EBCOG- part 1 -urogyeneacology -day 6(S.B.A)

1.A diagnosis of Fowler’s syndrome (FS) is made in a 25-year-old student with polycystic ovary syndrome. What treatment is most effective in restoring voiding in this patient?

A. Anticholinergics
B. Botulinum toxin
C. Intermittent self-catheterisation
D. Physiotherapy
E. Sacral neuromodulation

2.You suspect that a 20-year-old who presents with urinary retention suffers from Fowler’s syndrome (FS). What test will you perform to confirm the diagnosis?

A. A maximum urethral resting value of 80 mmHg
B. Concentric needle EMG of the striated urethral sphincter
C. Demonstration of painful withdrawal of a urethral catheter
D. Frequency and volume charts (voiding diary)
E. Routine cystometry

3. Mrs. Page needs a suprapubic catheter for neurogenic bladder. Which of the following material should the suprapubic catheter be made of to reduce complications?

A. Latex
B. Siliconised latex
C. Plastic/PVC
D. Latex coated with Teflon
E. 100% silicone

4. A 67 year old lady is having suprapubic catheterization following a gynaecological surgery. Following is a contraindication for the same:

A. Neurogenic Bladder
B. Inability to mobilize
C. Urethral stricture
D. Chronic retention
E. Anticoagulation therapy for blood clotting disorder

5. Which of the following statements about urethral diverticulum is true?

A.Congenital cases may occur from remnants of Gartner’s duct or abnormal union of primordial folds or persisting cell rests, especially Müllerian, and are com- monly found in children.
B.Most cases are acquired and result from repeated infections and obstruction of the periurethral glands.
3.The UD usually dissects within the urethral pelvic ligament with the orifice/ neck at 11 o’clock.
4.Traumatic childbirth, especially with assisted delivery, has been suggested as a cause of UD development, and they never develop in nulliparous patients.
5.Urethral diverticulum presents with the classical triad of dysuria, post-void drib- bling and dyspareunia in most of the patients.

6. A 28 year old woman presented with post micturition dribble. Video Urodynamics showed the following:

A. Urethral Stricture
B. Urethral Diverticulum
C. Neurologic Bladder
D. Faecal Impaction
E. Detrusor muscle Weakness

7) A 35 year old women presents with a history of frequency, urgency, nocturia and occasional suprapubic pain. Urodynamic investigations shows: 1st urge to void at 100 ml. There was no detrusor activity during filling phase and no leakage on coughing. The maximum bladder capacity was 400 ml. Bladder filling was painful. Cystoscopy was normal.What is the likely diagnosis?

A. Detrusor overactivity
B. Painful bladder syndrome/ sensory urgency
C. Interstitial cystitis
D. Recurrent UTI
E. Endometriosis

8. A 40-year-old woman suffers from dysuria, severe frequency, nocturia and urgency. She also complains of pain or pressure in the suprapubic area. She has been treated with antibiotics for suspected UTI in the past by her GP. On 3 occasions, MSU revealed ‘mixed growth’. She has deep dyspareunia and the pain persists for a few days after intercourse. Bladder capacity is around 400 ml. Initial cystoscopy was normal but on repeat filling, some petechial haemorrhage was seen. What is the most likely diagnosis?

A. Detrusor overactivity
B. Painful bladder syndrome/ sensory urgency
C. Interstitial cystitis
D. Recurrent UTI
E. Endometriosis