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TIRED YEAR > Gyne > Flashcards

Gyne Flashcards

1
Q

The effective urethral closure is influenced by several factors which include:

a. Sympathetic nervous system mediation
b. Muscle tone and strength
c. Intraabdominal pressure
d. Muscle attachment to the pelvic walls

A

b. Muscle tone and strength

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2
Q

This occurs with increase in abdominal pressure and can be treated with pelvic muscle exercise, vaginal devices, lifestyle changes, and surgery.

a. Urinary incontinence
b. Stress urinary incontinence
c. Urgency urinary incontinence
d. Mixed urinary incontinence

A

b. Stress urinary incontinence

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3
Q

The urinary bladder function is mediated primarily by:

a. Parasympathetic nervous system
b. Involuntary muscle contractions
c. Sympathetic nervous system
d. Micturition reflex

A

c. Sympathetic nervous system

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4
Q

This is accomplished by voluntary relaxation of the pelvic floor and urethra, accompanied by sustained contraction of the detrusor muscle, leading to complete bladder emptying:

a. Normal voiding
b. Micturition reflex
c. Bladder filling and emptying
d. Urinary incontinence

A

a. Normal voiding

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5
Q

The alpha receptors of the sympathetic nervous system are primarily located at which part?

a. Bladder body
b. Bladder neck
c. Detrusor muscle
d. Brainstem

A

b. Bladder neck

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6
Q

The pontine micturition center serves as the final common pathway for all bladder motor neurons and transection below this area would lead to this condition:

a. Urinary frequency
b. Incontinence
c. Urinary retention
d. Detrusor overactivity

A

c. Urinary retention

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7
Q

This is the involuntary loss of urine associated with urgency and with effort or physical exertion or on sneezing or coughing:

a. Urgency urinary incontinence
b. Mixed urinary incontinence
c. Stress urinary incontinence
d. Insensible urinary incontinence

A

b. Mixed urinary incontinence

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8
Q

What is the current most accepted theory of stress urinary incontinence pathogenesis?

a. Loss of integrity of structures intrinsic to the
urethra
b. Hammock theory
c. Connective tissue laxity in the vagina and its
supporting ligaments
d. Integral theory

A

a. Loss of integrity of structures intrinsic to the
urethra

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9
Q

What is the pathophysiology of overactive bladder?

a. Backward direction of the levator plate
b. Forward direction of the pubococcygeus muscle
c. There is no known cause that is documented
d. Abnormality between the micturition center and
the bladder

A

c. There is no known cause that is documented

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10
Q

This condition involves a congenital absence of the
anterior vaginal wall and the bladder/urethra:

a. Urethral diverticuli
b. Ectopic urethra
c. Bladder extrophy
d. Vesicovaginal fistula

A

c. Bladder extrophy

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11
Q

Which one is a risk factor for urgency urinary incontinence?

a. Obesity
b. Advancing age
c. White women - higher risk for stress urinary
d. Parity - no effect

A

a. Obesity

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12
Q

One of the reversible causes of urinary incontinence is:

a. Depression
b. Psychiatric cause
c. Enuresis
d. Atrophic vaginitis

A

d. Atrophic vaginitis

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13
Q

This is the amount of urine remaining in the bladder within 10 minutes from voiding and the abnormal threshold level is:

a. <50 mL
b. >100 mL
c. >150 mL
d. <200 mL

A

c. >150 mL

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14
Q

What is the hallmark of advanced bladder testing?

a. Quality of life measurement
b. Urodynamic tests
c. Uroflowmetry
d. Cystoscopy

A

b. Urodynamic tests

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15
Q

type of detrusor overactivity that refers to the involuntary detrusor contractions occurring at cystometric capacity which cannot be suppressed resulting in incontinence and bladder emptying

a. Neurogenic type
b. Phasic type
c. Terminal type
d. Idiopathic type

A

c. Terminal type

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16
Q

The difference between urethral pressure and vesical pressure is called:

a. Urethral closure pressure
b. Pressure profile
c. Total urethral pressure
d. Maximum urethral closure pressure

A

a. Urethral closure pressure

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17
Q

What is the normal volume when one has a strong desire to void?

a. 150 mL
b. 200 mL
c. 250 mL
d. 400 mL

A

c. 250 mL

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18
Q

The cut off pressure during a Valsalva leak point pressure measurement is:

a. >60 cm of H2O
b. 200 mmHg
c. 100 mmHg
d. >120 cm of H2O

A

a. >60 cm of H2O

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19
Q

The flow rate during voiding with detrusor pressure is:

a. <15 mL/sec
b. <40 mL/sec
c. >20 cm H2O
d. <50 cm H2O

A

a. <15 mL/sec

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20
Q

Bladder training is one of the nonpharmacologic treatments for which lower urinary tract disorder?

a. Idiopathic overactive bladder
b. Stress urinary incontinence
c. Mixed urinary incontinence
d. Primary bladder neck dysfunction

A

a. Idiopathic overactive bladder

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21
Q

Which statement is true regarding pelvic floor muscle training?

a. it a a method to restore function of pelvic relaxation
b. it a best done with full bladder
c. should be done while voiding
d. done by preventing passage of gas

A
22
Q

Which drug agent that is used for treatment of stress incontinence has the mechanism of action on the bladder to increase its storage?

a. Oxybutrin
b. Duloxetine
c. Tropium chloride
d. imipramine

A

b. Duloxetine

23
Q

This medication n a specific beta 3 receptor agonist that is used to treat urgency urinary incontinence

a. Mirabegron
b. Tolterodine
c. Desmopressin
d. imipramine

A

a. Mirabegron

24
Q

This surgical procedure involves performance through two incision, one
round the urethra, and one thrush the abdomen to gain access aroun

A
25
Q

Which statement is true regarding indication and characteristics of Mid-urethral retropubic slings?
a. The top-down route may be more effective than bottom-up route
b. Fewer adverse events occur with the retropubic approach
c. The retropubic sling is favored in cases of fixed immobile urethra
d. The trans-obturator approach is favored in cases of pelvic relaxation

A

c. The retropubic sling is favored in cases of fixed immobile urethra

26
Q

This happens when the desire to void occurs later than previously experienced despite awareness that bladder is filling

a. Increased bladder sensation
b. Reduced bladder sensation
c. Feeling of incomplete bladder emptying
d. Delayed bladder filling

A

b. Reduced bladder sensation

27
Q

The sudden and often painful inability to void despite the sensation of a full bladder and desire to urinate is called

a. Hesitancy
b. Acute urinary retention
c. Intermittency
d. Acute absent bladder sensation

A

b. Acute urinary retention

28
Q

What is the term also used to describe bladder atony?

a. Detrusor sphincter dyssynergia
b. Fowler syndrome
c. Idiopathic hypoactive bladder
d. Paralytic bladder syndrome

A
29
Q

What is the recommended management for non-obstructive voiding dysfunction?

a. Beta agonists
b. Calcium channel blockers
c. Neuromodulation
d. Intermittent catheterization

A

c. Neuromodulation

30
Q

When should urine cytology be done with bladder pain syndrome?

a. History of smoking
b. Younger women
c. Inflammatory disorders
d. Urethral diverticula

A

a. History of smoking

31
Q

This is one of the risk factors of pelvic organ prolapse:

a. Previous cesarean delivery
b. BMI > 35
c. History of a difficult delivery
d. Menopausal women

A

b. BMI > 35

32
Q

Among the support system of the uterus, this pertains to the distal vagina and is made up of the muscles and connective tissue surrounding the distal vagina and perineum:

a. Level 1
b. Level 2
c. Level 3
d. Level 4

A

c. Level 3

33
Q

This condition occurs when the pubocervical musculoconnective tissue weakens midline or detaches from its lateral or superior connecting points:

a. Rectocele
b. Cystocele
c. uterine prolapse
d. procidentia uteri

A

b. Cystocele

34
Q

Which structure is included as the endopelvic connective tissue?

a. Mackenrodt ligaments
b. Acus tendineous
c. Retroperitoneal portion of the uterus
d. Broad ligaments

A

c. Retroperitoneal portion of the uterus

35
Q

What happens when there is detachment of the fibromuscular tissue of the vagina from the anterior rectum?

a. Resultant enterocoele
b. Ballooning of the vaginal wall
c. Persistent rectocele
d. Pelvic organs prolapse

A

a. Resultant enterocoele

36
Q

This organ corresponds to the middle site (C) in POP-Q measurements:

a. anterior wall of hymen
b. posterior fornix
c. vaginal cuff
d. dependent portion of posterior wall

A

c. vaginal cuff

37
Q

What is the stage of pelvic organ prolapse when the most distal portion of the prolapse is less than 1 cm below the plane of the hymen but no further than 2 cm less than the total vagina length:

a. Stage I
b. Stage II
c. Stage III
d. Stage IV

A

c. Stage III

38
Q

one of the goals of a conservative therapy approach to the treatment of mild to moderate prolapse is:

a. Prevent prolapse
b. Decrease the severity of symptoms
c. Support of the pelvic floor musculature
d. Delay surgical intervention

A

a. Prevent prolapse

39
Q

Which one is a possible complication of pessary use?

a. Pain
b. Increase urgency urinary incontinence
c. Menstrual irregularities
d. Hydronephrosis

A

d. Hydronephrosis

40
Q

This is a recommended anterior compartment procedure for surgical management of pelvic organ prolapse:

a. Paravaginal repair
b. Traditional colporrhaphy (Posterior)
c. Transanal perineal repair (Posterior)
d. Iliococcygeal vaginal suspension (apical
compartment)

A

a. Paravaginal repair

41
Q

What is the term used for vaginal narrowing or surgical shortening of vaginal canal?

A. Colporrhexis
B. Colpocleisis
C. Culdocentesis
D. Colpopexy

A

B. Colpocleisis

42
Q

The colon plays an important role in the absorption and regulation of water and electrolytes, how much water can be absorbed in a day?

A. 2L
B. 3000mL
C. 4L
D. 5000mL

A

D. 5000mL

43
Q

This occurs as the normally compliant rectal vault relaxes in response to increased volume:

A. Rectoanal inhibitory reflex
B. Accommodation
C. Defecatory reflex
D. Urge to defecate

A

B. Accommodation

44
Q

Which muscle is essential for passive continence?

A. Internal sphincter muscle
B. Puborectalis muscle
C. External sphincter muscle
D. Levator ani muscle

A

A. Internal sphincter muscle

45
Q

Which statement is true regarding continence mechanism involving innervation or nerve supply?

A. IAS receives its sympathetic supply from S2-4
B. The autonomic nervous system provides local
circuitry
c. The EAS acts through reflex arcs at the spinal
cord w/out voluntary control
D. Rich sensory supply is from posterior rectal branch od the pudendal nerve

A

c. The EAS acts through reflex arcs at the spinal
cord w/out voluntary control

46
Q

Which condition is a risk factor for both fecal incontinence and defecatory dysfunction?

A. Myotonic dystrophy
B. Food allergy
C. Thyroid dse
D. Surgical trauma

A

C. Thyroid dse

47
Q

Which one is a central nervous system disorder that causes fecal incontinence and defecatory dysfunction?

A. Parkinsons dse
B. Hirschsprung dse
C. Autonomic neuropathy
D. Pudendal neuropathy

A

A. Parkinsons dse

48
Q

What is the cause of constipation in pregnancy?

A. Estrogen hormone
B. Iron supplementation
C. Hyperthyroidism
D. Drug and food allergies

A

B. Iron supplementation

49
Q

What is the surgical procedure of choice for the treatment of fecal incontinence?

A. Graciloplasty
B. Sacral nerve root stimulator
C. Artifical sphincter
D. Overlapping Sphincteroplasty

A

D. Overlapping Sphincteroplasty

50
Q

This procedure involves separation of the rectal mucosa from the phincter and muscularis propria, followed by resection of the rectal mucosa and plication of the distal rectal wall.

A. Altemeier operation
B. Deforme procedure
C. Ileorectal anastomosis
D. Bruel-Kjaer rectal procedure

A

B. Deforme procedure

TIRED YEAR (16 decks)

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