Committee Opinion: Microscopic Hematuria
Andy's Cautionary Tale
CREOG nights
fun in the sun
100
Does RBC on a urine dipstick indicate microscopic hematuria?
No, must order a microscopic U/A
100
What is the max volume deficit for hypotonic solutions like glycine or sorbitol during hysteroscopy?
1000mL
100
What is considered the first step for treatment of fecal incontinence?
Loperamide with lifestyle modification
100
The resident golf outing was last week! What was the OB/GYNs team estimated score for the day?
90
200
List 3 risk factors for urinary tract malignancy
male, older , past or current smoker, gross hematuria, history of pelvic irradiation
200
What is the max volume deficit for isotonic solutions like normal saline during hysteroscopy?
2500mL
200
Name 2 complications of botox injections for urinary incontinence
UTI and urinary retention
200
What is Matt's favorite hospital condiment for his chicken and fries?
Ketchup and Mayonnaise mixed together :(
300
Name 3 exclusively female conditions that can lead to urine contamination
menstruation, urogenital tract atrophy, pelvic organ prolapse
300
When considering pressure to fill the uterus during a hysteroscopy, what does the pressure used depend on?
Mean Arterial Pressure
normal pressures used are between 80-100
300
What is the best recommendation for patients who are still in child bearing years with desire to become pregnant again that are still experiencing urinary incontinence after lifestyle modifications and Pelvic floor therapy?
Pessaries
300
According to journal club last night, what is Dr. Taylor's opinion and rating of the article "Maternal and Neonatal Outcomes in Nulliparous Participants Undergoing Labor Induction by Cervical Ripening Method"?
"It made me sad- 3 out of 5 golden uteruses"
400
What is the proposed work up after a patient meets criteria for asymptomatic microscopic hematuria with unknown cause?
Cystoscopy and multiphasic CT urography with and without contrast
400
What are 2 physical exam findings that a patient may demonstrate if they are experiencing volume overload in the OR?
Parotid Swelling and Subconjunctival edema
400
If a patient has a rectovaginal fistula, what is the chance of closure if size is <4mm without intervention?
40% chance, >5mm typically requires surgical reconstruction
400
NAME THIS BABY RESIDENT
THE ONE AND ONLY DR. DEVYN COPE
500
What is the current recommendation by AUGS for when low-risk, asymptomatic never smoking women between the ages of 35-50 should be provided further evaluation?
>25 RBCs per high field on microscopy
500
Name 3 risk factors for increased systemic fluid absorption.
or list 2 along with the recommended time frame for checking fluid deficit
- High intrauterine distention pressure
- Low mean arterial pressure
- Deep myometrial penetration- deeper penetration means fluids can be rapidly absorbed through venous sinuses
- Large uterine cavities increase likelihood of systemic fluid absorption.
Check fluid deficit every 10 minutes
500
What is the definitive surgical management with highest success rate and shortest recovery time for Urinary incontinence? and what is the cure rate?
mid-urethral sling (90+% cure rate)
500
Melissa's husband (Dr. Brad Yannetti) is currently on colorectal surgery. What did his patient use to trim their own rectal prolapse?
Garden Shears