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NBME 18 Answers

nbme18/Block 3/Question#22 (reveal difficulty score)
70 yo woman routine pelvic examination
Cystocele ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—sympathetikey(1600)
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A o,eytelscc aslo onwnk as a reldspapo badel,rd si a caimeld inocoindt ni ihchw a samn'ow areddbl eulgsb noit erh in.gvaa mSeo mya vaeh no tso.mspym erthO may evah bloeurt nittgsar tourn,niia rynuair itnnconin,cee or qufentre taiinnu.ro camoCpiilnost mya elncdiu tucrneerr rauriny tactr ictensfnoi nda iurayrn e.otenirtn

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cbreland  How would you rule out uterine prolapse? +
baja_blast  With a Uterine Prolapse you would see the uterus move down, into the vagina. With Cystocele you have the finding described in the question; bulge of anterior vaginal wall (which borders the bladder) into the vagina. Here's a pic to help illustrate: https://www.health.harvard.edu/media/content/images/cr/205345.jpg +5
mkayman  and just for completeness, rectocele would have a posterior vaginal wall bulge +2
mkayman  and just for completeness, rectocele would have a posterior vaginal wall bulge +



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