B. Pelvic Pain

Question 1

Intermittent pelvic pain points towards?

Answer 1

Obstruction

Question 2

Constant pelvic pain points towards?

Answer 2

Perotinits/inflam

Question 3

Pelvic pain with nausea/vomiting is _________?

Answer 3

Bowel obstruction

Question 4

Pelvic pain with vaginal bleeding is _________?

Answer 4

Ectopic pregnancy

Question 5

Causes of acute pelvic pain?

Answer 5

Appendicitis (RLQ)
Inflammatory bowel disease (Chrons & ulcerative colitis)
Diverticulitis (which can rupture & lead to peritonitis, tend to be older & LLQ)
Cystitis or pylonephritis 
Renal/ureteral stone 
PID
Ectopic Pregnancy
Adnexal Torsion
Ruptured Ovarian Cyst

Question 6

What causes a patient to never be able to get comfortable due to pelvic pain?

Answer 6

Stone

Question 7

Pelvic Pain with fever is _________?

Answer 7

Infection

Question 8

Pelvic pain with hypotension is _________?

Answer 8

Bleeding –> ruptured cyst or ectopic

Question 9

Pelvic pain with absent bowel sounds is ________?

Answer 9

Ileus

Question 10

Pelvic Pain with racing bowel sounds (rushes) is ______?

Answer 10

Bowel obstruction

Question 11

Pelvic pain with flank tenderness is _________?

Answer 11

Pyelonephritis

Question 12

Pelvic pain with distended abdomen is ___________?

Answer 12

Mass, intraperotineal bleeding or ileus

Question 13

Pelvic pain where the patient lies with legs drawn up is ____________?

Answer 13

Peritonitis

Question 14

Pelvic pain with rebound tenderness is ___________?

Answer 14

Peritonitis

Question 15

Pelvic pain with + cough test, heel percussion test, Psoas sign or obturator sign is ___________?

Answer 15

Peritonitis

Question 16

Pelvic pain with mucopurulent discharge is ____________?

Answer 16

Infection (Gonorrhea or chlamydia)

Question 17

Pelvic pain with uterine or adnexal tenderness is ____________?

Answer 17

PID

Question 18

Diagnostic test for appendicitis?

[On test]

Answer 18

CT

WBC can also be helpful as is elevated & has left shift

Question 19

Treatment for appendicitis?

Answer 19

Surgery

Question 20

Diagnostic test for inflammatory bowel disease?

Answer 20

CT

Endoscopy

Question 21

Treatment for Inflammatory bowel disease?

Answer 21

Anti-inflammatory (NSAIDS) or immune modulating agents

Surgery for perforations or intractable pain

Question 22

Diagnostic test for Diverticulitis?

Answer 22

WBC

CT

Question 23

Treatment for diverticulitis?

Answer 23

Antibiotics

Surgery for perforation

Question 24

Diagnostic test for cystitis or pyelonephritis?

Answer 24

Urine culture

WBC also helpful

Question 25

Treatment for cystitis or pyelonephritis?

Answer 25

Antibiotics

Question 26

Diagnostic test for stones? [On test]

Answer 26

Best is Ultrasound (for calcified) CT if ultrasound is not diagnostic Will also have gross or microscopic blood in urine

Question 27

Treatment for stones?

Answer 27

Observation Lithotripsy Surgery

Question 28

Diagnostic test for ectopic preg? [On test]

Answer 28

Urine hcg Ultrasound CBC/Hematocrit (blod loss)

Question 29

Treatment for ectopic preg?

Answer 29

Methotrexate for non-ruptured | Surgery for ruptured

Question 30

Diagnostic test for PID? [On test]

Answer 30

PCR/Nucleic Acid Amplification Test (NAAT) for gonorrhea & chlamydia WBC Ultrasound for cysts

Question 31

Treatment for PID?

Answer 31

Antibiotics | Surgery for ruptured Tubo-ovarian abscess (TOA)

Question 32

Diagnostic test for Ovarian cyst?

Answer 32

ultrasound

Question 33

Treatment for ovarian cyst?

Answer 33

Observation | Surgery

Question 34

Diagnostic test for adnexal torsion?

Answer 34

Ultrasound

Question 35

Treatment for adnexal torsion?

Answer 35

Surgery

Question 36

Which is more of an emergency, acute or chronic pelvic pain?

Answer 36

Acute

Question 37

Causes of Chronic pelvic pain?

Answer 37

``` Infection --> adhesions Endometriosis Mass Leiomyoma (Fibroid tumor) Psychogenic (wants attention, depression, abuse, sexual dysfunction) ```

Question 38

Chronic pelvic pain & midline mass is ________?

Answer 38

Fibroid tumor of uterus

Question 39

Chronic pelvic pain & unilat mass is ___________?

Answer 39

Ovarian mass

Question 40

Diagnostic test for psychogenic?

Answer 40

Endoscopy diagnosis of exclusion

Question 41

Treatment for psychogenic pelvic pain?

Answer 41

Counseling, treat depression/sexual dysfunction

Question 42

Diagnostic test for chronic infection/adhesions?

Answer 42

Laparoscopy

Question 43

Treatment for chronic infection/adhesion?

Answer 43

Surgery

Question 44

Diagnostic test for Ovarian Tumor?

Answer 44

Ultrasound | Tumor markers

Question 45

Treatment for ovarian tumor?

Answer 45

surgery

Question 46

Diagnostic test for ovarian cyst?

Answer 46

Ultrasound

Question 47

Treatment for ovarian cyst?

Answer 47

Surgery

Question 48

Diagnostic test for Leiomyoma?

Answer 48

Ultrasound

Question 49

Treatment for Leiomyoma?

Answer 49

GnRH agonist | Surgery (myomectomy/hysterectomy)

Question 50

Diagnostic test for endometriosis?

Answer 50

Endoscopy | Biopsy

Question 51

Treatment of endometriosis?

Answer 51

Oral concraceptive (hormonal suppression) GnRH agonist Surgery

Question 52

If have chornic pelvic pain but can't figure out the cause, the best test is ________? [On test]

Answer 52

Laproscopy