SAEM M4 Curriculum 2 Exam Questions and Answers Latest Updated 2024/2025 | Scored A+

SAEM M4 Curriculum 2 Exam Questions and Answers Latest Updated 2024/2025 | Scored A+. PID cause correct answeroriginates as a cervical infection with Neisseria gonorrheaand/or Chlamydia trachomatis, and becomes polymicrobial as it ascends into the uterus, fallopian tubes and ovaries. 3 sx PID correct answer-lower abd pain -purulent vag d/c -vag bleed when getPID sx correct answerSymptoms begin shortly after the start of the menstrual cycle, when there are fewer defenses by the cervical mucosal barrier to ascending infections. PID with gonnoccal correct answermore likely to appear toxic (fever, N/V) dont forget one risk factor pid correct answer-recent instrumentation of uterus common exam findings pid correct answer-b/l adenexal tenderness -cervical d/c cervical motion tenderness -uterine tender -lower abd tenderness if pain is u/l think more correct answerTOA if RUQ tender think correct answerFitz-Hugh Curtis (perihepatitis, inflamation of liver capsule) best test for gonorrohea and chlaymida correct answerNAAT with PCR or DNA probes (either urine or cervical secretions) SAEM M4 Curriculum 2 Exam Questions and Answers Latest Updated 2024/2025 | Scored A+ if suspect TOA get correct answerUS ruptured ovarian cyst shows correct answerfree fluid in pouch of douglas ovarian torsion shows correct answerabsence of blood flow to one ovary on pelvic ultrasound with doppler why US>CT correct answerCT cannot eval for torsion bc there is no doppler who gets abx for PID correct answer-lower abdominal or pelvic pain coupled with adnexal, uterine or cervical motion tenderness on exam, in a patient at risk for STDs with no other discernible cause for the illness identified complications of pid correct answer-chronic pelvic pain -infertility -ectopic -toa -fitz-hiugh curtis toa process correct answerwalled-off abscess that originates in the infected fallopian tube and extends to involve the ovary how confirm dx of Fitz hugh curtis correct answerelevated liver fxn tests inpatient abx pid correct answer-cefoxitin + doxy or -cefotentan + doxy or clinda+gentamycin outpatient abx pid? add _____ if 2 correct answer-ceftriaxone -doxy -add metro if severe infection or hx of uterine instrumentation who getsa dmitted correct answer-toa -fitz hugh curtis -septic -peritontiis -pre-pubertal kid -iud (which needs to be removed) -pregnant d/c with PID need what testing correct answertest for other STD describe whats going on in ovarian torsion correct answerovary, and often the fallopian tube as well (adnexal torsion) become twisted around their vascular pedicle. progression of torsion correct answertwisting initially obstructs venous flow, which causes engorgement and edema. The engorgement can progress until arterial flow is compromised, leading to ischemia and infarction risk factors for torsion correct answerovary with a mass or cyst is more prone to twisting by virtue of its asymmetry classic present torsion correct answersudden onset of unilateral lower abdominal pain which is initially visceral in character (ie, vague and poorly localized) and may be accompanied by nausea and vomiting. It may radiate to the groin or flank. intermittent torsion correct answerseveral episodes of pain over the course of hours, days, or even weeks, why does current pregnancy inc risk of torsion correct answercorpus lutem cyst on ovary tests for torsion correct answerThere are no laboratory tests which are helpful in establishing the diagnosis of adnexal torsion best way to dx torsion correct answerUS careful with US: correct answerimportant to note that the presence of Doppler blood flow does not exclude the diagnosis of torsion signs of torsion on US correct answer-enlargement/edema of ovary -ovrian mass or cyst -free pelvic fluid what does CT torsion show correct answerfinding an enlarged ovary or ovarian mass -assocaited free fluid -thick fallopian tube -deviation of uterus to the affected side definitively dx torsion correct answerOR tx torsion correct answeror (try and salvage ovary but testicle just gets removed) torsion sotry often sounds like correct answerkidney story testicular torsion is correct answertwisting of the testis and spermatic cord within the scrotum, with resulting in occlusion of venous return and and edema which can progress to arterial occlusion and ischemia normal testicle anatomy and issue with torsion correct answeranchored within the scrotum by the tunica vaginalis, which surrounds the testicle and attaches posteriorly to the scrotal wall and epididymis. The tunica vaginalis consists of a visceral and parietal layer with an interposed potential space. This potential space allows the testicle to rotate about the spermatic cord within the tunica vaginalis if a firm posterior scrotal attachment is lacking. bell clapper deformity correct answerWhen the tunica vaginalis attaches higher up on the spermatic cord, the testicle can move and twist within the scrotum. inc risk of torsion 2 most common ages get torsion correct answer1st year of life and in puberty hx of testicular torsion correct answerairly sudden, severe unilateral testicular pain, sometimes radiating into the abdomen, associated with nausea and vomiting -may have urgency, freuqency, dysuria which testicle most common correct answerleft weird cause of torsion correct answertrauma exam correct answer-testicle is tender and swollen -sits higher in sac -sits in transverse lie -loss of cremasteric reflex (rise hihgerthan .5cm) labs in torsion correct answerusually not helpful best way to dx testicle torsion? what show2 correct answerUS: painful testicle is enlarged and hypeochoic as ocmpread to good side. can show absence of flow but this is alte finding torsion v. epididymitis correct answerusually associated with increased blood flow to the testicle and the epididymis, as part of the body's inflammatory response. torsion of testicular appendage -age of pop -where is pain -timeline of paiin -creamsteric reflex -us shows -tx -outcome correct answer-7-14yrs -upper pole of testicle -hrs-day -reflex is present -Body of testis similar to asymptomatic side with focal hypoechoic area -supportive -Infarction and resorption of appendage, no effect on fertility epididymis -timeline -2 sx -cremasteric reflex -exam shows -2 labs -US shows -tx -outcome correct answer-over days -fever, dysuria -present -Epididymal tenderness with or without testicular tenderness -wbc and nitrites -Body of testis similar to asymptomatic side with hypoechoic epididymis -abx -Possible scarring, possible impaired fertility definitive dx testicle torsion correct answerOR if delay in getting to OR what do correct answermanual detorsion (rotat eit way from midline at least 360) -know it owrked if dec pain within minutes how know twist right way correct answer-if hard to untwist, try twisting the other way when susepct trauma is cause of torsion correct answertesticular trauma who still has pain 1-2 hours after an injury. to US for torsion must correct answercompare side to side when managing torsion correct answerdo not delay OR trip to use US as torison is mostly a clinical dx 4 types of intracranial hemorrhages correct answer-epidural -subdural -subarachnoid -intracerebral sx of all intracrnial hemorrhages 4 correct answer-headache -N/v -altered -seizure who is at risk for big bleed even with minor trauma correct answer-old -alcohol -anticoagulated subarachnoid hemorrhage classic correct answer-thunderclap ha -reach max intensity within sec sah sx correct answer-loc -vomit -neck stiff sentinel ha correct answer-small headache=small bleed before a much larger bleed grading system for sah correct answerhunt and hess most common cause sah correct answersaccular aneurysms interestng risk factor for sah correct answerrecent exertion epidural hematoma patho correct answer-trauma causes fracture of temporal bone to rupture middlemeningeal artery classic story of epidural. but really correct answer-brief LOC after blow to head then lucid period than loc again -but most either dont hve loc or if they do, they dont get better subdural hematomas patho correct answerbridging eins are sheared during acceler-decel of head timeline of subdural/ esp what pop, why correct answer-can present late because the hematoma gros slow -esp delayed in those with brain atrophy bc there is more space in head for blood subdural in kid correct answerthink childabuse shaken baby syndrome 3 correct answer-subdural -retinal hemorrhages -long bone fractures chronic subdural in 2 pops? 2 reasons why correct answer-old and alcoolic bc most prone to atrophy and coaugloapthy cushings triad= correct answerhtn -brady -abnormal resp patterns signifcance of cushings correct answerphysiologic response to rapidly increasing intracranial pressure and imminent brain herniation colors of blood on ct by time correct answer-white if acute