O&G Long case Tan Zi Kheng Tan Zi Kheng

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O&G Long case

Tan Zi Kheng

1.prof jamiyah, prof lee way siah, dr.Lang (external)

2.O&G

3.coming in for IOL at 38 weeks of POG.

4. 42yo, G6P4+1, background history of DM for 2 years, on diet control only. currently, at 37 weeks

of POG. unwanted and unplanned pregnancy. antenatal uneventful. started on insulin at 12 weeks

POG. (As usual, DM history starting 2 years ago...until now. Luckily she is a stuff nurse, so she can

tell all the results for blood glucose.)

5. PE finding: singleton pregnancy, longitudinal lie with cephalic presentation. not engaged,

adequate liquor volume. estimated fetal weight 2.6kg

6. normal pregnanvy with 2 years history of DM

7. Prof J interuppted me along the way I presented. Everything was in a hurry. Never stop asking

qustions...even on the way to the examine the patient. The 2 other examiners just follow at the back.

What do you mean by POG?

How to calculate EDD? What is the EDD for this pt? since my patient's EDD is confirmed by U/S.

Why she didn't have OGTT done this time?

Why you say the control is suboptimal?

What is her contraception method?

How you ask for complication of DM? I already answered all, but she is expecting smthg else.

What is the definition of stillbirth?

Why peripheral neuropathy in pregnant lady? pt complaint of numbness over the fingers, but

bedside when I examine in front of examiners, she kept on saying 'Tajam tajam.."zzzz

How to do GCT?

How to do OGTT? how to advice pt before OGTT? normal value?

How to investigate the mother? ( I said all tests,even fructosamine.haha. still duno what she

wanted)

How to do monitoring? bla bla bla...

what is the weight gain allowed in this pt?

what is the normal weight gain?

What do you expect to find in U/S? I said cardiac anomalies. and also nuchal translucency in

Down's. (prof lee noded at the side) she asked cardiac defects in DM or GDM? I answer GDM. but

WHY?

When do you want to deliver the pregnancy?

PE: show me how to do peripheral neuropathy?

how you clinically estimate the week of gestation?

Is the head engaged?

What are the signs of complication you are looking for in this pt?

How to calculate BMI? ( prof I didn't calculate hers but i know is above 25.) How

you know? huh, got faster way? (Yup) Show me..

what is the urine glucose test results?

Raymond Yii Shi Liang

1. Lecturers who took u: Prof. C.K Liam (silent), Prof Mary (Caucasian- external,the main

examiner) & Prof Aili (silent)

2. Specialty: Gynaecology

3. Chief complaint: Sundravalli, a 49-year-old Indian lady, para 5, presented with menorrhagia for

2 months.

4. Brief history

- Menorrhagia for 2 months since Oct 2010.

- flooding, blood clots of multiple size with the largest one 20 cent-sized, daily 5-6 pampers fully

soaked with blood.

- It was associated with severe persistent abdominal pain localized at lower abdomen extending to

both right and left iliac fossa. There was also low back pain. Other associated symptoms such as

abdominal distension and pressure sx (urinary freq and tenesmus) were absent. No history

suggestive of PCOS.

- sought treatment in HTAR and was told that US showed fibroid.

5. PE finding

- Conjunctival pallor, left iliac fossa tenderness, mass in left iliac fossa (I couldn't feel it, but the

examiner could feel it - what a disastrous thing happening to me!)

- I also told that there were scleral jaundice and hepatomegaly. But Prof CK Liam confirmed that

there was none. So, be careful of the lighting condition when u're checking for scleral jaundice.

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O&G Long case Tan Zi Kheng Tan Zi Kheng 1.prof jamiyah, prof lee way siah, dr.Lang (external) 2.O&G 3.coming in for IOL at 38 weeks of POG. 4. 42yo, G6P4+1, background history of DM for 2 years, on diet control only. currently, at 37 weeks of POG. unwanted and unplanned pregnancy. antenatal uneventful. started on insulin at 12 weeks POG. (As usual, DM history starting 2 years ago...until now. Luckily she is a stuff nurse, so she can tell all the results for blood glucose.) 5. PE finding: singleton pregnancy, longitudinal lie with cephalic presentation. not engaged, adequate liquor volume. estimated fetal weight 2.6kg 6. normal pregnanvy with 2 years history of DM 7. Prof J interuppted me along the way I presented. Everything was in a hurry. Never stop asking qustions...even on the way to the examine the patient. The 2 other examiners just follow at the back. What do you mean by POG? How to calculate EDD? What is the EDD for this pt? since my patient's EDD is confirmed by U/S. Why she didn't have OGTT done this time? Why you say the control is suboptimal? What is her contraception method? How you ask for complication of DM? I already answered all, but she is expecting smthg else. What is the definition of stillbirth? Why peripheral neuropathy in pregnant lady? pt complaint of numbness over the fingers, but bedside when I examine in front of examiners, she kept on saying 'Tajam tajam.."zzzz How to do GCT? How to do OGTT? how to advice pt before OGTT? normal value? How t ...
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