Reproductive/Urinary

Question 1

Amenorrhea

Answer 1

Progesterone challenge

Check hCG, TSH, PRL

Question 2

DUB

Answer 2

Anovulation
Coag disorder
Tx: OCP

Question 3

Endometrial CA

Answer 3

Endometrial stripe > 5mm
Postmenopausal bleeding needs biopsy!
Risk - obesity, anovulation, nulliparity, FamHx

Question 4

Endometriosis

Answer 4

Chocolate cyst
Chronic pelvic pain
Dx - laparoscopy
Tx: OCP, leuprolide

Question 5

Leiomyoma

Answer 5

Shrinks @ menopause

Estrogen/progesterone-dependent

Question 6

Ovarian CA

Answer 6

Complex cyst
Early satiety, bloating
CA-125
BRCA-1/2

Question 7

Cervical CA

Answer 7

HPV 16, 18

Get a pap q3yr if >21yo to catch

Question 8

Bacterial Vaginosis

Answer 8

Clue cells

Question 9

Trichomoniasis

Answer 9

Strawberry cervix

Green, frothy discharge

Question 10

Candidiasis

Answer 10

Cottage cheese :|
Budding yeast
Hyphae

Question 11

Menopause

Answer 11

~51yo
Elevated FSH
Protect uterus c HRT (progesterone)

Question 12

Breast CA

Answer 12

Mammogram everyone >50yo
Risk - BRCA-1/2
Biopsy lumps
+receptors = Tx c Tamoxifen

Question 13

Galactorrhea

Answer 13

PRL

Question 14

PID

Answer 14

Chlamydia/gonorrhea

Cervical motion tenderness, pelvic pain

Question 15

Ab

Answer 15

<20wk

Pelvic pain + vaginal bleeding

Question 16

Ectopic Pregnancy

Answer 16

Fallopian tube usually
+preg test; IUP seen if hCG > 2000
Vaginal bleed, pelvic pain, cervical motion tenderness

Question 17

Molar Pregnancy

Answer 17

Snowstorm pattern

hCG > 100,000

Question 18

Chronic HTN

Answer 18

<20wks preg

Question 19

Gestational HTN

Answer 19

> 20wks preg
No end-organ damage or proteinuria
Tx: labetalol or methyldopa

Question 20

Eclampsia

Answer 20

Preeclampsia + Seizure

Mg2+ to reduce seizure risk!

Question 21

Placenta Previa

Answer 21

Painless 2nd-3rd trimester bleed

No digital or TV U/S

Question 22

Postpartum Hemorrhage

Answer 22

Uterine Atony

Question 23

PROM

Answer 23

<37wks preg

Premature Rupture of Membranes

Question 24

Placental Abruption

Answer 24

Painful 3rd trimester bleed

Question 25

BPH

Answer 25

Lower urinary tract obstruction
Inc PSA
Tx: a1 blockers

Question 26

Cryptoorchidism

Answer 26

Risk of CA, infertility

Tx: Surg by 6mo

Question 27

Hydrocele

Answer 27

Self-resolves by 2yo

Question 28

Varicocele

Answer 28

“bag of worms”

L side

Question 29

Stress Incontinence

Answer 29

Sneezing/coughing/laughing

Tx: Kegels, pessaries, surg

Question 30

Urge Incontinence

Answer 30

OAB (detrusor)

Tx: Kegels, oxybutynin

Question 31

Nephrolithiasis

Answer 31

Ca2+oxalate >10mm
Flank pain, hematuria
Tx: lithotripsy or uteroscopy; prevent c thiazide

Question 32

Paraphimosis

Answer 32

EMERGENCY

Foreskin permanently retracted

Question 33

Testicular Torsion

Answer 33

Risk - Bell-Clapper deformity
Absent Prehn sign/cremasteric reflex
Tx: surg

Question 34

Pyelonephritis

Answer 34

Cystitis + Fever + Tenderness of costovertebral angle

Question 35

Epididymitis

Answer 35

+Prehn sign

Question 36

Orchitis

Answer 36

Caused by mumps virus

Question 37

Bladder Carcinoma

Answer 37

> 40yo

PAINLESS HEMATURIA

Question 38

Prostate CA

Answer 38

No routine screening

Question 39

RCC

Answer 39

Abd mass
Hematuria
Flank pain
Tx: Nephrectomy

Question 40

Testicular Carcinoma

Answer 40

Risk - 15-35yo

Germ cell

Question 41

Wilms Tumor

Answer 41

<5yo

Painless, unilat abd mass

Question 42

Pre-Renal Failure

Answer 42

BUN:Cr > 20:1

Dehydration or dec urinary Na+

Question 43

Intrinsic Failure

Answer 43

BUN:Cr 10:1
ATN
Inc urinary Na+

Question 44

Post-Renal Failure

Answer 44

Obstruction

Cath!

Question 45

Nephrotic Syndrome

Answer 45

> 3.5g proteinuria
Edema, hyperlipidemia, hypoalbuminemia

NOT THE SAME AS NEPHRITIC SYNDROME, WHICH IS INFLAM/IgA NEPHROPATHY

Question 46

Renal Artery Stenosis

Answer 46

Resistant HTN

Abd bruit

Question 47

Anion Gap Acidosis

Answer 47

MUDPILERS!!!
Methanol/MXR
Uremia
DKA
Phen-Fen
Isoniazid
Lactic acidosis
Ethylene glycol/etOH
Rhabdo/RF
Salicylates