Wafa OBGYN

السلام عليكم 📣 مددت فترة توفر التسجيلات لين تاريخ ٢٨ فبراير، عشان يمدي للي بيختبرون بهالوقت 📌واللي فاته التسجيل تقدر تحصل على التسجيلات من خلال هذا الرابط👇🏻 https://medicalacademy.org/portal/event/view/2213/obgyn-smle-course-recorded-lectures?market=12

فاللي لسا ما بدأ يحمل هذا ، وبالتوفيق🙏🏻

هذا الملف نفس اللي ارسلته مسبقًا بس صححت الخطأ المطبعي اللي قلتلكم فوق + كان فيه سؤال مكتوب dysphagia بالغلط بدال dyschezia

هذا السؤال بالملزمه فيه خطأ مطبعي ، كاتبة الجواب A بدال ما اكتب B بس الشرح اللي تحت السؤال صح ويروح مع B بس عدلوه عندكم.

السلام عليكم ورحمة الله وبركاته 📣 هذا ملف ٢٠٢٤ وان شاء الله شامل (تم تعديل بعض الاجوبة والاسئلة، واضافة اسئلة جديدة) اعتمدو هذا كنت حاذفه صفحه بالغلط باللي ارسلته اول👇🏻

بكره ان شاء الله اول ايام الدوره نشوفكم باذن الله، الساعه ٧ مساءاً🕖🔥 اتمنى لكم التوفيق والنجاح يارب😍🙏🏻!

📌According to Berghella Placental removal Gentle cord traction resulting in spontaneous expulsion should be utilized for delivery of the placenta, given the significant decrease in blood loss and endometritis as compared to manual placental removal.

📌Endometrial hyperplasia - Management • Endometrial hyperplasia with atypia o Preferred: Hysterectomy - Candidates:  For most postmenopausal patients and premenopausal patients who have completed childbearing  o Alternative: Progestin therapy - Candidates:  Premenopausal patients who desire future fertility  Patients of any reproductive status who decline hysterectomy  Patients at high risk of surgical complications

📌According to UpToDate and Williams Gynecology - Pregnancy test — Pregnancy should be excluded in all reproductive-age patients with AUB. Pregnancy testing should be performed even in patients with recent vaginal bleeding since this may represent bleeding during pregnancy rather than menses - A complete blood count is performed for all patients with HMB to assess for anemia

📌According to Williams Gynecology and ACOG Management of Acute AUB in reproductive aged women - At times, women with AUB may have brisk bleeding that requires acute intervention  Start with fluid resuscitation and blood transfusion as indicated first  Then Medical treatment is simultaneously administered to slow bleeding. - Medical Management should be the initial treatment for most patients with acute AUB • Treatment options include: o IV conjugated equine estrogen: Primary choice for heavy bleeding (Once bleeding has slowed, patients can be transitioned to an oral taper using Prernarin pills or more commonly COCs.) o Combined oral contraceptives (OCs): Primarily for less severe bleeding o Oral progestins: Primarily for less severe bleeding and when estrogen is contraindicated o Tranexamic acid (TXA): is also an option for acute heavy menstrual bleeding (HMB). - Therapeutic D&C should be reserved as a last resort for the rare patient who continues to have life-threatening bleeding despite high-dose of estrogen administration

📌According to Williams Gynecgology Transvaginal US For premenopausal patients: • TVUS performed to exclude structural sources of abnormal bleeding. • Endometrial thickness threshold has not been established for this group. • Thus, to exclude endometrial cancer, endometrial biopsy is preferred to sonography for high-risk premenopausal women with AUB. Endometrial sample, ACOG recommends such a sample for • Women older than 45 years with AUB. Considered for those younger than 45 with: • Chronic excess estrogen exposure (exogenous or endogenous) • Failed medical management. • Persistent AUB.

📌According to UpToDate Urethral diverticulum - Are thought to be acquired rather than congenital in nearly all cases. - The most widely proposed theory is that a urethral diverticulum develops as a result of repeated infection of the periurethral glands, leading to obstruction and enlargement of the glands/ducts and formation of a suburethral abscess - The periurethral glands are located medially and posterolaterally along the distal two-thirds of the urethra and drain into the distal third of the urethra. The periurethral glands secrete mucin that acts as sealant and contributes to urinary continence. Skene glands are periurethral glands found on either side of the urethra

📌According to Comprehensive Gynecology Textbook and SOGC Guidelines Cervical cancer screening: ⁃ Cervical cancer screening should not be performed in women younger than 21 years of age, regardless of age of onset of sexual activity. ⁃ 21-29   cytology alone at 3-year intervals. ⁃ 30-65  co-testing at 5-year intervals. (preferred), OR with cytology alone at 3-year intervals (acceptable) ⁃ >65  no need for screening if three consecutive, negative cytology