy in that patient, Causes and
Complications of Malpresentation, Causes and Management of PPH (First tell
Resuscitation, then specific management)
Gynae: Post-menopausal bleeding (CA Cervix)......Ma'm Zohra (External) - Diagnosis
and reasons, Definite Investigation (Biopsy), Aetiology of Fibroids, Management and
staging of CA Cervix

Table Vivas (Unit 1):

Ma'm External - PCO and its presenting complaints, Complications of IUCD, How
IUCD is misplaced?, Presenting Complaints of Intramural fibroid, Complications of
myomectomy.......Ma'm Tabinda - APH Definition and Causes, Mechanism and PerAbdominal examination findings in Placental Abruption

OSCE very easy and same to same as in ward tests.....No cheating scene.....Very
short time (30min each) for completing histories in long case.....No permission to
open books but you can discuss with PGs and friends......The most relieving thing

about OBS and GYNAE viva is that examiners never ask anything except the same
10-12 important topics. So, prepare only them.
at last the end of gyne & obs, lets hope none of us has to visit LWH anymore :)

_____The End____
Compiled by the class of 2012
GYNAE/OBS VIVA+TOACS--30TH JAN,2013---MY combo was UNIT II n III and TOACS in
UNIT I...
sab say pehlay LONG CASE IN UNIT II---two long cases.....thirty minutes for each of
them...gynae long case MASS ABDOMEN ka tha,,and OBS long case was of
PROLONGED PREGNANCY....
GYNAE LONG CASE VIVA---MA'aM TAYYABA---listens to the history very carefully and
then askd about the D/D'z ...y does fibroid cause menorragia,,,causes of
amennorhea,,,n treatment options of fibroid uterus,,wts the most common
complication of myomectomy

OBS LONG CASE VIVA--DR.ARSHAD CHOHAN---sir is extremmlyy sweet...hardly

definitons pooch rahay thay aaj....teen say ziada ques tou kisi say bhi nahin
poochay....i was askd to dfine prologed preg n its complications in the fetus ...and
the causes of maternal mortality in Pakistan..

TABLE VIVA WITH EXTRNAL---andr very nyc examiner...askd to describe uses of sims
speculum,,types of contraceptives and their mode of action.....

TABLE VIVA WITH MA'AM AYESHA MALIK---wn is anomaly scan done??how wud u
cousel a pt wid a congenitally malformed fetus??how to terminate a pregnancy and
wt r the methods of induction of labour??wts BISHOP score....

TOACS---UNIT 1 walon nain tou bohat help ki thee...n her station p kuch bhi poochna
hota tha tou bta daitay thay.....scenarios of ecclempsia,,gestational
diabetes,peurperal
pyrexia,hysterosalpingograam,condom,hydrocephalus,hyeremesis
gravidarum,hysterectmy specimen,scenario of ruptured ectopic
pregnancy,,interactive sessions p breech n D n C tha....

P.S=WARD CARDSSS WERE GIVENNNN DUE IMPORTANCE TODAY BY ALL THE

EXAMINERS IN MY COMBO esp DR.TAYYABA n DR.ARSHAD CHOHAN..so make sure ur
ward cards r signd

b of lukk!!!!!