Answer 5

5.  Choice C is the correct answer.  Renal ultrasound is the modality of choice.  It has the lowest exposure to radiation, and highest yield.  It is important to note you do not actually see the kidney stone, but you will see the associated hydronephrosis and ureter dilation.  CT scan of abdomen and pelvis without contrast in the non pregnant patient is the ideal test, but is too much radiation exposure when other tests are available.  KUB will have some minimal radiation, but will be low yield.  MRI of the Abdomen and Pelvis is not an ideal modality because of cost and will have virtually radiation exposure.

Question 5

5.  Your patient is a 24 year old female who is approximately 34 weeks pregnant with left flank pain.  Her urinalysis shows gross blood and no white cells.  You are interested in confirming the presence of kidney stones because she had to have surgical intervention with them in the past with previous pregnancies.  Which radiographic modality is the best test to order?

A.  KUB
B.  CT abdomen and pelvis without contrast
C.  Renal Ultrasound
D.  MRI of abdomen and pelvis without contrast

Answer 4

4.  Choice C is the correct answer.  Oral antiviral agents are helpful, especially when instituted in the first 48 hours of onset.  Systemic symptoms can be present, but a small percentage of the time.  The initial outbreak usually is the worst.  The inflammation and lesions associated with HSV genital infections, are the most common cause of bladder outlet obstruction in young females.

Question 4

4.  Which of the following is not true regarding HSV genital infections?

A.  The first outbreak is usually worse than reoccurrence
B.  Systemic symptoms may be present
C.  Treatment with oral antiviral agents is not helpful
D.  It is the most common cause of bladder outlet obstruction in young females

Answer 3

3.  Choice D is the correct answer.  The pain maybe intermittent and present as unilateral pelvic pain. Untreated torsion can lead to peritonitis.  In addition, up to two thirds of patients will have associated nausea and vomiting.

Question 3

3.  Which of the following is true regarding the signs and symptoms of ovarian torsion?

A.  The pain may come and go
B.  Usually a sudden onset of unilateral pelvic pain
C.  Untreated torsion may lead to peritonitis
D.  All of the above

Answer 2

2.  Choice B is the correct answer.  PID, infertility treatments, and history of ectopic pregnancy are well defined risk factors for ectopic pregnancy.  Ovarian cysts are not a risk factor for ectopic pregnancy.

Question 2

2.  Which of the following patients would be less like to develop ectopic pregnancy?

A.  Patient with pelvic inflammatory disease

B.  Patient with ovarian cysts

C.  Patients that are on Clomid

D.  Patient with history of previous ectopic pregnancy

Answer 1

1.  Choice D is the correct answer.   Nitroprusside is not ideal for preclampsia patients.  It is actually pregnancy category C, but hydralazine, labetolol, and methyldopa are more safe.  In addition, there is a cyanide toxicity risk even at low infusion rates.

Question 1

1.  Your patient is a 24 year old female 31 weeks pregnant with preclampsia in the ER with headache, dizziness and vomiting.  Her blood pressure is 235/130 and heart rate is 88.  Which of the following is not appropriate for management of her elevated blood pressure emergently?

A.  Hydralazine
B.  Labetolol
C.  Methyldopa
D.  Nitroprusside