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GYNE 4TH BI > LONG EXAM 1- Lower Urinary Tract Disorders, Pelvic Organ Prolapse, Anorectal Dysfunction > Flashcards

LONG EXAM 1- Lower Urinary Tract Disorders, Pelvic Organ Prolapse, Anorectal Dysfunction Flashcards

1
Q

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

Sympathetic nervous system mediation
Muscle tone and strength
Intraabdominal pressure
Muscle attachment to the pelvic walls

A

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.

Urinary incontinence
Stress urinary incontinence
Urgency urinary incontinence
Mixed urinary incontinence

A

Stress urinary incontinence

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3
Q

The urinary bladder function is mediated primarily by:

Parasympathetic nervous system
Involuntary muscle contractions
Sympathetic nervous system
Micturition reflex

A

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:

Normal voiding
Micturition reflex
Bladder filling and emptying
Urinary incontinence

A

Normal voiding

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5
Q

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

Bladder body
Bladder neck
Detrusor muscle
Brainstem

A

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:

Urinary frequency
Incontinence
Urinary retention
Detrusor overactivity

A

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:

Urgency urinary incontinence
Mixed urinary incontinence
Stress urinary incontinence
Insensible urinary incontinence

A

Mixed urinary incontinence

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8
Q

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

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

A

Loss of integrity of structures intrinsic to the urethra

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9
Q

What is the pathophysiology of overactive bladder?

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

A

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 base of the bladder/urethra:

Urethral diverticuli
Ectopic urethra
Bladder extrophy
Vesicovaginal fistula

A

Bladder extrophy

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11
Q

Which one is a risk factor for urgency urinary incontinence?

Obesity
Advancing age
White women
Parity

A

Obesity

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12
Q

One of the reversible causes of urinary incontinence is:

Depression
Psychiatric cause
Enuresis
Atrophic vaginitis

A

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:

<50 mL
>100 mL
>150 mL
<200 mL

A

> 150 mL

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14
Q

What is the hallmark of advanced bladder testing?

Quality of life measurement
Urodynamic tests
Uroflowmetry
Cystoscopy

A

Urodynamic tests

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15
Q

This 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

Neurogenic type
Phasic type
Terminal type
Idiopathic type

A

Terminal type

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16
Q

The difference between urethral pressure and vesical pressure is called:

Urethral closure pressure
Pressure profile
Total urethral pressure
Maximum urethral closure pressure

A

Urethral closure pressure

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17
Q

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

150 mL
200 mL
250 mL
400 mL

A

250 mL

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18
Q

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

> 60 cm of H2O
200 mmHg
100 mmHg
120 cm of H2O

A

> 60 cm of H2O

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19
Q

The flow rate during voiding with detrusor pressure is:

<15 mL/sec
<40 mL/sec
>20 cm H2O
<50 cm H2O

A

<50 cm H2O

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20
Q

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

Idiopathic overactive bladder
Stress urinary incontinence
Mixed urinary incontinence
Primary bladder neck dysfunction

A

Idiopathic overactive bladder

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21
Q

Which statement is true regarding pelvic floor muscle training?

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

A

done by preventing passage of gas

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?

Oxybutynin
Duloxetine
Tropium chloride
imipramine

A

Duloxetine

23
Q

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

Mirabegron
Tolterodine
Desmopressin
imipramine

A

Mirabegron

24
Q

This surgical procedure involves performance through two incision, one around the urethra, and one through the abdomen to gain access around the upper space of Retzius

Burch sling procedure
Pubovaginal sling procedure
Mid-urethral sling procedure
M…

A

Pubovaginal sling procedure

25
Q

Which statement is true regarding indication and characteristics of mid-urethral retropubic slings?

The top-down route may be more effective than bottom up route
Fewer adverse events occur with the retropubic approach
The retropubic sling is favored in cases of fixed immobile urethra
The trans-obturator approach is favored in cases if pelvic relaxation

A

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

Increased bladder sensation
Reduced bladder sensation
Feeling of incomplete bladder emptying
Delayed bladder emptying

A

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

Hesitancy
Acute urinary retention
Intermittency
Acute absent bladder sensation

A

Acute urinary retention

28
Q

What is the term also used to describe bladder atony?

Detrusor sphincter dyssenergia
Fowler syndrome
Idiopathic hypoactive bladder
Paralytic bladder syndrome

A

?

29
Q

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

Beta agonists
Calcium channel blockers
Neuromodulation
Intermittent catheterization

A

Neuromodulation

30
Q

When should urine cytology be done with bladder pain syndrome?

History of smoking
Younger women
Inflammatory disorders
Urethral diverticula

A

History of smoking

31
Q

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

Previous cesarean delivery
BMI > 35
History of a difficult delivery
Menopausal women

A

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:

Level 1
Level 2
Level 3
Level 4

A

Level 3

33
Q

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

Rectocele
Cystocele
uterine prolapse
procidentia uteri

A

Cystocele

34
Q

Which structure is included as the endopelvic connective tissue?

Mackenrodt ligaments
Acus tendineous
Retroperitoneal portion of the uterus
Broad ligaments

A

Retroperitoneal portion of the uterus

35
Q

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

Resultant enterocoele
Ballooning of the vaginal wall
Persistent rectocele
Pelvic organs prolapse

A

Resultant enterocoele

36
Q

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

anterior wall of hymen
posterior fornix
vaginal cuff
dependent portion of posterior wall

A

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:

Stage I
Stage II
Stage III
Stage IV

A

Stage III

38
Q

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

Prevent prolapse
Decrease the severity of symptoms
Support of the pelvic floor musculature
Delay surgical intervention

A

Prevent prolapse

murag except ni nga question ai

39
Q

Which one is a possible complication of pessary use?

Pain
Increase urgency urinary incontinence
Menstrual irregularities
Hydronephrosis

A

Hydronephrosis

40
Q

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

Paravaginal repair
Traditional colporrhaphy
Transanal perineal repair
Iliococcygeal vaginal suspension

A

Paravaginal repair

41
Q

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

Colporrhexis
Colpocleisis
Culdocentesis
Colpopexy

A

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?

2L
3000mL
4L
5000mL

A

5000mL

43
Q

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

Rectoanal inhibitory reflex
Accommodation
Defecatory reflex
Urge to defecate

A

Accommodation

44
Q

Which muscle is essential for passive continence?

Internal sphincter muscle
Puborectalis muscle
External sphincter muscle
Levator ani muscle

A

Internal sphincter muscle

45
Q

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

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

A

The autonomic nervous system provides local circuitry

46
Q

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

Myotonic dystrophy
Food allergy
Thyroid dse
Surgical trauma

A

Thyroid dse

47
Q

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

Parkinsons disease
Hirschsprung disease
Autonomic neuropathy
Pudendal neuropathy

A

Parkinsons disease

48
Q

What is the cause of constipation in pregnancy?

Estrogen hormone
Iron supplementation
Hyperthyroidism
Drug and food allergies

A

Iron supplementation

49
Q

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

Graciloplasty
Sacral nerve root stimulator
Artifical sphincter
Overlapping Sphincteroplasty

A

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.

Altemeier operation
Deforme procedure
Ileorectal anastomosis
Bruel-Kjaer rectal procedure

A

Deforme procedure

GYNE 4TH BI (14 decks)

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