Daily Targets

• Read/Revise ~8 hours across topics (blocks of 60–75 min + 10–15 min breaks).
• Solve 180–220 MCQs/day (25–30 per block, timed) with an error log.
• Make 5–7 mini‑cards/day (algorithms, staging one‑liners, diagnostic cut‑offs, DOCs, postpartum bundles).
• End each day with a 15‑minute Rapid Recap (staging, “first step” in emergencies, contraindications lists).

Day 1 — Obstetrics I: Foundations, ANC & Normal Labour (Deep Dive)

Anatomy & physiology

• Pelvis types, obstetric conjugate vs diagonal conjugate; pelvic planes; station & engagement.
• Fetal skull: sutures/fontanelles; diameter set (suboccipitobregmatic, occipitofrontal, mentovertical); caput vs molding.
• Maternal adaptations: plasma volume↑ (physiol anemia), CO↑, SVR↓, GFR↑; respiratory alkalosis tendency; insulin resistance in 2nd–3rd trimesters.

Antenatal care (ANC)

• EDD (Naegele); dating scan window (CRL best in 1st tri); NT 11–13+6 wk; anomaly scan 18–22 wk; growth scans by risk.
• Booking labs: blood group/Rh + antibody screen, CBC (anemia cut‑ins), RBS/OGTT concept, TSH (selective), urine routine/culture, HIV/HBsAg/HCV/syphilis; rubella IgG status awareness.
• Supplements: iron–folate (dose logic), calcium; deworming concept; TT/Td schedule (platform‑specific awareness).
• Risk stratification & danger signs (bleeding, severe headache/visual, ↓FM, leaking, fever).

Fetal surveillance

• SFH + symphysio‑fundal growth; kick count concept; NST categories (baseline/variability/accels/decels); BPP (5 components); UA/MCA Doppler general cues (↑UA PI = placental resistance; ↓MCA PI = brain‑sparing).

Labour & delivery

• True vs false labour; Bishop score components; induction methods (PGE analogues, mechanical, oxytocin) — contraindication cues.
• Partograph: alert/action lines; protraction vs arrest disorders; augmentation steps.
• Mechanisms: vertex LOA; instrumental delivery indications (vacuum vs forceps outline).
• Active management of 3rd stage (AMTSL): oxytocin, controlled cord traction, uterine massage.

Day‑1 MCQs focus

• Pelvic diameters; fetal skull diameters; dating/NT/anomaly windows; ANC bundle; Bishop score; partograph; AMTSL.

Day 2 — Obstetrics II: HDP, GDM & Medical Disorders (Deeper)

Hypertensive disorders of pregnancy (HDP)

• Definitions: gestational HTN; preeclampsia (with/without severe features); eclampsia; HELLP basics.
• Severe features list (memorize mini‑card): very high BP, CNS/visual symptoms, RUQ pain/↑LFTs, thrombocytopenia, pulmonary edema, renal dysfunction.
• Investigations: baseline labs (CBC/platelets, LFT, RFT, urine protein), fetal growth & Doppler as indicated.
• Management ladder: antihypertensives (labetalol/nifedipine/hydralazine — concepts), MgSO₄ for seizure prophylaxis/Tx (Pritchard/ Zuspan regimens, toxicity monitoring, antidote calcium gluconate); timing/mode of delivery principles.

Diabetes in pregnancy

• GDM vs pre‑gestational; common screening approach (75‑g OGTT concept); glycemic targets; fetal macrosomia & hypoglycemia risk.
• Treatment: MNT + insulin cornerstone; metformin awareness; intrapartum insulin–glucose protocol idea; postpartum re‑screening.

Other medical disorders (snapshots)

• Thyroid (↑dose requirement in hypothyroid; hyperthyroid antithyroid choice per trimester idea).
• Cardiac: NYHA class; anticoagulation in mechanical valves (concept); endocarditis prophylaxis not routine.
• Epilepsy: safer options awareness; avoid valproate when possible; folate.
• Asthma: ICS/LABA safe; avoid prostaglandin F‑analogues in severe asthma.
• Anemia thresholds; iron therapy strategies; transfusion concept for severe anemia.

Fetal growth & fluid

• FGR: early vs late; UA/MCA Doppler directionality; delivery timing concepts.
• Poly‑/oligohydramnios: basic etiologies & monitoring.

Day‑2 MCQs focus

• Severe features & lab set; MgSO₄ regimen + antidote; OGTT window; FGR vs constitutionally small; antihypertensive picks; thyroid dose change.

Day 3 — Obstetrics III: Preterm/PPROM, APH, Emergencies & Puerperium (Expanded)

Preterm labour & PPROM

• Risk factors; diagnosis; fetal fibronectin/ cervical length (concept); tocolytics (nifedipine/ atosiban/ indomethacin — GA considerations); antenatal steroids window; MgSO₄ for neuroprotection (<~32–34 wk idea); PPROM latency antibiotics concept; cerclage snapshot.

Antepartum haemorrhage (APH)

• Placenta previa vs abruption: presentation, diagnosis (TVS safe for previa), first steps; no PV exam in suspected previa.
• Placenta accreta spectrum (previa + scar) — red flags; delivery planning concept.

Intrapartum emergencies

• PPH: primary vs secondary; 4 Ts; stepwise: uterine massage → oxytocin → ergometrine (avoid in HTN) → prostaglandin analogue → tranexamic acid → uterine tamponade → compression sutures (B‑Lynch) → devascularization → hysterectomy.
• Shoulder dystocia: call for help; McRoberts + suprapubic pressure → internal rotational maneuvers; avoid fundal pressure.
• Uterine rupture: risk factors (previous scar, augmentation), recognition, immediate laparotomy.
• Amniotic fluid embolism (awareness); sepsis bundle.

Intrapartum monitoring

• CTG categories (baseline, variability, accelerations, decelerations); fetal scalp stimulation/ pH idea (awareness).

Puerperium

• Normal changes; lactation (contraindications red flags); DVT prophylaxis in high risk; baby blues vs PPD pointers.

Day‑3 MCQs focus

• PPROM vs PROM; tocolysis + steroid + MgSO₄ windows; previa vs abruption; PPH algorithm; shoulder dystocia sequence; accreta flags; CTG basics.

Day 4 — Gynecology I: AUB, Benign Disorders, STIs & Contraception (More Detail)

AUB

• Physiology recap; PALM‑COEIN map; evaluation: pregnancy test, CBC, TSH, prolactin/selective, USG; when to biopsy.
• Acute AUB first steps: high‑dose COCs or progestins, tranexamic acid; stabilize; IV estrogen concept.
• Chronic AUB: LNG‑IUS, COCs, tranexamic/NSAIDs; surgical (ablation/myomectomy/hysterectomy) per cause.

Benign gyne disorders

• Fibroids: FIGO leiomyoma classification idea; bulk vs bleeding symptoms; fertility/obstetric implications; medical vs surgical ladder.
• Endometriosis: triad (dysmenorrhea, dyspareunia, infertility); imaging clues (endometrioma); medical (COCs/progestins/GnRH) vs laparoscopy.
• Adenomyosis: globular uterus; MRI/US features; heavy dysmenorrhea; LNG‑IUS.
• Ovarian cysts: functional vs neoplastic; torsion red flags; adnexal mass approach (US features, tumor markers concept, IOTA simple rules idea).
• Prolapse: support defects; Kegel/pessary vs surgery.

Infections & STIs

• BV vs candidiasis vs trichomoniasis patterns; PID criteria; outpatient vs inpatient regimens (concept); cervicitis.

Contraception

• Barrier, COCs/POPs, DMPA, implants, IUDs (Cu vs LNG); contraindications (MEC) cues.
• Emergency contraception windows (levonorgestrel/UPA/Cu‑IUD concept); sterilization (interval vs postpartum) pointers.

Day‑4 MCQs focus

• PALM‑COEIN; acute AUB drugs; fibroid type→symptom; endometriosis vs adenomyosis; PID outpatient set; MEC matching; EC windows.

Day 5 — Gynecology II: Infertility, ART, Ectopic, RPL & Uro‑Gyn (Deeper)

Infertility work‑up

• Timeline definitions; semen analysis core parameters (volume, count, motility, morphology — memory anchors); infections/varicocele quick cues.
• Ovulation documentation: mid‑luteal progesterone idea; follicular tracking US; LH kits.
• Tubal patency: HSG window; SSG/HyCoSy concept.
• Ovarian reserve: AMH & AFC concept; age impact.
• PCOS (Rotterdam): phenotypes; metabolic screen; letrozole first‑line OI concept.

ART & OHSS

• IUI/IVF/ICSI snapshots; luteal support idea; OHSS recognition.

Ectopic pregnancy

• Risk factors; β‑hCG discriminatory zone (TVUS); US signs (adnexal mass, free fluid); methotrexate criteria vs surgery; follow‑up β‑hCG logic.

Recurrent pregnancy loss (RPL)

• Buckets: genetic, uterine (septum/adhesions), endocrine (thyroid/DM/PCOS), APS; basic work‑up; management concept.

Uro‑gyne snapshot

• SUI vs UUI; evaluation; pelvic floor therapy; mid‑urethral sling awareness.

Day‑5 MCQs focus

• WHO semen ideas; OI in PCOS (letrozole); HSG timing; ectopic β‑hCG/US thresholds; MTX contraindications; RPL buckets; OHSS.

Day 6 — Gyn Oncology, GTN, Breast & Imaging/Advances (Expanded)

Cervical precancer/cancer

• Screening: Pap/HPV test overview; colposcopy triggers; transformation zone concept; Bethesda snapshots (ASC‑US/LSIL/HSIL) awareness.
• FIGO staging (concept level) & general management pathways; fertility‑sparing options idea.
• HPV vaccination (concept only), screening intervals idea.

Endometrial & ovarian cancers

• Risk factors: unopposed estrogen (endometrial), nulliparity/BRCA (ovarian); hallmark presentations (PMB; adnexal mass + ascites).
• Tumor markers (CA‑125 context); staging & principles of treatment (surgery + adjuvant where indicated).

Vulvar/vaginal neoplasia

• VIN basics; invasive disease pointers.

Gestational trophoblastic disease (GTD/GTN)

• Complete vs partial mole: karyotype pattern awareness; snow‑storm US; β‑hCG follow‑up; WHO risk score concept; low‑risk single‑agent vs high‑risk multi‑agent idea.

Breast (exam snapshot)

• Benign: fibroadenoma vs fibrocystic; mastitis/abscess; galactocele.
• Malignant: red flags; triple assessment; BI‑RADS idea; sentinel node concept.

Imaging & advances

• USG/Doppler in Ob/Gyn; MRI pelvis indications; minimally invasive/robotic; fertility‑sparing and ERAS outlines.

Day‑6 MCQs focus

• Bethesda cues; FIGO concepts; CA‑125 context; mole differences & β‑hCG follow‑up; BI‑RADS basics; sentinel node.

Heat‑Map: High‑Yield Focus

• Very High: HDP (preeclampsia/eclampsia, MgSO₄), GDM, PPH algorithm, previa vs abruption, PPROM/preterm bundle, PALM‑COEIN, endometriosis, ectopic, cervical screening/HSIL, GTD.
• High: FGR & Dopplers, labour mechanisms/partograph/ AMTSL, fibroids, contraception & MEC, infertility/PCOS, ovarian cancer basics, RPL.
• Moderate: Prolapse, PID/STIs, adenomyosis, benign breast disease, uro‑gyn, recent advances.

Practice Pattern (all 6 days)

• Timed MCQ blocks → immediate key‑learning note per error.
• Vignette flow: identify stage/risk → choose first step → pick best investigation → state delivery/definitive plan.
• Mini‑cards set: HDP severe features & MgSO₄; OGTT targets; APH diff; PPH ladder; preterm/PPROM bundle; PALM‑COEIN map; ectopic criteria; cervical screening cues; GTN hCG follow‑up; MEC ranks; CTG categories.

3‑Day Revision Plan (Post‑Study)

Day R1 — High‑Yield Obstetrics Blitz (8 h; 150 MCQs)

• HDP severe features & MgSO₄; GDM screening/targets; APH (previa vs abruption) & accreta flags; PPROM/preterm bundle; labour mechanisms/partograph; PPH step‑ladder + TXA cue; CTG categories.

Day R2 — High‑Yield Gynecology Blitz (8 h; 150 MCQs)

• PALM‑COEIN algorithms; endometriosis/adenomyosis; fibroids (symptom→management); contraception/MEC & EC; ectopic criteria & methotrexate; infertility/PCOS; cervical screening Bethesda snapshots; GTN β‑hCG follow‑up logic.

Day R3 — Integrated Cases + Full Mock (8 h; 1 FLT)

• 3–4 integrated vignettes (e.g., severe preeclampsia @ 35 w, PPROM @ 31 w, HSIL on Pap, adnexal mass with ↑CA‑125); finalize weak‑topic mini‑cards; sit a full‑length Ob/Gyn mock under exam timing.

Rapid‑Revision (carry‑along list)

• HDP: definitions, severe features, MgSO₄ regimen & toxicity antidote.
• GDM: screening window & targets; intrapartum/postpartum insulin logic.
• PPH: stepwise ladder; uterotonics & TXA; balloon→B‑Lynch→devascularization→hysterectomy.
• APH: previa vs abruption differentiators; first steps; no PV exam in suspected previa.
• Preterm/PPROM: steroids, MgSO₄ neuroprotection, antibiotics concept.
• Labour: Bishop, partograph, LOA mechanism; induction basics.
• PALM‑COEIN: quick map; acute AUB algorithm.
• Endometriosis: triad; medical vs lap.
• Ectopic: discriminatory zone & US signs; MTX criteria.
• Cervical screening: Pap/HPV basics; colposcopy triggers.
• GTD: complete vs partial; β‑hCG follow‑up; WHO score idea.
• Contraception: MEC highlights; EC windows.

MCQ Gold‑Nuggets (must‑remember one‑liners)

• Severe preeclampsia + neuro/visual → MgSO₄ now; plan timely delivery.
• MgSO₄ toxicity → stop infusion + calcium gluconate.
• PPROM @ ~30–34 w → steroids + latency antibiotics (concept) ± MgSO₄; expectant vs deliver per status.
• PPH uterotonic order → oxytocin → ergometrine (avoid in HTN) → PG analogue (caution asthma) → balloon.
• Suspected placenta previa → no digital exam; image/plan.
• Methotrexate for ectopic → hemodynamically stable, low β‑hCG, no rupture, reliable follow‑up.
• PALM‑COEIN memory aid; HSIL → colposcopy pathway (concept).