■ part 5 :-

● endometriosis :
♤ keywords : hx of dysmenorrhea & dyspareunia & cx excitation & lower abd pain
* US: kissing cyst , echo ( ground glass apperance)
ttt : surgical by ablation or laparascopy

● rupture of ovarian cyst :
♤ keywords : *hx of ovarian cyst  & POP use + no bleeding or discharge  + sudden onset abd pain in left iliac fossa
* tenderness in lt iliac fosaa & suprapubic
* Abd us : free fluid in douglas pouch
♤ ttt : supportive with analgesia + change of pop to a different contraceptive

● dermoid cyst in ovary complicated by torsion :
♤ sudden onset of lower abd pain & in lt iliac fossa
♤ pain is intermittent  & increase by excerise & gradually become more frequent & worse
♤ palpable mass in lt iliac fossa
♤ TVS : ovarian cyst with mixed echogenisty  with acoustic shadow
♤ x-ray : teeth in lt iliac fossa
♤ ttt : *ovarian cystectomy
*Asymptomatic cysts : expectant ( wait & watch )  

■ مساء الخير يا شباب درس intraoperative emergency في النساا ركزوا عليه و خاصة steps بنعمل ايه غالبا هيكرر منها ف اوسبي العملي

■ notes on orthopedic :

♤ Ant drawer test is used to assess integrity ACL & while post drawer test to assess integrity of PCL

♧ valgus stress test is used to assess intergity of MCL , while varus stress test to assess integrity of LCL

♡ McMarry test is used to assess integrity of meniscus ligament

■Part 6 :

● degeneration of fibroid :

♤ keywords :
* progressive  worsening abdominal pain  in left lower abdomen & pain is sharp & constant
*  ut size larger than dates
* localized uterine tenderness
* closed cx with no blood
* fetal parts not palpated
* US show encapsulated mass in uterus

♤ ttt : expectant management with analgesia & bedrest
♤ خلي بالك لو كان pelvic fibroid هتيجي ب malpresentation & obstructed labor