Uro/ Gyn Surgery

Question 1

Abn uterine bleeding- Eti

Answer 1

• Determine if

Question 2

Abn uterine bleeding- Sx

Answer 2

• Determine flow is regular and heavy or irregular

- Menorrhagia or metorrahagia

Question 3

Abn uterine bleeding- Tx

Answer 3

• Oral progesterone followed by
• Dilation and curettage to dx and tx
• IUD or NSAIDs

Question 4

Abn uterine bleeding- Dx

Answer 4

• Biopsy
• Transvaginal US
• Hysteroscopy

Question 5

Urinary stone disease- Eti

Answer 5

• Males

- Calcium stones most common

Question 6

Urinary stone disease- Sx

Answer 6

• Flank pain
• Hematuria
• Pyelonephritis
• CVA tenderness

Question 7

Urinary stone disease- Dx

Answer 7

• Visual stone on urography, US or CT
• Leukocytosis
• Abn UA

Question 8

Urinary stone disease- Tx

Answer 8

• Laser lithotripsy or extracorporeal shock wave lithotripsy

- Percutaneous stone removal

Question 9

Ectopic pregnancy- Eti

Answer 9

• 95% in fallopian tube

- 2% pregnancies

Question 10

Ectopic pregnancy- Sx

Answer 10

• Amenorrhea
• Severe abd pain, referred to shoulder
• Uterus enlarged larger than expected

Question 11

Ectopic pregnancy- Dx

Answer 11

• Absence of intrauterine pregnancy with positive hCG

- Transvaginal US

Question 12

Ectopic pregnancy- Tx

Answer 12

• Methotrexate
• Laparoscopy
• Ensure hCG falls

Question 13

Leiomyoma of uterus- Eti

Answer 13

• Most common benign neoplasm

Question 14

Leiomyoma of uterus- Sx

Answer 14

• Round, firm smooth tumor of CT
• Asymptomatic
• Pelvic pain or pressure

Question 15

Leiomyoma of uterus- Dx

Answer 15

Ultrasound

Question 16

Leiomyoma of uterus- Tx

Answer 16

• Myomectomy to preserve fertility

- Recurrence is common

Question 17

Endometrial carcinoma- Eti

Answer 17

• Most common US malignancy
• Prolonged estrogen exposure
• DM, early menarche and late menopause

Question 18

Endometrial carcinoma- Sx

Answer 18

• Postmenopausal bleeding in 90%

- Cervical stenosis with pyometrium

Question 19

Endometrial carcinoma- Dx

Answer 19

• Endometrial biopsy

- Dilatation and curettage

Question 20

Endometrial carcinoma- Tx

Answer 20

• Laparotomy or laparoscopy
• Total hysterectomy, salping oopherectomy
• Pelvic radiation

Question 21

Cervical carcinoma- Eti

Answer 21

• Persistent infection with HPV

- Increased risk with HIV, smokers

Question 22

Cervical carcinoma- Sx

Answer 22

• Metrorrhagia
• Post-coital spotting
• Cervical ulceration

Question 23

Cervical carcinoma- Dx

Answer 23

• Postitive pap

- Cervical biopsy and curettage or conization

Question 24

Cervical carcinoma- Tx

Answer 24

• Total hysterectomy if done with children

- Conization or laser ablation

Question 25

Testicular carcinoma- Eti

Answer 25

- Most common neoplams in men 20-35 | - More common on right

Question 26

Testicular carcinoma- Sx

Answer 26

- Painless enlargement in testis - Sensation of heaviness - Acute testicular pain from hemorrhage - Signs of METs

Question 27

Testicular carcinoma- Dx

Answer 27

Orchiectomy | - Scrotal US

Question 28

Testicular carcinoma- Tx

Answer 28

- Radical orchiectomy by inguinal exploration

Question 29

Testicular torsion- Eti

Answer 29

- Young men | -

Question 30

Testicular torsion- Sx

Answer 30

- Hx of scrotal pain - Abrupt, severe unilateral scrotal pain - May progress to hypoxia - Elevated, horizontal testicle

Question 31

Testicular torsion- Dx

Answer 31

Doppler US- diminished blood flow

Question 32

Testicular torsion- Tx

Answer 32

- Manual detorsion within 6 hours | - Surgical detorsion and fixing

Question 33

Torsion of testicular appendage- Eti

Answer 33

- Appendix testis most common

Question 34

Torsion of testicular appendage- Sx

Answer 34

- Blue dot sign- firm nodule - Sudden onset of severe pain and nausea - Normal and minimally tender scrotal skin

Question 35

Torsion of testicular appendage- Dx

Answer 35

RO testicular torsion with Doppler US

Question 36

Torsion of testicular appendage- Tx

Answer 36

- Bed rest - Scrotal elevation - Pain control - Surgical excision if pain control inadequate