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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 cystocele, also known as a prolapsed bladder, is a medical condition in which a woman's bladder bulges into her vagina. Some may have no symptoms. Other may have trouble starting urination, urinary incontinence, or frequent urination. Complications may include recurrent urinary tract infections and urinary retention.

https://en.wikipedia.org/wiki/Cystocele

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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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