IMM Part 2 Written – 3 Months August 22 – Genitourinary problems, Urogynecology & pelvic floor problems, Gynecological infections, Urodynamics, UV prolapse – Day 4

1.Asymptomatic bacteriuria (ASB) is most commonly seen in early pregnancy, which is the reason why it is standard antenatal practice to send a urine sample for microscopy and culture at the initial booking. Which of the following organisms is the most common cause of ASB?

2.A 26-year-old primigravida presented to the labour ward at 18 weeks’ gestation with a fever of 38.6C, rigors, abdominal and loin pain. She was diagnosed with pyelonephritis, and received intravenous antibiotics, antipyretics and fluid hydration What is the risk of recurrence of pyelonephritis in the current pregnancy?

3.A 32-year-old woman in her first pregnancy was admitted to hospital at 29 weeks’ gestation because of colicky pain in the left loin, vomiting and a fever of 37.8 degrees centigrade. Investigations showed that she has a left ureteric stone. The patient was counselled and offered conservative management with pain killers, antibiotics and hydration. Unfortunately, 48 hours later she was still spiking a temperature with deteriorating renal function. Which of the following methods is the most frequently used to treat obstruction caused by calculi during pregnancy in this situation?

4.A 58-year-old woman presents with a nine-month history of urinary frequency, urgency, and pelvic pain. Investigations including urine R/E and urodynamics have been normal. What is the likely diagnosis?

5.A 36-year-old woman presents with urinary incontinence. She has some associated urinary frequency and some suprapubic pain. What should be the initial step?

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

7.‘Long-term’ intraurethral catheters are kept in situ for at the most

8.A 24-year-old woman in her first pregnancy is referred to see you as she has female genital mutilation (FGM). What complication in pregnancy is associated with FGM?

1.You are asked to review a 22-year-old woman in her first pregnancy because she has type 4 female genital mutilation. Which of the following does this include?

10.A 45-year-old woman has been referred tothe urogynaecology clinic with recurrent urinary tractinfections over the last 3 months. Despite repeated courses of antibiotics, frequency and dysuria have continued. Today’s urinary dipstick test is positive for leucocytes. What isthe next step in management?