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Flashcards in Genitourinary/Gynecological Disorders Deck (80)
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1

UTIs are the most common pediatric urinary tract problems seen in primary care. Which of the following statements is not true regarding UTIs?
a) symptoms are often nonspecific, especially in infancy
b) urine culture is required for definitive diagnosis
c) trimethoprim-sulfamethoxazole is drug of choice for most children
d) radiologic studies are rarely indicated with first infection

d) radiologic studies are rarely indicated with first infection

Renal US and VCUG indicated if

2

A 2 yo girl presents with symptoms of painful urination, frequency, and occasional incontinence over the past week. When seen in your office, she has a temp of 101.6. Which of the following would be your approach in establishing a definitive diagnosis?
a) clean-catch midstream collection of specimen for urine analysis
b) clean-catch midstream collection of specimen for urine culture
c) straight catheterization collection of specimen for urine culture
d) voiding cystourethrogram

c) straight catheterization collection of specimen for urine culture

3

The most likely organism to cause a UTI in the pediatric population is:
a) Staphylococcus saprophyticus
b) Klebsiella
c) Chlamydia
d) E. coli

d) E. coli

4

One of the most commonly suggested reasons for primary enuresis is:
a) certain medications such as theophylline
b) genitourinary abnormalities
c) family disruptions and stress
d) delayed maturation of voiding inhibitory reflex

d) delayed maturation of voiding inhibitory reflex

5

A 7 yo female comes to you for a PE prior to participation in soccer. Her mother is concerned that she "still has accidents at night". You determine that she has primary nocturnal enuresis and your first recommendation is to:
a) avoid use of criticism and punishment
b) use a sticker/star chart
c) treat with medication
d) purchase an enuresis alarm

a) avoid use of criticism and punishment

6

The incidence of cryptochidism at one year of age is about 1%. The best explanation for this is:
a) examination of the scrotum begins at this age
b) a child can usually stand making palpation of the testes easier
c) spontaneous resolution often occurs in the first year
d) surgical repair can now be done in the neonatal period

c) spontaneous resolution often occurs in the first year

7

Communicating hydrocele is best differentiated from the noncommunicating type by the fact that:
a) there is no association with hernia
b) it usually resolves on its own
c) the fluid is static in the scrotum
d) frequently develops into hernia

d) frequently develops into hernia

8

In counseling parents when their child is diagnosed with mild hypospadias, suggest that the following may be part of the management:
a) circumcision
b) radiography
c) consult with pediatric urology
d) surgical correction at 2 years of age

c) consult with pediatric urology

9

On PE of a 2 yo uncircumcised male you note that the foreskin is retracted and discolored. there is swelling of the glans. The most likely diagnosis is:
a) phimosis
b) balanitis
c) UTI
d) paraphimosis

d) paraphimosis

10

Meatal stenosis, narrowing of the distal urethra, is seen following:
a) orchiopexy
b) circumcision
c) epididymitis
d) hypospadias repair

b) circumcision

11

During a track meet, a 14 yo male pole-vaulter falls to the ground screaming in pain. He complains of intense, searing pain in his right scrotum. He vomits twice while waiting for the ambulance. He most likely has:
a) orchitis
b) hydrocele
c) acute epididymitis
d) testicular torsion

d) testicular torsion

12

During a track meet, a 14 yo male pole-vaulter falls to the ground screaming in pain. He complains of intense, searing pain in his right scrotum. He vomits twice while waiting for the ambulance. He most likely has testicular torsion. Treatment of this disorder is primarily:
a) scrotal elevation
b) ice
c) immediate surgical referral
d) bedrest

c) immediate surgical referral

13

Labial adhesions are a relatively common finding among infants and young girls. Which of the following statements about this condition is true?
a) adhesions are usually present at birth but may be missed on examination
b) highest incidence is from birth to 3 years
c) simple lysis of adhesions is often recommended
d) most cases resolve without intervention

d) most cases resolve without intervention

14

Which of the following statements is true regarding the use of topical application of conjugated estrogen cream with labial adhesions?
a) it is highly successful in resolving most adhesions within 2 months
b) it is no longer recommended because it may stimulate precocious puberty
c) topical applications of bland creams or petroleum jelly are equally effective
d) mechanical lysis is preferred treatment today

a) it is highly successful in resolving most adhesions within 2 months

15

A 12 yo complains of a vaginal discharge for the past 8-9 months. She tells you her underpants are frequently wet. When she wipes after urinating there is "white stuff" on the tissue. She denies urinary problems, genital itching, or odor. She also denies sexual activity. Her menses have not yet started, but she reports she has "started to develop" in her breasts at about age 10. Her vaginal discharge is most likely a result of:
a) a fungal infection
b) poor hygiene
c) retained foreign body
d) physiologic leukorrhea

d) physiologic leukorrhea

16

Your recommendations for a girl with physiologic leukorrhea include which of these?
a) vinegar and water douche
b) placing a sanitary "mini pad" in her underpants
c) a 10 day course of penicillin or erythromycin
d) use of a monilial cream for 1 week

b) placing a sanitary "mini pad" in her underpants

17

Which of the following is not true of dysmenorrhea?
a) onset is usually within the first 2-3 months following menarche
b) a leading cause of school absenteeism in adolescent females
c) systemic symptoms include vomiting and dizziness
d) pain is from start of menses to about 24-48 hours later

a) onset is usually within the first 2-3 months following menarche

18

A 16 yo has symptoms of PMS. She refuses to take NSAIDs preferring instead more "natural" treatments. Her options include:
a) eating foods rich in sodium and fat
b) including more foods or supplements with vitamin C
c) limited fluid intake to avoid "bloating"
d) adequate rest, a healthy diet, and exercise

d) adequate rest, a healthy diet, and exercise

19

In cases of accidental genitourinary trauma which of the following is not commonly seen?
a) extensive tears of the vaginal wall
b) hematuria
c) hematoma of the urethra, scrotum, lower abdomen
d) periurethral lacerations

a) extensive tears of the vaginal wall

20

The most common form of glomerulonephritis in children is:
a) mesangial proliferative
b) poststreptococcal
c) membranoproliferative
d) mesangiostreptococcal

b) poststreptococcal

21

Which of the following signs/symptoms is not associated with acute forms of glomerulonephritis?
a) edema
b) hematuria
c) increased urine output
d) dark urine

c) increased urine output

22

One of your male patients presents with weight loss, abdominal pain, and decreased urine output. On examination, you palpate a right sided mass, noting tenderness in the abdomen and flank. Urinalysis reveals significant leukocytosis. An intravenous pyelogram is ordered, which shows marked delay of emptying from the renal pelvis. The most likely diagnosis is:
a) glomerulonephritis
b) pyelonephritis
c) hydronephrosis
d) UTI

c) hydronephrosis

23

Which of the following is true of renal tubular acidosis (RCA) type 1?
a) genetically transmitted as autosomal recessive disorder
b) distal tube defect affecting secretion of hydrogen ions
c) distal tube defect affecting bicarbonate reabsorption
d) most children remain short in stature in spite of early treatment

b) distal tube defect affecting secretion of hydrogen ions

24

Vulvovaginitis may be caused by all of the following except:
a) poor hygiene
b) herpes simplex virus
c) pinworms
d) condylomata acuminata

d) condylomata acuminata

25

Meatal stenosis can be identified by all of these with the exception of:
a) crying with urination
b) inflammation of glans penis
c) slit-like meatus
d) wide urinary stream

d) wide urinary stream

26

A 14 yo female is seen for complaints of headache and nausea. She is sexually active and uses a condom "sometimes". She had a period last month but it only lasted 2 days instead of the usual 7. Which are not perceived as risk factors for adolescent pregnancy?
a) early onset of sexual activity
b) familiarity with fertility knowledge
c) sporadic, if any contraceptive use
d) low self-image

b) familiarity with fertility knowledge

27

A urine pregnancy test is positive and confirmed by serology. Which of the following physical findings is not consistent with a gestation of less than 12 weeks?
a) Hegar sign
b) Goodell sign
c) doppler auscultation of fetal heart sounds
d) 4-6 pound weight gain

d) 4-6 pound weight gain

28

Congenital defects are present in approximately 3-5% of infants born in this country. Which of the following factors is the lowest contributor to defects?
a) genetic
b) unknown
c) environmental
d) combination of environmental and genetic

b) unknown

29

Which of the following is the earliest screening test that you would use in managing care during a patient's first trimester of pregnancy?
a) amniocentesis
b) chorionic villus sampling
c) serum alpha-fetoprotein
d) fetal radiograph

c) serum alpha-fetoprotein

30

A patient in her first trimester expresses to you that she may want to terminate a pregnancy. She has heard that abortion is a simple procedure without complications. Your discussion with her is based on the fact that:
a) adolescents only choose to terminate pregnancy 10% of the time
b) menstrual extraction could be done at this point
c) the risk is high for hemorrhage and fever
d) cervical injury overall from induced abortion is rare

b) menstrual extraction could be done at this point