OBGYN Advice and Study Guides

Texts/Useful Resources
***required read

**highly recommended

*Useful resource

*Obstetrics and Gynecology (Beckman)

**Case Files: Obstetrics and Gynecology
***APGO U-wise Q-bank (provided by the department)
**World Q-bank
Kaplan Q-bank

Sign-In/Morning rounds
Every student, except those who are at the VA for the week, has to sign-in by
5:30 am. Each patient has to be checked on each morning by one student
who will write a progress note and present the patient at rounds. The
residents prefer that the notes be done by 6 am so that they can view the
charts. Its a good idea to come in earlier than 5:30 to have enough time to
write your note. Checkout and rounds begin at 7am. The residents will be
helpful in giving pointers on how to present; ask them to review
your note/presentation before rounds your first time.
There are usually way more students than patients. To help ensure that
each student gets an opportunity to present that week, you can
decide as a group who will be responsible for writing notes on the
patients. You can do this a day in advance (i.e. at the end of rounds)
to prevent uncovered patients.
**Gyn students dont have to come to rounds but still have to sign in by 5:30
am
H&P/SOAP Notes
The example H&P and SOAP note packet that they distribute is a useful
template.
Weekly Quizzes (are EAGLES)
-10 multiple choice questions straight from the U-wise q-bank; every student
on rotation gets access. They usually email the topics that will be on the quiz
earlier in the week. Essentially, the quiz can be any 10 out of the 50-60
questions that you should have already seen.
Mid-Term Exam (apparently it used to be a rock, but of course they switched it up for
2014)
See Study Guides

Mid-Term OSCE

Usually does not count for a grade but is used to help you improve for
the final OSCE. 4 stations, 5 min. each, there will be an attending at
each station silently evaluating your performance:
Clinical Breast Exam (model)
Pelvic Exam (model)
Taking a Gyn history (standardized patient)
Taking an OB history (standardized patient)
Helpful hints: Talk directly to the model or SP, not the attending; During
the pelvic exam TURN ON THE LIGHT!

GYN HISTORY
1. Introduces his/herself to patient
2. Chief complaint
3. Present illness
4. Menstrual history
5. Are you on hormone therapy?
6. Were you passing blood/clots?
7. When was your last pap smear
8. Obstetric History
9. Sexual history
10.Contraceptive history
11.family history
12.Social history
13.Informs patient of possible diagnosis
14.Inform patient of planned test/evaluation
OB HISTORY
15.Introduces oneself to patient
16.Professionalism
17.Eye Contact
18.LMP
19.G.P
20.Obstetrical past history
21.Gynecological history
22.PMH
23.Genetic history
24.Surgical history
25.Family history
26.Social history

27.Allergies
28.Current medicines
CERVICAL EXAM
29.Introduces oneself to patient
30.Explains what is going to be done
31.Washes hands before examination
32.Gloves both hands to do exam
33.Turns on lamp
34.Tells patient they are about to begin exam
35.Examines vulva for hair patter, lice, nits, masses or lesions
36.Examines labia majora and labia minora
37.Inspects clitoris
38.Inspects urethra, vaginal opening, and anus
39.palpates urethra and Skenes gland
40.Palpates Bartholins glands
41.Correctly inserts speculum
42.Asses patients comfort
43.evaluate cervix (GIVE DESCRIPTION)
44.Obtain pap correctly
45.Obtain cultures correctly
46.Correctly remove speculum
47.Palpate cervix and tries to ascertain position, consistency and mobility
48.Asses anterior uterine surface
49.Palpates adnexa
50.recto-vaginal exam
51.Washes hands after examination
BREAST EXAM
52.Professionalism (GREETS, INTRODUCES)
53.Washes hands
54.Explains procedure to patient
55.Assures patient comfort
56.Uses pads of fingers
57.Uses acceptable method
58.Maintains contact with models (Does not lift fingers)
59.Examines axillary nodal area
60.Squeezes nipple
61.Assures patient comfort
62.Identifies breast mass
63.Instruct patient on self breast exam
Final OSCE
Exactly like the mid-term OSCE with one additional station:

Fetal monitor strip: baseline, variability, accels/decels?

Oral Presentations/Exam
Each student has to present the H&P of a patient that they encountered to
their individual preceptor from memory near the end of the rotation. Your
preceptor will also ask you to explain OBGYN concepts from your H&P. Your
preceptor will provide more details about their preferences for the
presentation.
Dress Code
-Scrubs are worn when you are on Gyn for the week, on-call, or night float.
Everything else, including lecture Thursday, is professional dress with white
coat. Bring scrubs to change into if youre going to be on call Thursday after
lecture; dont wear scrubs to class.
-There is no real color code for the scrubs, but the Docs mostly wear blues.
Misc. Advice
Just do as youre told to do and you will be fine
Attendings:
Dr. Byrd: Extremely intense but very focused on education and not
violating HIPPA.
Dr. Khoder: Asks a lot of detailed questions that you probably wont
know, but he likes to pimp everyone (residents and students)
Dr. Borne: funny, gives you the answer to every question he asks five
mins before he asks it...keep your hands out of your coat pockets and
keep you collar straight around him. Know what a cotyledon is.
Dr. Tucker: Very focused on education. Has a tendency towards
pimping. She asks about the tests you do on each prenatal visit and
why.
Dr. Bruce: Very cool, talks a lot; likes for students to assess patient
reliability on H&P
Dr. Nowiski: Pimps. Asked about what causes preterm labor.
Dr. Hills: Very particular; loves a thorough H&P and fundal exams of the
eyes
Dr. Ladson: Likes a professional presentation (use your doctor
vocabulary)
Dr. Toussaint: Will pimp you and try to convert you to OB/Gyn. Her
pimping is done with an educational objective and actually helped for
the subject board. Overall nice
Residents:
All are really cool and will take the time to teach you pertinent things
you need to know
Study Guides
Midterm Study Guide (50 questions)

Read an entire book (either the textbook or First Aid) before

the midterm. Also do the online questions that go with the
textbook. The questions were all over the place and some were
very detailed.
Menopause average age of onset
Karyotype of partial/complete moles
Most common neoplasm in women
Quad screening: which quantities can be used to detect each
aneuploidy?
STDs--know them
Final paper OSCE study guide

Written (not mult. choice) exam on about 4 major concepts

Cervical Cancer; steps in screening and treatment

Interpreting a fetal monitor strip: baseline, variability, accels/decels,
Reassuring/Non Reassuring
Screening/Treatment of Syphilis and Gonorrhea in pregnancy
Methods of contraception; which is better for a nursing mother? which
can be used as emergency contraceptive

Subject Board
Questions were very similar to WORLD OBGYN questions; Case Files in its entirety
was also great preparation. 100 questions; everything below was ~70% of the
exam...
NO CALCULATIONS (e.g. Bishop score, Montevideo units, etc)
NO ANATOMY
Threated, Complete, Incomplete, Missed Abortions diagnosis and
treatment
Molar/Ectopic pregnancy diagnosis and treatment
Sonogram of Twin Gestation, dichorionic? monochorionic?
Cervical cancer diagnosis and treatment. (screening in 32 y/o woman
with a history of CINIII; hydronephrosis is the most common
complication), CIN III management (choices of pap every month for 3
months, repeat colpo in 3 months vs. other radical choices)
Abnormal pap management
Management of Breech presentation, arrest in descent
Primary amenorrhea Presentations of Mullerian Agenesis , Androgen
insensitivity, Kallman, Turners
Secondary amenorrhea due to anorexia, vigorous exercise, Sheehans,
Ashermans
Primary dysmenorrhea in a young girl (due to prostaglandin release)
vs. Mittelschmerz
Dysmenorrhea diagnosis/investigation (laparoscopy)
PCOS (diagnosis, treatment, metformin helps with diabetes and
infertility of PCOS)

What do you do when you find an ovarian cyst

Other causes of hirsuitism
PID diagnosis and treatment
Fetal tracings: know what different decels mean (early, late, prolonged)
Arrest of decent management
Fetal tachycardia after maternal infection
Penicillin desensitization in allergic woman
Diagnosis of missing cotyledons
STD differentiation/diagnosis and treatments ( Gonn, Chlam, Trich, B.
vag and Candida were favorites)
Make sure to review urinary diseases such as UTI or cystitis.
When is a C-section, external/internal cephalic version, or forceps
delivery indicated
Urinary Incontinence (Types and treatment for each), really old woman
(>70 years old) with urinary incontinence
very heavy on the exam
Uterine rupture and inversion signs
Placenta previa signs
Preeclampsia and treatment
Nontender indurated ulcer
Woman with symptoms of cholelithiasis of pregnancy (itching but no
rash on physical exam)-diagnose by checking bile salt/acids
Cause of a child with vaginal bleeding and foul smelling discharge
Counceling of obese patient to start exercise
Woman who gets nausea with iron supplements
Cause of lab values of low Hb and MCV >100
hematocolpo (menstraul bleeding into the cervix)
Leiomyoma types (subserosal, intrauterine, etc)
Breast disorders (nipple discharge, lumps, diagnosis and treatment)
fine needle aspiration or excisional biopsy? Breast masses: solid firm
breast mass with calcification, woman who had a motor vehicle
accident and broke her femur and had a firm irregularly bordered mass
with calcifications, smooth breast mass with skin thickening over it
Infertility-heavy on the exam
Vaginal bleeding
Vulvar lesions-small pink lesions on the vulva
UTIs and treatment (when TMP-SMX is not an answer choice), origin of
a UTI
Complication to fetus if the mother has type 1 DM vs. Gestational DM
Causes of hydrops fetalis
Pregnancy and fibroids, IUD and fibroids
Menstrual cycle temperature changes and the best day to conceive
Little girls without public hair showed up 23 times-diagnosis and
treatment
12 year old who started menses at 11 years old and didnt have a
period for 5 months = anovulatory