This document provides an outline of the contents of a course book for a gynecology course. It includes: 1. An introduction with the course coordinator and list of teachers. 2. An outline of the course contents including 33 topics that will be covered over the lectures, readings, and clinical sessions. 3. A syllabus with details on 7 sample topics that will be covered, including learning objectives and references. The document provides a comprehensive overview of the structure and key elements of the gynecology course.

1. Course Book
Contents
1- Course coordinator and list of teachers on this course.
2- Course overview
3- Course objectives.
4- Course Reading list.
5- Course Contents.
6- Syllabus.
7- Exams: Rules and instructions.
8- Samples of expected questions and their answers.
9- External examiners.
10-Student's feedback.

2. Course coordinator and list of teachers on
this course
.Name of the Course: gynecology -1
lecturer/tutor in charge: -2
Dr Hanaa alani
Department Branch and the college: Department of -3
Obstetrics and Gynecology/ College of Medicin
:Contacts -4
Address: University of Sulaimani/ College of Medicine/ -
.Department of Obstetrics and Gynecology
E-mail:HA_GRD @yahoo.com -
:Website Link -
Other participant -
:Lecturers
1-Dr. Sallama Kamel Nasir.
2-Dr. Sundus Yousif Kellow.
3-Dr. Hanaa Abbas Al-ani.
4-Dr. Mahabat Salih Saeed

3. Course Overview
The clinical and basic science of gynecology deals with female
genital organs (external and internal).
This involves the normal development, physiology and functions of
the female genital organs, as well as abnormal development.
The course deals with all diseases (including infections and
malignancies) of the female reproductive organs.It also deals with
infertility and contraception.
Course objectives
The fifth year students usually have about 30 theoretical
lectures/ year in gynaecology (2 hours / week), and they have
three weeks/ year of clinical session( 3hours/day, 5days/ week )
in suliamani maternity teaching hospital.
For theoretical lectures by the end of the year the students
should have knowledge about:
- Normal and abnormal sexual development and puberty
- The normal menstrual cycle
-Disorders of the menstrual cycle
- Fertility control( contraception).
-infertility
-Disorders of early pregnancy (abortion, ectopic pregnancy and
trophoblastic diseases).
-Infections of the female genital organs
- Benign and malignant tumours of the female genital organs
- Endometriosis and adenomyosis

4. - Urogynaecology
- Uterovaginal prolapse
- Menopause.
Regarding the clinical sessions:
The 5th year students will have 3weeks /year of clinical sessions
during which the student will learn how to take history from a
woman with gynecological problem and how to examine a
woman as well as they are going to see instruments,
contraceptive methods and x rays used in gynecology.

5. Course Reading list
REFRENSES:
Gyaenecology by Ten Teachers 18th edition.
Further reading:
1 – Essentials of Obstetrics and Genecology 4th edition.
2 – Lecture notes obstetrics and gynaecology 2nd edition.
3- Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith
Edmonds

6. Syllabus
No. Title of the Subject Lecturer's/Tutor's Name
1. Developmental &congenital Dr Hanaa Alani
malformation of female genital
tract
2 Physiology and menstruation Dr Hanaa
3 Vaginal discharle Dr Hanaa
4 Adolescence & puberty Dr Hanaa
5 PID Dr Salama
6 Tuberculosis of the lenital tract Dr Hanaa
7 Infertility & IVF Dr Hanaa
8 Sexually transmitted diseases Dr sundus
and AIDS
9 Family planning Dr mahabat
10 Abortions (miscarriages) Dr mahabat
11 Dysmenorrhea & premenstrual Dr sundus
syndrome
12 Abnormal uterine bleeding Dr Salama
13 Early pregnancy problems and Dr mahabat
ectopic pregnancy

7. 14 Trophoblastic disease Dr mahabat
15 Endometriosis Dr Salama
16 Primary Amenorrhea Dr sundus
17 Secondary amenorrhea Dr Hanaa
&polycystic ovarian syndrome

8. 18 Intersexuality Dr Hanaa
19 Genital prolapsed Dr Salama
20 Urine incontinence Dr mahabat
21 Tumours of the vulva(benign Dr Hanaa
&malignant
22 Tumours of the vagina (benign Dr Hanaa
&malignant
23 Benign tumours of the uterus Dr mahabat
24 Premalignant diseases of the Dr Hanaa
cervix
25 Malignant diseases of the Dr Hanaa
cervix
26 Carcinoma of the endometrim Dr sundus
27 Menapouse &HRT Dr mahabat
28 Postmenapousal bleeding Dr sundus
29 Operative gynecology Dr mahabat
30 Chronic pelvic pain Dr sundus
31 Ovarian tumours (benign) Dr Salama
32 Malignant ovarian tumours Dr Salama
33 Pre &postoperative evaluation Dr Hanaa

9. First Subject: Family Planning:
Lecturer/tutor’s name: Dr. mahabat Salih saeed
Learning Objectives:
1) to outline the types of contraception
2) to evaluate the methods of contraception, the advantage and
disadvantage of each method.
3) to determine the complications of contraception.
Reference:
Gynaecology by ten teachers, 18th edition, Chapter 6, fertility control
-Obstetric and Gynaecology by Lawrence Impey, Printed in 1999
Chapter 12 Contraception, page 78.
-Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith Edmonds
7th edition 2007, Chapter 32, page 299
Early pregnancy problems:
Lecturer/tutor’s name: Dr. Mahabat Salih Saeed
1. Miscarriages

10. Learning objectives:
1) To familiarise the students with the cause of early pregnancy
bleeding,
2) To learn about the risks of morbidity and mortality associated with
miscarriages
3) To learn the methods of diagnosis
References:
- Gynaecology by ten teachers, 18th edition, Chapter 8, Disorders of
early pregnancy.
-Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith
Edmonds
7th edition 2007, Chapter 12 + 13, page 94, 100
-Obstetric and Gynaecology by Lawrence Impey, Printed in 1999
Chapter 14, page 94
2) Ectopic Pregnancy
Learning objectives:
1) To learn about risks of Ectopic pregnancy
2) To understand the seriousness of the delayed management
3) To outline the methods of management
References:
-Gynaecology by ten teachers, 18th edition, Chapter 8, page 97
-Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith
Edmonds

11. 7th edition 2007,Chapter 14, page 106
-Obstetric and Gynaecology by Lawrence Impey, Printed in 1999
Chapter 14, page 97
3) Trophoblastic disease
Learning objectives:
1) To determine the types of trophoblastic disease, differentiate between
benign and malignant types.
2) To understand the types of management
References:
Gynaecology by ten teachers, 18th edition, Chapter 8, page 99
Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith
Edmonds
7th edition 2007, Chapter 15, page 117
Obstetric and Gynaecology by Lawrence Impey, Printed in 1999
Chapter 14, page 100
5) Benign tumours of the uterus
Learning objectives:
1) to understand the effect of this problem on pregnancy
2) To provide a framework for different ways of managing this
problem. 3) To learn about the types and locations of fibroids.

12. References:
Gynaecology by ten teachers, 18th edition, Chapter 9, page 103
Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith
Edmonds
7th edition 2007, Chapter 56, page 636
Obstetric and Gynaecology by Lawrence Impey
Printed in 1999
Chapter 3, page 18
6)Menopause and HRT
Learning objectives: 1) to know the definition of menopause and age of
menopause
2) to recognise the psychological and physical signs of
menopause
3) to raise awareness about the benefits and risks of
HRT
References: Gynaecology by ten teachers, by Ash Monga
18th edition
Chapter 18, page 207
Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith
Edmonds
7th edition 2007

13. Chapter 47, page 479
Obstetric and Gynaecology by Lawrence Impey
Printed in 1999
Chapter 13, page 86
7)Operative Gynaecology
Learning objectives: 1) to learn about the technique of laparoscopy and
hysteroscopy
2) to understand the risks of laparoscopy and
hysteroscopy.
3) to determine the indications for these procedures.
References: Gynaecology by ten teachers, by Ash Monga
18th edition
Appendix 1, common gynaecological procedures, page 232
Dewhurt’s textbook of Obstetric and Gynaecology, by D. Keith
Edmonds
7th edition 2007
Hysteroscopy and laparoscopy, chapter 50, page 560

14. Obstetric and Gynaecology by Lawrence Impey
Printed in 1999
Chapter 15, page 103
1-Normal and abnormal sexual development
• Genetic sex is determined by the presence of the sex chromosomes X and
Y.
• The presence of a Y chromosome determines male development; the
absence of a Y chromosome leads to a female phenotype.
• In Turner's syndrome, the absence of a second X chromosome leads to
streak ovaries.
• If the testis fails to develop or cannot function, the default state is female.
• True hermaphrodites have both ovarian and testicular tissue.The effect is
determined by the dominant cell line
• Congenital absence of the uterus and vagina is the second
most common cause of primary amenorrhoea.
• Uterine maldevelopment does not usually result in reproductive failure.
• External genitalia in girls may be virilized by excessive androgen exposure
in utero.
• Puberty is genetically determined and controlled from the hypothalamus.
References
Gynaecology by Ten Teachers,2006,18th Edition,P21
2-Gynaecological disorders of childhood and adolescence
• Gynaecological problems in the prepubertal child and at adolescence
create great levels of anxiety in parents
• The end result of puberty is the establishment of the fully
physically mature adult woman capable of reproductive
performance and fully psychologically developed as an
adult.
• Precocious puberty is defined as the onset of secondary
sexual characteristics prior to the age of 8 years. The
aetiology of this is varied.
• Delayed pubertyis rare with only 1% of females not having had
menarche by the age of 18. If there are no secondary sexual

15. characteristics by the age of 14 delay is diagnosed and investigation is
appropriae.
References
• Gynaecology by Ten Teachers,2006,18th Edition,
3-INFERTILITY
History, examination, investigations and counselling must include both
partners
• Treatment should be initiated taking into account the
duration of infertility, the female partner's age, previous
conception history and success rates.
• Men with abnormal sperm analysis should have endocrine assessment;
those with low «5 million/mL) or no sperm must be offered
chromosomal analyses.
• Couples must be given written information regarding the
risks of ovarian hyperstimulation syndrome, multiple
gestation and ovarian tumours.
• FSH and human menopausal gonadotrophin should be used
in low dose in clomiphene-resistant women ; clomiphene is
an effective treatment in anovulatory women.
• All ovulation induction cycles should be monitored
References
• Gynaecology by Ten Teachers,2006,18th Edition,P30
• Dewhurst’s textbook of obstetrics and gynaecology. / edited by D.
Keith Edmonds. –7thed. 2007
4-Genital tuberculosis
• Genitourinary TB is almost always secondary to infection
elsewhere in the body, usually pulmonary TB, but active
pulmonary disease can be documented in only one third of
patients
• Vascular dissemination is responsible for infection of fallopian
tubes in almost all patient with genitalTB, & involvement of
endometrium follows in 90%
• Most patients are cured by medical management alone , patients
who respond poorly or who have other problems( e.g tumer or

16. fistula) may require total hysterectomy & BSO after a trial of
chemotherapy.
References
Current obstetric &gynecologic diagnosis &treatment,fiftht
edition,p421-422,2003
5-Premalignant conditions of the cervix.
• Dysplasia The process of metaplasia can be disrupted by
external influences& can lead to disordered squamous
epithelium called dysplastic epithelium ( HPV ,smoking ,
immune suppression may act as coagent
• Observation and repeat Pap smears and biopsies can
confirm such spontaneous self-correction. Currently,
there is no treatment per se for CIN I, which either
resolves or progresses to CIN II, which is treated.
• If CIN does not resolve but instead progresses, or is
detected at CIN stage II or III, treatment is needed to
prevent the development of invasive disease.
• CIN lesions may be treated on an outpatient or inpatient
basis.
References
• Current obstetric &gynecologic diagnosis
&treatment,fiftht edition,p894-903,2003
• Gynaecology by Ten Teachers,2006,18th Edition
6-cervical cancer
• The cervix is made up of two kinds of cells: columnar cells and
squamous cells. Columnar cells constantly change into squamous

17. cells in an area of the cervix called the transformation zone. As a
result of this natural process of change, some cervical cells can
become abnormal. Infection can also cause abnormal cervical cell
changes. When abnormal cell changes persist over time (years) and
become severe, these cells may develop into cervical cancer
• Surgery is generally only employed in early stage cervical cancers.
• Higher stage disease is usually treated with radiation and
chemotherapy, but sometimes surgery is employed if cervical cancer
comes back after it has already been treate
References
• Current obstetric &gynecologic diagnosis
&treatment,fiftht edition,p903,2003
• Gynaecology by Ten Teachers,2006,18th Edition,
7-HYPERANDROGENISM, HIRSUTISM AND POLYCYSTIC
OVARY S
• The most common clinical presentation of hyperandrogenism in
reproductive-aged women is hirsutism or acne with or without
evidence of anovulation such as oligoamenorrhea - or amenorrhea or
dysfunctional uterine bleeding.
• PCOS is the most common cause of hirsutism and the most common
endocrinopathy in reproductive aged women.
• The etiology of anovulation in PCOS is often explained by high
intraovarian androgen levels which induce atresia and prevent the
emergence of a dominant follicle
• There are many therapies for the induction of ovulation in PCOS
patients.

18. The aim of medical therapy in hirsutism is to suppress androgen
production, block androgen receptors or decrease the
conversion of testosterone to dihydrotestosterone by inhibition
of the enzyme 5a-reductase
References
• Current obstetric &gynecologic diagnosis
&treatment,fiftht edition,p1001,2003
• Gynaecology by Ten Teachers,2006,18th Edition,
8-Secondary amenorrhea
• the cessation of menstrual flow for a period of 6 months or
more in the absence of pregnancy, breastfeeding or
menopause.
• The problem may lie in the hypothalamus and the pituitary, or
the uterus or the ovary. Other endocrine glands like the
thyroid, the pancreas and the adrenal cortex also have a role to
play in causing amenorrhoea.
References
• Current obstetric &gynecologic diagnosis
&treatment,fiftht edition,p991-1000,2003
• Gynaecology by Ten Teachers,2006,18th Edition
9-Vaginal discharge

19. • In children, vaginitis usually involves infection with GI
tract flora (nonspecific vulvovaginitis).
• Women of reproductive age: In these women, vaginitis
is usually infectious. The most common types are
bacterial vaginosis ,candidal vaginitis and trichomonal
vaginitis which is sexually transmitted.
• Postmenopausal women: Usually, a marked decrease in
estrogen causes vaginal thinning, increasing
vulnerability to infection and inflammation.
• Normal vaginal discharge is white, becoming yellowish
on contact with air, due to oxidation.
References
 Dewhurst’s textbook of obstetrics and gynaecology. / edited by D.
Keith Edmonds. –7thed ,2007
 Obstetrics and gynaecology an evidence- based text for MRCOG
 Gynaecology by Ten Teachers,2006,18th Edition,
10-DISEASES OF THE VULVA and VAGINA
•Be familiar with common inflammatory conditions affecting the vulva and
vagina. Know which are infectious and which are frequently transmitted
sexually.
• Understand the relationship between HPV, VIN, VAIN, and squamous cell
carcinoma.
• Be familiar with “Bowen’s disease” and “extramammary Paget’s disease.”
• Understand the relationship between DES, vaginal adenosis and clear cell
carcinoma of the vagina.
• Know which mesenchymal tumors (benign and malignant) can involve
the vagina.

20. References
 Dewhurst’s textbook of obstetrics and gynaecology. / edited by D.
Keith Edmonds. –7thed ,2007
 Obstetrics and gynaecology an evidence- based text for MRCOG
 Gynaecology by Ten Teachers,2006,18th Edition,
Subject name: pelvic inflammatory disease.
This subject is given in two hours.
Objectives: this lecture is included in the program so that the student
can understand the following
1. The natural defense mechanisms against genital infection.
2. The conditions that predispose to genital infection.
3. What is pelvic inflammatory disease?
4. causes of PID.
5. Pathological changes of PID.
6. Clinical presentation and diagnosis of PID.
7. Complications of PID.
8. Treatment of PID.
References
Gynecology by ten teachers 18th edition.
Current for obstetrics and gynecology.
Dweharts for obstetrics and cynecology 7th edition

21. Endometriosis:
This lecture is included so that the student will understand the following:
1. The definition of endometriosis.
2. The theories that explain the development of endometriosis.
3. The pathological features of endometriosis.
4. Clinical features and diagnosis of endometriosis.
5. The relationship between endometriosis and infertility and
endometriosis.
6. Treatment of endometriosis.
References:
Gynecology by ten teachers 18th edition.
Dwehurts obstetrics and gynecology 7th edition.
Ovarian tumours:
This subject is given in two hours.
Objectives:
This subject is included so that the student should understand:
1. The classification and different pathological types of ovarian tumours.
2. What is functional ovarian cysts and how to differentiate between
functional ovarian cysts and true ovarian tumours?
3. How to differentiate between benign and malignant ovarian tumor.

22. 4. How to diagnose ovarian tumours.
5. Risk factors of malignant disease of the ovary.
6. Staging of malignant ovarian tumours.
7. Management of ovarian tumours.
8. Prognosis and 5years survival.
References:
Genital prolapse:
Objectives:
1. Defenition of genital prolapse.
2. Classification of genital prolapse.
3. Structures that support the genital organs and prevent prolapse.
4. Factors that predispose to genital prolapse.
5. Clinical presentation of genital prolapse.
6. Treatment of genital prolapse.
Reference:
Gynecology by ten teachers 18th edition.
Dwehurts obstetrics and gynecology 7th edition.
NAME OF THE LECTURE: DYSMENORRHOEA
Objectives:
At the completion of this presentation, the participant should know:
1 – Definition and classification of dysmenorrhoea.
2 – Etiology, diagnosis and management of primary dysmenorrhoea.

23. 3 – Etiology, diagnosis and management of secondary dysmenorrhae
4 – Definition and the various hypothesis behind the etiology of
premenstrual syndrome.
5 – Diagnosis and management of premenstrual syndrome.
References:
1 –Gynaecology by ten teacher 17th edition.
2 –Current 2003 obstetric and gynaecologic diagnosis and treatment 9th
edition.
NAME OF THE LECTURE: Sexually transmitted infections (2 hours)
Objectives:
At the completion of this presentation, the participant should know:
1 – Principles of management of sexually transmitted infections (STDs).
2 – Why STDs are a significant problem, classification of STDs.
3 – Chlamydia trachomatis; prevalence, signs and symptoms, diagnosis and
treatment.
4 – Gonorrhea; incidence and epidemiology, diagnosis and treatment.
5 – Classification of genital ulcer diseases.
6 – Herpes simplex virus; epidemiology, primary and recurrent herpes
infection, diagnosis, treatment and complications.
7 – Syphilis; epidemiology, clinical features, diagnosis and treatment.
8 – Tropical Genital Ulcer Disease; Lymphogranuloma venereum (LGV) and
Chancroid. Their clinical features and treatment.
9 – Human papilloma virus; epidemiology, diagnosis and treatment.

24. 19- HIV infection; virology, diagnosis, transmission, natural history and
principles of treatment, gynecological manifestations of HIV, Vertical
transmission of HIV and how to minimize it.
References:
1 –Gynaecology by ten teacher 17th edition.
NAME OF THE LECTURE: PRIMARY AMENORRHOEA
Objectives:
At the completion of this presentation, the participant should know:
1 – Definition of primary amenorrhoea.
2 – Causes of primary amenorrhoea.
3 – Description of the various causes of primary amenorrhoea.
4 – General investigations of primary amenorrhoea .
5 – Management of the various causes of primary amenorrhoea.
References:
1 –Gynaecology by ten teacher 17th edition.
2 – Lecture notes obstetrics and gynaecology 2nd edition.
NAME OF THE LECTURE: Disorders of the menstrual cycle/ abnormal
vaginal bleeding
Objectives:
At the completion of this presentation, the participant should know:
1 – Classification of menstrual disorders.
2 – Definition of the various terms used in abnormal uterine bleeding.

25. 3 – Causes of abnormal uterine bleeding.
4 – MENORRHAGIA; definition, prevalence, classification and etiology.
5 – Diagnosis; clinical features, Initial investigations, Investigations in
women who fail to respond to treatment after 3 months.
6 –Treatment; various medical options and surgical treatment (different
types and indications).
References:
1 –Gynaecology by ten teacher 18th edition.
2 – Essential of obstetrics and gynecology 4th edition.
NAME OF THE LECTURE: Post menopausal bleeding (PMB)
Objectives:
At the completion of this presentation, the participant should know:
1 – Definition of PMB.
2 – Causes of PMB; gynecologic causes and non gynecologic causes.
3 – Management of PMB including diagnosis, investigations and treatment
options.
References:
1 –Gynaecology by ten teacher 18th edition.
2 – Essential of obstetrics and gynecology 4th edition.
NAME OF THE LECTURE: Operative gyneacology/ laparoscopy

26. Objectives:
At the completion of this presentation, the participant should know:
1 – What is pelvic endoscopy.
2 – What is laparoscopy; indications and contraindications of the
procedure.
3 – Equipment for laparoscopy.
4 – Technique of laparoscopy.
5 – Complications of the procedure.
References:
1 – Dewhursts textbook of obstetrics and gynaecology 7th edition.
2 – Lecture notes obstetrics and gynaecology 2nd edition.
NAME OF THE LECTURE: Premalignant and malignant disorders of the
uterine corpus
Objectives:
At the completion of this presentation, the participant should know:
1 – Epidemiology and incidence.
2 – Etiology and risks factors for endometrial hyperplasia and cancer.
3 – Classification; endometrial hyperplasia and malignant endometrial
cancer.
4 – Pathology, spread, and FIGO staging of endometrial cancer.
5 – Clinical presentation and diagnosis.
6 – Differential diagnosis and prognosis.
7 – Treatment of the different stages of endometrial cancer.

27. References:
1 –Gynaecology by ten teacher 18th edition.
2 – Essential of obstetrics and gynecology 4th edition.
:
Student's feedback on the subject

28. Date: Course: Year: Lecturer/ tutor:
No. Evaluation Questions Subject's Subjective Remarks
Level
1-5
1 The objectives and key messages of
the subject were clear
2 The contents of the subject were
useful and related to the main
objectives of the course
3 The materials were prepared
carefully as needed
4 The lecturer/ tutor while lecturing
tried to analyze the principles,
contents and the important points of
the subject simply and properly.
5 The lecturer/ tutor while lecturing
kept my attention.
6 The lecturer/ tutor came into the
classroom on time and was
committed to the duration of the
lecture.
7 The lecturer's behavior in the
classroom was calm and respectful.
8 The slides used in the lecture were
clear and attractive.
9 At the end of the lecture, the lecturer
gave the students a chance for
questions and comments. His/ her
answers were complete.
10 The reading sources are new and
compatible with the subject.
Total of the levels
Standards to evaluate the level of
the contents
1 2 3 4 5
Very Bad Mediu Good Very
bad m good

29. Exams
The fifth year students will have one clinical exams and one
written final exam.
The clinical exams is at the end of the course & it includes all
the gynecological cases that have been discussed in an out
patient clinic in maternity hospital ,the student is asked about
history, examination,investigation& how to manage these cases
including medical & surgical management.
For the written exam, it is only one exam at the end of the
year lasts for 3 hours and includes the following types of
questions:
1. An essays questions (there will be long and short essays):
For long essays the student will asked the following:
Discuss, write in details about, how you manage, mention the
causes, presentation and management, ect.
For such type of question the student should write in details
about the subject.
For short essays, the student will asked to enumerate, write
briefly, and Mention the causes, ect.
For such question the student should answer briefly
according to the question.
We advice the students to do the following in order to have
proper answer:

30. -To read the questions twice.
-Think carefully before answering.
-Plan the answer on a separate paper.
-The answer should contain preface, main contents and conclusion.
2.Multiple choice questions:
For such questions, there will be a statement and below it
four different answers.
For each answer the student should write true or false.
3.Single choice questions:
For such question there will be a statement, and below it
four different answers, the student should select one
answer only which is the right answer.
Samples of the expected questions and their answers
Long essay question:
A 32- year- old lady with 8 weeks amenorrhea came to outpatient
clinic with mild vaginal bleeding and she feels no more pregnant and
ultrasound result showed no fetal heart. What is your management plan:

31. To answer such question, the student should analyze its
component:
1. Woman with 8weeks amenorrhea and she feel no more
pregnant, this means that she is pregnant 8weeks.
2. Clinically she feels disappearance of symptoms of
pregnancy and her ultrasound showed no fetal heart
sound so the pregnancy is not viable, so the diagnosis is
missed abortion.
3.Treatment of such woman will be treatment of missed
abortion at 1st trimester and the student should write about
treatment in details.
Short essays questions:
1. What are the complications of fibroid on pregnancy?
2. Enumerate the types of urinary incontinence.
To answer such questions is only by mentioning the
complications and enumerating the types.
Multiple choice questions
In the presence of a positive pregnancy test and vaginal bleeding, the
following are possible differential diagnoses if the CERVIX is closed:
(T ) a – Ectopic pregnancy.

32. (F ) b – Incomplete miscarriage.
( T) c – Threatened miscarriage.
( F) d – Inevitable miscarriage.
(T ) e – Complete miscarriage.
– Regarding the pathophysiology of pelvic organ prolapsed:
( F) a – Pelvic organ prolapse is commoner in nulliparous than in
multiparous women.
( F) b – Pelvic organ prolapsed is never seen in nulliparous women.
(T) c –Prolapse is commoner after the menopause partly due to oestrogen
deficiency
( F) d – Epidural in labour is a risk factor for subsequent development of
prolapse.
( T) e – Forceps delivery is a risk factor for the development of prolapse.
The main tissues which provide support to the uterus include:
(T)a- uterosacral ligaments
(F)b-perineal body
(F)c- round ligament
(T) d-cardinal ligaments
(F) e-broad ligaments
Single choice questions:
Select the ONE lettered answer or completion that is BEST in each
statement below.

33. 1–The most common symptom of endometrial hyperplasia is:
a –Vaginal discharge.
T (b) –Vaginal bleeding.
c –Amenorrhoea.
d –Pelvic pain.
e –Abdominal distensions.
2 –Hirsutisim is associated with all the following EXCEPT:
a – Polycystic ovary syndrome.
b – Congenital adrenal hyperplasia.
c – Cushing syndrome.
d – Increased androgen utilization by skin.
(T) e – Hyperprolactinemia.
For each description below, choose the SINGLE most
appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 –Gynaecological investigation:
a –colostomy.
b –laparoscopy.
c –hysteroscopy.
d –hysterosalpingography.
e –ultrasound.

34. F –more than one of the above.
G – None of the above.
D 1- A procedure that assesses both the uterine cavity and tubal lumen.
B 2- A procedure that visualizes pelvic endometriosis.
C 3- A procedure that visualizes the endometrial cavity.
F 4-A procedure that assesses the tubal patency.

35. External Examiner
From now on every course should have its own external examiner
with identified roles.
The one who can play the role of an external examiner should:
• Have an academic post with the scientific rank of assistant
Professor and higher.
• He/she should be an active, reputable and experienced
academic staff in his field or a related field to the course.
• He/she should have not participated in lecturing or
administering of the course.
The roles of the external examiner are:
• Evaluating the contents and the program of the course.
• Prior to the exam, he/she should contribute to choosing the
questions and looking at the ideal answers.
• Evaluating the process of the examinations: he/she should see
all the marked exam papers, then choose randomly nine
marked papers: three with high marks, three with medium
and three with low marks.
• Evaluating the students' feedbacks
• He/she should participate in the final meeting of the first
round examinations committee and give his assessment on
the entire course and the examination process, then to give
his opinion about the final results.
• He/she should participate in the final meeting of the second
round examinations committee and should have a main vote
on those problems that may face them.

36. • Then the lecturer/ tutor in charge will respond to the external
examiner's questions and will reply officially to all the
questions and clarify the reasons.

37. Student's Feedback on the Course
Date: Course: Year: Lecturer/ tutor:
Evaluation Questions Subject's Subjective Remarks
Level
1-5
1 The objectives and key messages of the
subject were clear
2 The contents of the subject were useful and
were related to the main objectives of the
course
3 The coordinator teacher had worked hard to
prepare the materials
4 The coordinator teacher had worked hard to
cooperate and prepare the course
5 The lecturers were carefully selected and were
expert in their fields
6 The coordinator teacher gave a good attention
to the students' criticisms and claims
7 Information on the Examination process was
well provided
8 The questions of the exams were related to the
contents of the course.
9 Total of the levels
10 There is a potential to
promote and develop the
course in the following
areas:
Standards to evaluate the level of the
contents
1 2 3 4 5
Very Bad Medium Good Very
bad good