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Pelvic Organ Prolapse

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Which of the following are risk factors for the development of pelvic organ prolapse?

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a. Spina bifida

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b. Hypoestrogenism

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c. Prior hysterectomy

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d. All of the above

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Compared with selective use, elective episiotomy during the second stage of labor has been associated with all EXCEPT which of the following?

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a. Periurethral tears

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b. Anal sphincter laceration

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c. Increased postpartum pain

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d. Postpartum anal incontinence

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Which statement is true regarding measurements taken for the Pelvic Organ Prolapse Quantification (POP-Q) examination?

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a. All are taken at rest, except for total vaginal length, which is obtained during Valsalva.

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b. Point D is omitted in the absence of a cervix.

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c. GH is measured from the midline of the posterior hymenal ring to the mid-anal opening.

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d. Point Aa corresponds to the most distal portion of any part of the upper/proximal anterior vaginal wall.

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As shown in this image of vaginal prolapse, when the leading edge of bulge is approximately even with the plane of the hymen or within 1 cm distal to the hymen, a patient is said to have which stage of prolapse?

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Reproduced, with permission, from Buckley RG, Knoop KJ: Gynecologic and obstetric conditions. In Knoop KJ, Stack LB, Storrow AB, et al (eds): The Atlas of Emergency Medicine, 3rd ed. New York, McGraw-Hill, 2010, Figure 10-17.

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a. Stage I

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b. Stage II

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c. Stage III

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d. Stage IV

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Pelvic organ support is maintained in part by the levator ani muscle, which is composed of all EXCEPT which of the following?

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a. Puborectalis

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b. Iliococcygeus

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c. Pubococcygeus

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d. Obturator ...

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