EBCOG -Part 1 -Urogyneacology- Day 1(S.B.A)

1. A 50-year-old woman is seen in the gynaecology clinic with urinary symptoms of frequency, urgency, urge incontinence and nocturia. She has had three normal vaginal deliveries and does not have any features of prolapse. A urodynamic assessment is arranged and lifestyle changes are introduced. This has confirmed detrusor overactivity. The lifestyle changes instituted have made no difference to her symptoms after 6 months, hence a decision has been taken to offer her an antimuscarinic.What will be a contraindication to starting her on such a medication?

A.Crohn’s disease
B.Hypertension on treatment with an angiotensin-converting-enzyme inhibitor
C.Irritable bowel syndrome
D.Myasthenia gravis
E.Severe asthma

2.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

3.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

4.A woman does not have symptoms of UTI but tests positive for both leucocytes & nitrites on urine dipstick at first visit. What should be the appropriate management?

A. Treat with antibiotics
B. Send MSU – c/s & prescribe antibiotics only if culture is positive
C. Do not send MSU – c/s
D. Prescribe antibiotics pending culture results
E. Repeat urine dipstix

5. Painful bladder syndrome is characterised by all of the below except:

A. Increased frequency
B. Increased night-time frequency
C. Pain related to bladder filling
D. Positive urine cultures
E. Urgency

6.A 38‐year‐old woman with a long‐standing history of overactive bladder symptoms attends a urogynaecology clinic. Her GP records show that her three most recent mid‐stream urine samples have both grown Staphylococcus aureus.Which one of the following is true regarding the relevance of this result?

A) Bacteriuria <105 CFU/ml is not considered relevant
B) Asymptomatic bacteriuria must always be treated
C) The most common uropathogen is Staphylococcus aureus
D) All women with recurrent UTI should have a cystoscopy performed
E) Overactive bladder symptoms are associated with bacteriuria

7. A 57‐year‐old woman has been troubled by occasional urinary tract infections associated with sexual intercourse since going through the menopause aged 55. At her last infection, E. coli were cultured from the urine. Which one of the following is true regarding her management?

A) A short course of antibiotics would be less effective than a long course for simple UTIs
B) Trimethoprim is the preferred antimicrobial treatment
C) Escherichia coli are rarely susceptible to nitrofurantoin
D) Local oestrogen therapy would reduce her risk of recurrent UTIs
E) Postcoital nitrofurantoin is associated with pulmonary fibrosis

Name*	You must fill out this field.
Phone*	You must fill out this field.
Email*	You must fill out this field.