Master Specialist Obstetrics & Gynecology (OBG5891)
for DHA Speciality
Access 247+ high-yield questions tailored for the 2026 syllabus. Includes AI-powered explanations and performance tracking.
Core Concepts
Specialist Obstetrics & Gynecology encompasses the comprehensive care of women across their lifespan, focusing on reproductive health, pregnancy, childbirth, and disorders of the female reproductive system. It integrates understanding of complex physiology (menstrual cycle, pregnancy adaptations, menopause), common benign conditions (fibroids, endometriosis, PCOS), malignant diseases (cervical, endometrial, ovarian cancers), infertility, and pelvic floor dysfunction. Core principles include evidence-based practice, patient safety, ethical considerations in reproductive choices, and a multidisciplinary approach to complex cases.
Clinical Presentation
- Obstetrics: Nausea/vomiting (hyperemesis gravidarum), abdominal pain (ectopic, abruption, preterm labor), vaginal bleeding (threatened miscarriage, placenta previa/abruption, PPH), decreased fetal movement, hypertension/edema (pre-eclampsia), contractions, preterm rupture of membranes.
- Gynecology: Abnormal Uterine Bleeding (AUB - heavy, irregular, post-menopausal), pelvic pain (acute/chronic, dysmenorrhea, dyspareunia, endometriosis, PID), pelvic mass (ovarian cyst, fibroid, malignancy), infertility, abnormal vaginal discharge/itch (infections, atrophy), urinary incontinence, pelvic organ prolapse symptoms, menopausal symptoms (hot flashes, vaginal atrophy), abnormal cervical screening results.
Diagnosis (Gold Standard)
Diagnosis often relies on a combination of history, physical examination, imaging, and laboratory tests. Key gold standards include: high-resolution ultrasound (obstetric dating, anomaly scan, fetal growth, ectopic pregnancy, ovarian/uterine pathology), colposcopy with directed biopsy for abnormal cervical cytology, endometrial biopsy for abnormal uterine bleeding, hysteroscopy for intrauterine pathology, laparoscopy for endometriosis or ectopic pregnancy, genetic testing (NIPT, CVS, amniocentesis), specific hormonal assays for infertility/PCOS, and histopathological confirmation for malignancies.
Management (First Line)
- Obstetrics: Comprehensive antenatal care (risk assessment, screening), labor induction/augmentation, operative vaginal delivery (forceps/ventouse), Caesarean section for indications, management of pre-eclampsia (anti-hypertensives, magnesium sulfate, timely delivery), medical/surgical management of postpartum hemorrhage (uterotonics, uterine massage, B-Lynch suture, embolization), corticosteroids for fetal lung maturity in preterm labor, tocolytics for threatened preterm labor, GDM management (diet, insulin).
- Gynecology: Hormonal contraception (OCPs, IUDs), GnRH agonists for endometriosis/fibroids, medical abortion, surgical management of fibroids (myomectomy, hysterectomy), ovarian cysts (cystectomy), ectopic pregnancy (salpingectomy), endometrial polyps (hysteroscopic polypectomy). Management of cervical dysplasia (LEEP/cold knife conization), HRT for menopausal symptoms, first-line fertility treatments (clomiphene citrate, ovulation induction), pessaries/pelvic floor physiotherapy for prolapse/incontinence, and multidisciplinary treatment protocols for gynecological malignancies (surgery, chemotherapy, radiation).
Exam Red Flags
- Acute Abdomen in Pregnancy: Always consider ectopic pregnancy (especially with pain, bleeding, positive HCG), placental abruption, ovarian torsion, appendicitis.
- Post-menopausal Bleeding: Always assume endometrial cancer until proven otherwise; requires prompt investigation (TVUS, endometrial biopsy).
- Severe Pre-eclampsia/Eclampsia/HELLP Syndrome: Requires urgent medical stabilization and timely delivery to prevent maternal/fetal mortality.
- Postpartum Hemorrhage: Rapid recognition and management (uterotonics, bimanual massage, surgical intervention) are critical; remember the 4 T's: Tone (atony), Trauma, Tissue (retained placenta), Thrombin (coagulopathy).
- Abnormal Fetal Heart Rate Tracing: Suggests fetal distress; requires immediate evaluation and potential urgent delivery.
- Cord Prolapse: OBSTETRIC EMERGENCY requiring immediate intervention (elevate presenting part, emergent C-section).
- Shoulder Dystocia: Maneuvers (McRoberts, suprapubic pressure, internal rotation) must be applied promptly to prevent brachial plexus injury or fetal asphyxia.
- Ethical Dilemmas: Questions on informed consent, patient autonomy, reproductive choices, and confidentiality are common.
Sample Practice Questions
A 34-year-old woman (G2P1) at 36 weeks' gestation presents with a 3-day history of right calf pain and swelling. She has no chest pain or dyspnea. Her BMI is 38 kg/m?. Vital signs: HR 92/min, BP 118/74 mmHg, SpO2 98% on room air. Compression ultrasound confirms an acute proximal deep vein thrombosis in the right popliteal vein. She has no renal impairment (creatinine 62 umol/L) and no history of heparin-induced thrombocytopenia. Which is the most appropriate anticoagulation regimen?
A 28-year-old woman (G1P0) at 10 weeks' gestation presents with a 2-week history of palpitations and heat intolerance. She has no eye signs. Vital signs: HR 118/min, BP 132/68 mmHg, temperature 37.1?C. TSH is
A 42-year-old woman (G3P2) at 33 weeks' gestation presents with a 1-day history of severe right upper quadrant pain, nausea, and vomiting. She has no fever. Vital signs: BP 158/98 mmHg, HR 96/min, temperature 36.8?C. Laboratory results: platelets 88 x 109/L, AST 210 U/L, ALT 185 U/L, creatinine 110 umol/L, uric acid 480 umol/L. Urine protein is 3+ on dipstick. Which is the most appropriate immediate management?
A 31-year-old woman (G2P1) at 38 weeks' gestation presents in active labor. She reports a history of penicillin anaphylaxis. She is group B Streptococcus (GBS) positive on rectovaginal swab at 36 weeks. Vital signs: BP 118/72 mmHg, HR 88/min, temperature 37.0?C. Membranes ruptured 2 hours ago. Which is the most appropriate intrapartum antibiotic prophylaxis?
A 26-year-old woman (G1P0) at 12 weeks' gestation presents with a 1-week history of vaginal itching and a thick, white, curd-like discharge. She has no fever or abdominal pain. Vital signs: BP 110/70 mmHg, HR 76/min, temperature 36.9?C. Wet mount shows budding yeast and pseudohyphae. She has no history of diabetes or immunosuppression. Which is the most appropriate treatment?
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Specialist Obstetrics & Gynecology (OBG5891) Questions for DHA Speciality — FAQ
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