NBE CME programme for DNB consultants - National Board Of ...

NBE CME programme for DNB consultantsHemoptysis; Wight loss; H/o smoking & alcohol consumtionClinical examination-General-Comfortable/in stridor,Cachexia/pallor; Throat-Dental/oralhygiene,IDL-mass description, cord mobility,. Airway adequacy, pooling os saliva; Neck-Lymphadenopathy-level, Laryngeal contour, Laryngeal crepitus, Laryngeal tenderness, Thyroidgland, Trachea; Abdomen; Respiratory system; Spine; Provisional diagnosis-TNM stagingInvestigations-DL scopy & biopsy; X-ray soft tissue neck-AP & lateral; X-ray chest; Barium swallow;CT scan neck; Blood investigations; USG abdomen; Whole body bone scanDifferential Diagnosis-Squamous cell ca; Adeno ca; Lymphoma; Basaloid sq. cell ca; Adeno sq.cell ca; Lipa sarcoma; Lympho epitheliomaNon surgical management -Palliative/Curative radiotherapy; Cobalt-60/linear accelerator; Irradiationfield perimeters; Dose 60Gy-70Gy; Duration 6-7 weeks; Complications of radiotherapy; Preparationof patient for RT; Role of chemotherapySurgical management -Lateral pharyngotomy; Total pharyngolaryngectomy; TotalPharyngolaryngoesophagectomy with gastric pull up(ONG’s procedure)OBGLong casesPrimary amenorrhea- Student should know the following in a case of primary amenorrhea - Normalpuberty changes, Definition of primary and secondary amenorrhea, Various underlying causes ofprimary amenorrhea - Presence of secondary sexual characters, Absence of secondary sexualcharacters; History; Examination - General weight, height, BP; Presence and extent of Secondarysexual characteristics; Perineal examination – Introitus, Hymen, Anal opening; Investigations -General – Haemogram, Hormonal profile (Thyroid, prolactin, LH,FSH, if indicated), Ultrasound –Pelvic organs, Kidney & Ureter; Management - Surgery for imperforate hymen, If lower tract normal- 1 st withdrawal with progestecone, 2 nd withdrawal with estrogen- progesterone; PsychosocialsupportVaginal discharge- The student should know the following in a case of vaginal discharge - Anatomyand physiology of vagina -Changes from puberty to reproductive age and to old age, pH of vagina,lactobacillus; Various causes of abnormal vaginal discharge and classical s/s of each; Historyincluding - Drug intake, Medical history, Recurrences, Sexual history / contraceptive use; Examination- Perspeculum examination, Bimanual pelvic examination; Investigations and diagnosis - Clinicaldiagnosis, KOH mount, gram stain microscopy, Pap’s smear; Treatment - a. Medical treatment -Metronidazole, - Fluconazole, b. Vaginal pessaries – clotrimazole for candida, c. Cryosurgery forcervical erosion; For discussion should know cervical erosion, PIDInfertility- The student should know the following in a case of infertility - Definition of primary /secondary infertility; Various causes of infertility – Male factors/ Female factors; Normal semenperameters; Normal menstrual cycle, tests for ovulation; Tests for tubal patency –Hysterosalpingography, Sono salpingo infusion, Laproscopic evaluation; History ( coital, menstrual,medical or surgical history etc.); Examination (Breasts for galactorrhea, pelvic infections etc.);Investigations for finding cause and evaluating treatment - Husband semen analysis, USG (uterus,follicle monitoring , PCOS), Role of hormonal evaluation e.g. LH,FSH, TSH, prolacting levels, Day22 progesterone, Role of post coital test, Hysterosalpingography, Role hystero laparoscopy;Counselling for - Rubella Screen and vaccination, Hepatitis B virus & vaccination, Diet and weightcontrol in obese, Smoking check, Psychological support, Folic and supplementation; Treatment -Drugs for ovulation induction – Clomiphene, letrozole, Gonotrophines, What is IUI and procedure ofIVF, Other drugs- Metformin, d. When to do IVF/ICSI- indications, risks, successPost menopausal bleeding- The student should know the following in a case of postmenopausalbleeding - What is menopause, physiological changes of menopause, definition of postmenopausalbleeding; Various causes of postmenopausal bleeding; History in detail – Drug intake – HRT,Medical history – DM, Hypertension, Family History – of cancer; Examination – General - P, BP,71