Bladder Pain Syndrome GTG

1. 32 year old Maggie, presented with pelvic pain, pressure or discomfort perceived to be related to the bladder, lasting at least 6 months, and accompanied by persistent urge to void or frequency, all other tests seems to be negative. Her cystoscopy shows glomerulations, all are true except

A. Glomerulations (lesions seen after hydrodistension under anaesthesia to 80–100 cm water pressure for 1–2 minutes
B. Where the glomerulations must be diffuse
C. Present in at least three quadrants of the bladder at a rate of at least 10 per quadrant
D. Must Present along the path of the cystoscope as well
E. Hunner ulcer can be present

2. Causes of sterile pyuria include all except

A. Tuberculosis
B. Malignancy
C. Ureaplasma urolyticum
D. Urinary tract stones
E. Gonorrhoea

3. 54 year old postmenopausal woman presents with pelvic pain, pressure or discomfort perceived to be related to the bladder, lasting at least 8 months, and accompanied by persistent urge to void or frequency. Her urine test shows RBC -20-30:cells /Hpf . She had similar complaints in last2 months. The most appropriate advise for her would be

A. Refer for cystosocopy
B. Send for urine cytology
C. Ask her to complete food diary to understand aggravating and relieving factors
D. Give her bladder dairy
E. None of the above

4. 22year old Tina is presented with urgency, frequency and haematuria. She gives history of recreational drug abuse as well as excessive use of hallucinogens. On investigations showed persistent urine infection and deranged renal functions tests. Advised cystoscopy which showed marked fibrosis. Cause of her symptoms is

A. Bladder pain syndrome
B. Interstitial cystitis
C. Ketamine cystitis
D. Marijuna cystitis
E. Pelvic inflammatory disease

5. Hunners ulcer and reduced bladder capacity is seen in

A. Type 1BPS
B. Type 2BPS
C. Type 3BPS
D. Type1A BPS
E. Seen in all types of BPS

6. All are true regarding management of BPS with cimetidine except

A. Cimetidine can be started As first line if conservative management fails
B. Can only be prescribed by competent clinician
C. Cimetidine is licensed for use in BPS.
D. Can present with side effects of dry mouth, blurring of vision .
E. Shows improvement in pain scores

7. All are true regarding intravesical DMSO all are true except

A. 50% DMSO for two sessions each week for 2 weeks-not licensed treatment.
B. 53% had marked symptomatic improvement
C. Adverse effects include a garlic-like taste and odour on the breath and skin, and bladder spasm.
D. Full eye examination is needed prior to starting treatment
E. Monthly blood tests for renal, liver and full blood counts are advised.

8. All are true regarding conservative management for BPS are true except

A. Careful and detailed history to be taken
B. It is diagnosis of exclusion
C. Conservative managements like relaxation techniques are helpful
D. Refer to Gynaecologists if main symptoms are pelvic pain
E. Majority of women takes 2months to improve symptoms with conservative measurements .

9. Regarding Treatment of BPS in pregnancy all are true except

A. Oral amitriptyline has the lowest risks in pregnancy.
B. Hepain is the safest intravesical treatment and is not excited in milk
C. Intravesical DMSO is not teratogenic and safe to use in pregnancy
D. Sacral nerve stimulators need to be turned off during pregnancy as their effects are known
E. BPS was not affected by the node of delivery

10. In woman with BPS – quality of life is affected – the following are used to assess QOL except

A. King’s Health Questionnaire
B. EuroQoL
C. Short Form-36 Health Survey.
D. University of Wisconsin scale