Download University of Jaffna MBBS 2021 July Obstetrics and Gynaecology Paper II Question Paper

UNIVERSITY OF JAFFNA, SRI LANKA

FINAL EXAMINATION FOR MEDICAL DEGREES

July - 2021

OBSTETRICS AND GYNAECOLOGY PAPER II

Date: 27.07.2021

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Time: 03 hours

ANSWER ALL THE FIVE QUESTIONS

Answer each question in separate answer book

1. A 30 year old primigravida with gestational diabetes mellitus was in active labour at 38 weeks of gestation. Following the delivery of the fetal head, difficulty was encountered with delivering the rest of the baby.

   1. Identify the above emergency and mention three factors that would predict its occurrence during labour. (30 Marks)

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   2. Briefly describe the steps you would take to deliver this baby safely (50 Marks)
   3. Mention four fetal complications that can occur as a result of this condition. (20 Marks)

2. A 28 year old primigravida presented to the antenatal clinic at 16 weeks of gestation.

   Her Full blood Count reveles:

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   Hb- 8.2 g/dL, MCV- 65 fl, MCH-20. 9pg, MCHC- 28.3g/dL, PCV 26%, Platelets 340 X 10³/dL.

   Other investigations are normal and has no significant past medical and surgical history.

   1. Mention the most likely diagnosis and describe how you would further assess this pregnant woman. (30 Marks)
   2. Enumerate maternal and fetal complications of above mentioned condition. (30 Marks)
   3. Briefly discuss how you would treat the condition you mentioned in 2.1 to improve the outcome of this pregnancy. (40 Marks)

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3. A 30 year old nulliparous woman married for three years was admitted to the gynaecology ward with painful heavy menstrual periods for the last 8 months duration. Abdominal and pelvic examinations reveals a 17 weeks size uterus with a firm mass which moved with the cervix.

   1. Mention the most likely diagnosis based on the initial presentation and examination findings with reasons. (20 Marks)
   2. How you will further investigate this woman. (30 Marks)
   3. Discuss management options available for this woman considering her wish to conceive. (50 Marks)

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4. A 58 year old post-menopausal woman presents to the gynaecology clinic with a recent onset of malodourous, blood stained vaginal discharge. Speculum examination reveals a cervical growth with contact bleeding suggestive of a malignancy.

   1. Mention the commonest type of cervical carcinoma and its aetiology. (20 Marks)
   2. Briefly describe how you would proceed to make a definitive diagnosis and stage the disease. (50 Marks)
   3. Discuss how we could have prevented this malignancy in this woman. (30 Marks)

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5. Unrecognised and untreated postpartum depression can lead to serious consequences to the mother, baby and her family.

   Discuss the strategies to recognise this condition early to improve its outcome in Sri Lanka. (100 Marks)

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