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Course, academic year 2023/2024
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Gynaecology and Obstetrics - Practice before State Examination - B83387 (General Medicine - English parallel)
Title: Gynaecology and Obstetrics - Practice before State Examination
Guaranteed by: Department of Gynaecology, Obstetrics and Neonatology First Faculty of Medicine Charles University and General University Hospital in Prague (11-00790)
Faculty: First Faculty of Medicine
Actual: from 2023
Semester: winter
Points: 11
E-Credits: 11
Examination process: winter s.:
Hours per week, examination: winter s.:0/150, C [HS]
Extent per academic year: 150 [hours]
Capacity: unlimited
Min. number of students: unlimited
4EU+: no
Virtual mobility / capacity: no
State of the course: taught
Language: English
Teaching methods: full-time
Teaching methods: full-time
Explanation: doc. MUDr. Kamil Švabík, Ph.D. kamil.svabik@lf1.cuni.cz
Additional information: https://gynpo.lf1.cuni.cz/en/
Old code: B01054
Guarantor: prof. MUDr. David Cibula, CSc.
Comes under: Compulsory for GM 6.y._23/24
Attributes: Lékařství
Klinický předmět
Pre-requisite : B81399
Interchangeability : B81054
Annotation
Last update: Jana Kolářová (24.06.2021)
The teaching is aimed at basics of gynaecological care and care during pregnancy. Ongoing screening programs in gynaecology and obstetrics will be discussed. Students will be taught during commented live transmissions about surgical procedures in gynaecology and obstetrics. They will be trained on Viktorie simulator for vaginal delivery during obstetrics practical seminar, practice perineal wound repair. Basic set of gynaecological instruments will be presented, PAP smear technique and HPV test usage will be trained. Lectures are focused on all subspecialties in gynaecology and obstetrics aiming at both theoretical knowledge and clinical skills.
Syllabus
Last update: Jana Kolářová (24.06.2021)

Women’s physiology

Physiological changes in pregnancy and fetal development

OB-GYN examination methods

Surgical approaches in gynaecology

Minor surgical procedures in gynaecology

Infection in pregnancy

Infection, physiology and pathology of the breast during pregnancy

Disorders of early pregnancy and differential diagnosis

Perinatology and fetomaternal medicine
Organization of prenatal care in the Czech Rep., obstetric examination

Prenatal screening and congenital abnormalities

Pharmacotherapy in pregnancy

Pathological pregnancy (preterm delivery and prolonged pregnancy, intrauterine

fetal death)

Pathological pregnancy (FGR, fetal anaemia, multiple pregnancy, TTTS)

Pathological pregnancy (medical disorders during pregnancy - diabetes,

hypertension, HELLP syndrome, blood and heart disorders)

Delivery, abnormal uterine activity, intrauterine hypoxia, cardiotocography

Obstetric emergencies

Infection in pregnancy, sepsis

Peripartum haemorrhage

Obstetric analgesia and anaesthesia

Breech, abnormal fetal positions, disorders of normal delivery

Instrumental and operative delivery, obstetric injury

Placental pathologic conditions, abnormally adherent placenta

Disorders of puerperium

Gynaecological Oncology
Surgical anatomy

Management of malignant tumours - surgical treatment

Premalignant lesions

Hereditary cancer syndromes

Management of malignant tumours - other treatment modalities

Gestational trophoblastic disease

Breast disorders

Urogynaecology
Functional anatomy

Urine incontinence

Pelvic organs descensus

Endocrinology and reproductive medicine
Gynaecological endocrinology

Contraception

Infertility and assisted reproduction

Oocyte maturation and early embryonic development

Gynaecological endoscopy
Common procedures

Endometriosis

Benign gynaecology
Infections

Acute abdomen

Basics of surgical anatomy

Entry requirements - Czech
Last update: Jana Urbanová (06.04.2023)

For the current schedule follow the website of the clinic and the FB group:

https://gynpo.lf1.cuni.cz/en/

Obstetrics and Gynecology 

24. 4. 2023 Monday

8.45 - 9.15          Basic information doc. Švabík

9.15 - 10.45        Organization of prenatal care in the Czech Republic, obstetric examination doc. Koucký

10:45-11:45         Prenatal screening and the most common congenital fetal aneuploidy and           malformations prof. Calda

12:00-13:15        Psychological care of patients at Department of Obstetrics and Gynecology PhDr. Slabá

 

25. 4. 2023 Tuesday (ATTENTION – Bulovka University Hospital, bulding No. 15, lecture hall)

8.30 - 10.00        Pregnancy-induced physiological changes in women and fetal development

as. Hurt/as. Mojhová

10.15 - 11.45      Infections in pregnancy. Physiology and pathology of the mammary gland in

pregnancy as. Matěcha/as. Mojhová

12.00 - 13.15     Pathology and differential diagnosis of early pregnancy as. Dubová/as. Brtnický

 

26. 4. 2023 Wednesday

8.30 - 9.15           High risk pregnancy, fetal growth restriction (FGR) as. Vojtěch

9.15 – 10.15       Anatomy of the pelvis, mechanism of physiological labor as. Přáda

10.30 – 11.15     „Obstructed labor“ doc. Koucký

11.15 – 12.00     Sudden events in pregnancy doc. Koucký

 

27. 4. 2023 Thursday

8.30 – 10.00       Abnormal fetal position and presentation MUDr. Laštůvka

10.15 – 11.15    Peripartum/postpartum hemorrhage prof. Pařízek

11.15 – 12.30     Cardiopulmonary resuscitation in pregnancy, analgesia and anaesthesia in obstetrics 

prof. Pařízek

 

28. 4. 2023 Friday

8.30 –   09:15     Fetal hypoxia, CTG as. Přáda

09.15 – 11.15     Operative delivery, C-section prof. Hájek, as. Přáda

11:15 – 12:00     The most important cardiovascular diseases in pregnancy-preeclampsia as. Šimják  12:00 – 13:00    Diabetes in pregnancy, Intrahepatic cholestasis of pregnancy as. Andrlová, as.  Šimják

 

1. 5. 2023 Monday         holiday

8.30 – 10.00       Multiple pregnancy and its complications as. Vojtěch

10.15 – 11.30     Pharmacology in pregnancy, erytrocyte alloimmunization as. Žižka

11.30 – 12.30     Disorders of the duration of pregnancy as. Vojtěch

 

2. 5. 2023 Tuesday

8.30 – 9.05          Distribution of newborns according to weight and length of gestation. Physiological adaptation late preterm/early term  and  mature newborns, lung cleansing and reconstruction of fetal circulation, specifics of adaptation of immature newborns prof. Plavka/MUDr. Lamberská

9.10 – 9.45          Placental transfusion-physiology and significance for newborns, delayed umbilical cord clamping vs milking MUDr. Lamberská/MUDr. Dunajová

9.50 – 10.25       Resuscitation of premature newborns in the delivery room - algorithm, aids, monitors, devices MUDr. Nguen/MUDr. Lamberská, MUDr. Dunajová

10.35 – 11.05     Care of newborns in the delivery room-treatment, bonding, monitoring. Non-initiation of care in live-born newborns, comfort care in the NICU, parents

MUDr. Lukšová/MUDr. Paslerová

11.10 – 12.00     Modern neonatology, building blocks, evolution of mortality and morbidity, limits of viability prof. Plavka

 

3. 5. 2023 Wednesday (ATTENTION – Bulovka University Hospital, bulding No. 15, lecture hall)

8.30 - 10.00       Minor surgeries in gynaecology as. Brtnický/as. Kabele

10.15 - 11.45      Examination methods in gynaecology and obstetrics as. Hubka/as. prim. Koliba

12.00 - 12.45      Surgical approaches in gynaecology prof. Zikán/as. Brtnický 

13.00 - 13.45      Breast diseases prof Zikán/as. Dubová

 

4. 5. 2023 Thursday

8.30 – 10.30      Gynaecological endocrinology, endometriosis, contraception doc. Fanta

10.45 – 12.15     Gynaecological emergencies doc. Fanta

12.15 - 14.45     Examination of the infertile couple, treatment of infertility, complications. MUDr. Adamcová

 

5. 5. 2023 Friday

8.30 - 10.00        Vulval and endometrial cancer as. Kocián

10.15 - 11.45      Hereditary Syndromes in Gynaecologic Oncology, Prevention, GTD/GTN as. Frühauf

12.00 - 13.15     Video Lectures – Surgery in Gynaecologic Oncology as. Frühauf

 

8. 5. 2023 Monday holiday

 

9. 5. 2023 Tuesday

8.30 – 10.00       Basics of gynaecological endoscopy. Video: Total Laparoscopic Hysterectomy prof. Kužel

10.00 – 11.00     Puberty and bleeding disorders MUDr. Poncová

11.15 – 12.30     Gynaecologic infection prof. Mašata

12.30 – 13.30     Benign uterine tumours, reproductive surgery prof. Mára

 

10. 5. 2023 Wednesday Rector´s day

 

11. 5. 2023 Thursday

Practical seminars (½)

 

12. 5. 2023 Friday

Victoria obstetrical simulator (for practicing at Bulovka)

 

15.5. - 26.5.2023 clinical rotation

 

29. 5. 2023 Monday

8.30 - 10.00        Precancerous lesions in gynaecology prof. Sláma

10.15 - 11.45     Ovarian cancer management prof. Fischerová

12.00 - 13.15     Cervical cancer prof. Cibula

 

30. 5. 2023 Thuesday

8.30 – 10.00       Multiple pregnancy and its complications as. Vojtěch

10.15 – 11.30     Pharmacology in pregnancy, erytrocyte alloimmunization as. Žižka

11.30 – 12.30     Disorders of the duration of pregnancy as. Vojtěch

 

31.5.2023  Wednesday

8.30 – 9.30          Urogynaecology – introduction, diagnostic methods doc. Švabík

9.30 – 10.45       Urinary incontinence prof. Martan

11.00 – 12.30     Pelvic organ prolapse prof. Mašata

12.30 -13.30       Delivery and obstetrical pelvic floor injury vs pelvic floor function.  MUDr. Dvořák

Video

 

5.6.-9.6.2023 EXAM

 

 

 

 

 

Requirements to the exam - Czech
Last update: MUDr. Adéla Richtárová (16.11.2022)

Credits before the state exam:

 There are 3 ways how to receive credit

1) Students in the end of the 5th week of  Ob/Gyn rotation will discuss  clinical case at the  departement. (according the table)  and will get a signed certificate (for download here). There will be  no mark, this signed document, please bring to Mrs. Urbanova. (Office Apolinar, First floor, Chairman office) 

2) Certificate about 2 clinical weeks -  to Mrs. Urbanova

3) Certificate about Full course at  cooperating Universities - to Mrs. Urbanova or via Students office

State Exam:

- takes place during the 7th week of traineeships.

Students register for the State Exam through the Information Study System of the 1st Faculty of Medicine, Charles University

Questions for the final state examination in Gynaecology and Obstetrics:

There is a combination of theoretical questions and clinical questions.

Clinical question focuses on the management of a patient (diagnosis and treatment) with described symptoms.

 

1.

a) Prenatal care in the Czech Republic (system of visits, guidelines)

b) Clinical question - Bleeding in the third trimester of pregnancy (diagnosis, differential

diagnosis, management)

c) Malignant tumours of the ovary, types, management, treatment

d) Clinical question - Genital bleeding in children and adolescents (diagnosis, differential

diagnosis, management) 

 

2.

a) High-risk pregnancy - definition, types of risks

b) Clinical question - Hypertension after the 20th week of pregnancy (diagnosis,

differential diagnosis, treatment)

c) Uterine myomatosis - types, complications

d) Clinical question - Postmenopausal bleeding (diagnosis, differential diagnosis,

treatment)

 

3.

a) Cardiopulmonary resuscitation in pregnancy and labour

b) Clinical question - Vomiting in pregnancy (diagnosis, differential diagnosis according to

trimester, management)

c) Menstrual bleeding disorders – types, diagnosis, treatment

d) Clinical question - Urinary incontinence (diagnosis, differential diagnosis,

management)

4.

a) Internal diseases in pregnancy (focusing mainly on cardiovascular, endocrinological,

hepatic and pulmonary diseases)

b) Clinical question – Intrapartum haemorrhage (management of the patient - diagnosis,

differential diagnosis, treatment)

c) Examination of an infertile couple, evaluation of the causes of infertility

d) Clinical question - Cardiopulmonary decompensation and sudden cardiac arrest during and after gynaecological surgery (diagnosis, differential diagnosis, management)

5.

a) Main statistical indicators in obstetrics. Causes and prevention of maternal and

perinatal mortality and morbidity.

b) Clinical question – Fever in the puerperium (diagnosis, differential diagnosis,

management).

c) Sexually transmitted diseases (definition, examples, diagnosis, treatment)

d) Clinical question - Irregular uterine bleeding (differential diagnosis according to the

woman's life stage, diagnosis, management)

6.

a) Pre-eclampsia and eclampsia, HELLP syndrome

b) Clinical question – Postpartum haemorrhage (management of the patient - diagnosis, differential diagnosis, treatment)

c) Thromboembolic disease in gynaecology - etiopathogenesis, risk factors, symptoms, diagnosis, treatment, prevention

d) Clinical question - Painful menstruation (differential diagnosis, diagnosis, treatment)

7.

a) Anatomy of the pelvis and birth canal.

b) Clinical question - Hypertonus of the uterus in pregnant women (management of the

patient - diagnosis, differential diagnosis, management)

c) Diagnosis, differential diagnosis and treatment of gynaecological emergencies.

d) Clinical question - Excessive menstrual bleeding (management of the patient –

diagnosis, differential diagnosis, management)

8.

a) Abdominal emergencies during pregnancy

b) Clinical question - Pruritus of the skin in pregnancy (diagnosis, differential diagnosis, management)

c) Congenital defects of the uterus and vagina - causes, diagnosis, treatment, disorders of sexual differentiation

d) Clinical question - Contact bleeding and bleeding after intercourse (diagnosis, differential diagnosis, management)

9.

a) External and internal obstetric examination at the end of pregnancy and during labour, position, presentation and lie of the foetus

b) Clinical question - Breast redness in the puerperium (diagnosis, differential diagnosis, management)

c) The life stages of a woman from the gynaecologist's point of view. Changes of the reproductive organs of a woman during her lifetime

d) Clinical question - Chronic pelvic pain (differential diagnosis, diagnosis, management)

10.

a) Determination of gestational age, system of prenatal care in the Czech Republic.

b) Clinical question - Back pain in pregnancy (diagnosis, differential diagnosis, treatment)

c) Diagnosis, differential diagnosis, and management of gynaecological emergencies

d) Clinical question - Patient with uterine fibroids - management and treatment options

11.

a) Rh incompatibility, isoimmunization - definition, diagnosis, treatment

b) Clinical question - Headache in pregnancy (diagnosis, differential diagnosis, treatment)

c) Menstrual cycle, regulation and disorders

d) Clinical question - OASI after delivery with stool leakage (what is OASI, classification

system, differential diagnosis of anal incontinence, treatment options)

12.

a) Physiological changes in the mother's body during pregnancy and their significance

b) Clinical question- Abdominal pain in the second half of pregnancy, irritable uterus (diagnosis, differential diagnosis, management)

c) Treatment of infertility, assisted reproduction technology, complications of infertility treatment

d) Clinical question - Dyspareunia (differential diagnosis, typical clinical findings and history, age of the patient, risk factors)

13.

a) Acute and chronic foetal hypoxia

b) Clinical question - Abnormal urine dipstick test results during routine monitoring in

pregnancy (abnormal findings in diabetes, preeclampsia, infection, suggestions for

further management)

c) Endometriosis - types, symptoms

d) Clinical question – Urinary frequency and urgency (diagnosis, differential

diagnosis, treatment options)

14.

a) Pathology of early pregnancy from the perspective of foetal egg development, definition of terms

b) Clinical question - Reduced foetal activity (diagnosis, differential diagnosis, management)

c) Vulvovaginal infections

d) Clinical question - Dysuria, slow urine flow, sensation of incomplete bladder emptying (differential diagnosis of symptoms, management)

15.

a) Multiple pregnancy - types, complications

b) Clinical question - Swelling in the second half of pregnancy (diagnosis, differential

diagnosis, management)

c) Appendicitis and adnexitis - differential diagnosis

d) Clinical question - Primary amenorrhoea (diagnosis, differential diagnosis,

management)

 

16.

a) Breech presentation - definition, types, management of labour

b) Clinical question - Amniotic fluid leakage before 20th week of pregnancy (diagnosis,

differential diagnosis, management)

c) Ectopic pregnancy - localizations, diagnosis, management

d) Clinical question - Oligomenorrhoea (diagnosis, differential diagnosis, treatment)

17.

a) Embolic events in pregnancy and labour

b) Clinical question - Amniotic fluid leakage at term before the onset of uterine activity –

PROM (diagnosis, differential diagnosis, management)

c) Planned parenthood, contraception, sterilization

d) Clinical question - Secondary amenorrhoea (diagnosis, differential diagnosis,

treatment)

18.

a) Peripartum life-threatening haemorrhage

b) Clinical question - Amniotic fluid leakage after 24th week of pregnancy (PPROM)

(diagnosis, differential diagnosis, management)

c) Artificial termination of pregnancy - indications, performance, legal standards

d) Clinical question - Hypotension, oliguria, bleeding after gynaecological surgery

(differential diagnosis, diagnosis, management)

19.

a) Placenta - morphology, function, pathology, examination

b) Clinical question - Sudden unconsciousness during and after labour (diagnosis,

differential diagnosis, management)

c) Endoscopic methods in gynaecology - definition, types, indications

d) Clinical question - Positive pregnancy test and lower abdominal pain (diagnosis,

differential diagnosis, management)

20.

a) Infectious diseases and pregnancy

b) Clinical question – maternal collapse in pregnancy (diagnosis, differential diagnosis,

management)

c) Diagnosis and treatment of gynaecological precancerous lesions

d) Clinical question - Routine ward round after laparoscopic hysterectomy (what, how,

why I routinely check, possible complications, their manifestations)

21.

a) Physiology and pathology of puerperium and lactation. Principles of care of women in puerperium.

b) Clinical question – Bleeding in the second trimester of pregnancy (management of the patient - diagnosis, differential diagnosis, treatment)

c) Malignant tumours of the cervix

d) Clinical question – Finding of free fluid in the abdominal cavity after gynaecological surgery (diagnosis, differential diagnosis, management)

22.

a) Abnormal and pathological foetal lie and presentation, diagnosis, management of

labour

b) Clinical question - Convulsions in pregnancy (diagnosis, differential diagnosis,

management)

c) Malignant tumours of the uterine body

d) Clinical question - Vaginal discharge in a patient of reproductive age (diagnosis,

differential diagnosis, treatment)

23.

a) Foetal delivery in the cephalic presentation, physiological course

f) Clinical question - Wound redness after caesarean section (diagnosis, differential

diagnosis, treatment)

g) Risk factors for gynaecological malignancies, hereditary syndromes

h) Clinical question - Oliguria and flatulence after ovulation induction (diagnosis,

differential diagnosis, management)

24.

a) Disorders of the foetal delivery mechanism in the 1st , 2nd and 3rd stage of labour

b) Clinical question - Dyspnoea in pregnancy (management of the patient - diagnosis,

differential diagnosis, management)

c) Surgical treatment of gynaecological malignant tumours

d) Clinical question - Palpable lump in the breast (diagnosis, differential diagnosis,

management)

25.

a) Shock in pregnancy

b) Clinical question - Sudden devastating pain in labour (diagnosis, differential diagnosis,

management)

c) Breast disease (classification, diagnosis, treatment)

d) Clinical question - Pelvic and lumbar pain after gynaecological surgery (diagnosis,

differential diagnosis, management)

26.

a) Diabetes mellitus and pregnancy

b) Clinical question - Hypotension after delivery (diagnosis, differential diagnosis, management)

c) Precancerous lesions of the vulva, vagina, endometrium, and cervix

d) Clinical question - Bleeding in the first trimester of pregnancy (diagnosis, differential diagnosis, management)

27.

a) Premature newborn and low birth weight newborn - division, anatomical and physiological signs of prematurity.

b) Clinical question – Postpartum bleeding (diagnosis, differential diagnosis, management)

c) Urinary incontinence in women - definition, types, diagnosis, treatment

d) Clinical question – Vulvar and vaginal pruritus (diagnosis, differential diagnosis, treatment)

28.

a) The most common causes leading to failure of adaptation of the newborn,

resuscitation of the newborn.

b) Clinical question - Painful swelling of the lower limbs in pregnancy (diagnosis,

differential diagnosis, management)

c) Complications of laparoscopy and hysteroscopy

d) Clinical question – Preoperative medical assessment, evaluation, and preparation

prior vaginal hysterectomy - types of examinations and procedures and rationale

29.

a) Delivery injuries - causes, classification, treatment, prevention.

b) Clinical question - Bleeding manifestations related to pregnancy (diagnosis,

differential diagnosis, treatment)

c) Reproductive surgery

d) Clinical question - Peri-menstrual and post-coital bleeding (diagnosis, differential

diagnosis, management)

30.

a) Prenatal screening of chromosomal aberrations

b) Clinical question - Excessive weight gain in pregnancy (diagnosis, differential diagnosis,

management)

c) Primary and secondary prevention, screening for gynaecological tumours.

d) Clinical question - Irregular bleeding in the 4th decade of life (diagnosis, differential

diagnosis, management)

31.

a) Ultrasound screening in pregnancy - distribution and significance

b) Clinical question - Discharge in pregnancy (diagnosis, differential diagnosis, treatment)

c) Breast cancer - types, diagnosis, treatment

d) Clinical question – Genitourinary prolapse 6 months after delivery (diagnosis,

differential diagnosis, treatment)

 

32.

a) Induction of labour

b) Clinical question - Dysuria and urinary frequency in pregnancy (diagnosis, differential

diagnosis, treatment)

c) Radiotherapy, chemotherapy, and hormonal therapy for gynaecological malignancies –

typical examples

d) Clinical question - Choice of contraceptive method (patient management - diagnosis,

differential diagnosis, treatment)

33.

a) Operative vaginal delivery - types, indications, complications

b) Clinical question - Urinary retention in pregnancy (management of the patient –

diagnosis, differential diagnosis, management)

c) Fertility-sparing treatment in gynaecological oncology - definition, examples

d) Clinical question – Elevated temperature and pain after gynaecological surgery by

laparotomy (diagnosis, differential diagnosis, treatment modalities)

34.

a) Caesarean section

b) Clinical question - Pain in the lower abdomen and around the pubic symphysis prior

to labour (differential diagnosis and treatment)

c) Malignant tumours of the vulva and vagina

d) Clinical question - Vaginal discharge in postmenopausal woman (diagnosis, differential

diagnosis, causes, treatment)

35.

a) Foetal hypoxia during pregnancy and labour

b) Clinical question - Non-progressive labour (diagnosis, causes, management)

c) Prebioptic examination methods of the lower genital tract

d) Clinical question - Complications of antibiotic treatment (allergic manifestations, diarrhoea, dysmicrobia) (management of the patient - diagnosis, differential diagnosis, treatment)

36.

a) Pathology of the pelvis and relation to the management of labour

b) Clinical question - Fetal heart rate abnormalities during labour (diagnosis, differential diagnosis, management)

c) Benign tumours and pseudotumours of the ovary

d) Clinical question - Constipation, vomiting, gas and stool passage disorders after gynaecological surgery (management of the patient - diagnosis, differential diagnosis, treatment)

37.

a) The most common congenital anomalies. Teratogens

b) Clinical question - Bradycardia, cyanosis and hypotonia of the newborn (Apgar score,

causes, management)

c) Uterine and vaginal wall prolapse - nomenclature, classification, causes, types of

treatment

b) Clinical question - Pain in the lower abdomen (differential diagnosis and key diagnostic

parameters)

38.

a) Invasive methods of prenatal diagnosis, indications, treatment options for foetuses in utero

b) Clinical question - Preterm uterine activity after 22nd gestational week (management of the patient - diagnosis, differential diagnosis, treatment)

c) Examination methods in urogynaecology (overview, typical indications)

d) Clinical question- Prevention of complications after gynaecological surgery (examples of preventive measures)

 
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