Obstetrics & Gynecology – MCCQE1 High-Yield Notes

OB/GYN is a high-yield MCCQE1 specialty. Questions focus on obstetric emergencies, prenatal screening, labour management, and common gynecological conditions in Canada.

🔑 Key Topics for MCCQE1

Prenatal care: booking visit, routine screening, dating ultrasound
Ectopic pregnancy: amenorrhea + pain + vaginal bleeding, β-hCG, transvaginal US
Preeclampsia: BP ≥140/90 + proteinuria after 20 weeks, magnesium sulfate, delivery
Eclampsia: seizures in preeclampsia → IV magnesium, stabilize, deliver
Placenta previa: painless vaginal bleeding, DO NOT do digital exam, C-section
Placental abruption: painful bleeding, rigid uterus, fetal distress
Preterm labour: <37 weeks, tocolytics, corticosteroids for fetal lung maturity
Postpartum hemorrhage: 4 Ts (Tone, Trauma, Tissue, Thrombin), oxytocin first
GBS prophylaxis: swab at 35-37 weeks, penicillin G in labour if positive
Gestational diabetes: OGTT at 24-28 weeks, diet first, then insulin
Cervical cancer screening: Pap smear every 3 years age 25-69 in Canada
Endometriosis: dysmenorrhea + dyspareunia + infertility, laparoscopy gold standard
PCOS: oligomenorrhea + hyperandrogenism + polycystic ovaries, metformin + OCP
Menopause: FSH >40, vasomotor symptoms, HRT indications and contraindications
Ovarian torsion: sudden onset pelvic pain, Doppler US, surgical emergency

⚠️ High-Yield Clinical Pearls

Ectopic pregnancy: If ruptured → immediate surgery; if stable + small → methotrexate
Preeclampsia: Magnesium sulfate is for seizure prophylaxis, NOT to lower BP
Placenta previa: NEVER do digital vaginal exam – risk of catastrophic hemorrhage
PPH Tone: Uterine atony = most common cause → bimanual massage + oxytocin
GDM: Fasting glucose ≥5.1 or 1h ≥10.0 or 2h ≥8.5 on OGTT = diagnosis
Ovarian torsion: Surgical emergency – detorse and assess viability within hours

📊 Quick Reference Table

Condition	Key Feature	Management
Ectopic pregnancy	β-hCG + empty uterus on US	MTX or surgery
Preeclampsia	BP >140/90 + proteinuria	MgSO4 + delivery
Placenta previa	Painless bleeding	C-section, no digital exam
Abruption	Painful bleeding + rigid uterus	Emergency delivery
PPH	Atony (most common)	Oxytocin IV + uterine massage

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