Saem m4 Curriculum 2 Midterm Exam
Questions With All Correct
Answers(2025)Updated.
PID cause - Answer originates as a cervical infection with Neisseria gonorrhea and/or
Chlamydia trachomatis, and becomes polymicrobial as it ascends into the uterus, fallopian tubes
and ovaries.
3 sx PID - Answer -lower abd pain
-purulent vag d/c
-vag bleed
when getPID sx - Answer Symptoms 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 - Answer more likely to appear toxic (fever, N/V)
dont forget one risk factor pid - Answer -recent instrumentation of uterus
common exam findings pid - Answer -b/l adenexal tenderness
-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
if pain is u/l think more - Answer TOA
if RUQ tender think - Answer Fitz-Hugh Curtis (perihepatitis, inflamation of liver capsule)
best test for gonorrohea and chlaymida - Answer NAAT with PCR or DNA probes (either urine
or cervical secretions)
,ovarian torsion shows - Answer absence of blood flow to one ovary on pelvic ultrasound with
doppler
why US>CT - Answer CT cannot eval for torsion bc there is no doppler
who gets abx for PID - 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 - Answer -chronic pelvic pain
-infertility
-ectopic
-toa
-fitz-hiugh curtis
toa process - Answer walled-off abscess that originates in the infected fallopian tube and
extends to involve the ovary
how confirm dx of Fitz hugh curtis - Answer elevated liver fxn tests
inpatient abx pid - Answer -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
outpatient abx pid? add _____ if 2 - Answer -ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
who getsa dmitted - Answer -toa
-fitz hugh curtis
,-pregnant
d/c with PID need what testing - Answer test for other STD
describe whats going on in ovarian torsion - Answer ovary, and often the fallopian tube as well
(adnexal torsion) become twisted around their vascular pedicle.
progression of torsion - Answer twisting 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 - Answer ovary with a mass or cyst is more prone to twisting by virtue
of its asymmetry
classic present torsion - Answer sudden 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 - Answer several episodes of pain over the course of hours, days, or even
weeks,
why does current pregnancy inc risk of torsion - Answer corpus lutem cyst on ovary
tests for torsion - Answer There are no laboratory tests which are helpful in establishing the
diagnosis of adnexal torsion
best way to dx torsion - Answer US
careful with US: - Answer important to note that the presence of Doppler blood flow does not
exclude the diagnosis of torsion
signs of torsion on US - Answer -enlargement/edema of ovary
-ovrian mass or cyst
-free pelvic fluid
, -deviation of uterus to the affected side
definitively dx torsion - Answer OR
tx torsion - Answer or (try and salvage ovary but testicle just gets removed)
torsion sotry often sounds like - Answer kidney story
testicular torsion is - Answer twisting 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 - Answer anchored 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 - Answer When 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 - Answer 1st year of life and in puberty
hx of testicular torsion - Answer airly sudden, severe unilateral testicular pain, sometimes
radiating into the abdomen, associated with nausea and vomiting
-may have urgency, freuqency, dysuria
which testicle most common - Answer left
weird cause of torsion - Answer trauma
exam - Answer -testicle is tender and swollen
-sits higher in sac
-sits in transverse lie
Questions With All Correct
Answers(2025)Updated.
PID cause - Answer originates as a cervical infection with Neisseria gonorrhea and/or
Chlamydia trachomatis, and becomes polymicrobial as it ascends into the uterus, fallopian tubes
and ovaries.
3 sx PID - Answer -lower abd pain
-purulent vag d/c
-vag bleed
when getPID sx - Answer Symptoms 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 - Answer more likely to appear toxic (fever, N/V)
dont forget one risk factor pid - Answer -recent instrumentation of uterus
common exam findings pid - Answer -b/l adenexal tenderness
-cervical d/c
cervical motion tenderness
-uterine tender
-lower abd tenderness
if pain is u/l think more - Answer TOA
if RUQ tender think - Answer Fitz-Hugh Curtis (perihepatitis, inflamation of liver capsule)
best test for gonorrohea and chlaymida - Answer NAAT with PCR or DNA probes (either urine
or cervical secretions)
,ovarian torsion shows - Answer absence of blood flow to one ovary on pelvic ultrasound with
doppler
why US>CT - Answer CT cannot eval for torsion bc there is no doppler
who gets abx for PID - 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 - Answer -chronic pelvic pain
-infertility
-ectopic
-toa
-fitz-hiugh curtis
toa process - Answer walled-off abscess that originates in the infected fallopian tube and
extends to involve the ovary
how confirm dx of Fitz hugh curtis - Answer elevated liver fxn tests
inpatient abx pid - Answer -cefoxitin + doxy
or
-cefotentan + doxy
or
clinda+gentamycin
outpatient abx pid? add _____ if 2 - Answer -ceftriaxone
-doxy
-add metro if severe infection or hx of uterine instrumentation
who getsa dmitted - Answer -toa
-fitz hugh curtis
,-pregnant
d/c with PID need what testing - Answer test for other STD
describe whats going on in ovarian torsion - Answer ovary, and often the fallopian tube as well
(adnexal torsion) become twisted around their vascular pedicle.
progression of torsion - Answer twisting 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 - Answer ovary with a mass or cyst is more prone to twisting by virtue
of its asymmetry
classic present torsion - Answer sudden 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 - Answer several episodes of pain over the course of hours, days, or even
weeks,
why does current pregnancy inc risk of torsion - Answer corpus lutem cyst on ovary
tests for torsion - Answer There are no laboratory tests which are helpful in establishing the
diagnosis of adnexal torsion
best way to dx torsion - Answer US
careful with US: - Answer important to note that the presence of Doppler blood flow does not
exclude the diagnosis of torsion
signs of torsion on US - Answer -enlargement/edema of ovary
-ovrian mass or cyst
-free pelvic fluid
, -deviation of uterus to the affected side
definitively dx torsion - Answer OR
tx torsion - Answer or (try and salvage ovary but testicle just gets removed)
torsion sotry often sounds like - Answer kidney story
testicular torsion is - Answer twisting 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 - Answer anchored 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 - Answer When 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 - Answer 1st year of life and in puberty
hx of testicular torsion - Answer airly sudden, severe unilateral testicular pain, sometimes
radiating into the abdomen, associated with nausea and vomiting
-may have urgency, freuqency, dysuria
which testicle most common - Answer left
weird cause of torsion - Answer trauma
exam - Answer -testicle is tender and swollen
-sits higher in sac
-sits in transverse lie
