A 33-year-old woman comes to the emergency department because of a 1-hour history of severe pelvic pain and nausea. She was diagnosed with a follicular cyst in the left ovary 3 months ago. The cyst was found incidentally during a fertility evaluation. A pelvic ultrasound with Doppler flow shows an enlarged, edematous left ovary with no blood flow. Laparoscopic evaluation shows necrosis of the left ovary, and a left oophorectomy is performed. During the procedure, blunt dissection of the left infundibulopelvic ligament is performed. Which of the following structures is most at risk of injury during this step of the surgery?
ABladder trigone
BUterine artery
CKidney
DUreter
A 67-year-old man comes to the physician because of a 3-month history of difficulty initiating urination. He wakes up at least 3–4 times at night to urinate. Digital rectal examination shows a symmetrically enlarged, nontender prostate with a rubbery consistency. Laboratory studies show a prostate-specific antigen level of 2.1 ng/mL (N < 4). Which of the following is the most likely underlying cause of this patient's symptoms?
ALymphocytic infiltration of anterior prostatic lobe stroma
BHyperplasia of lateral prostatic lobe tissue
CInfiltrating dysplasia of posterior prostatic lobe epithelium
DInfiltrating neoplasia of bladder urothelium
EHypertrophy of middle prostatic lobe tissue
A 56-year-old man comes to the clinic complaining of sexual dysfunction. He reports normal sexual function until 4 months ago when his relationship with his wife became stressful due to a death in the family. When asked about the details of his dysfunction, he claims that he is “able to get it up, but just can’t finish the job.” He denies any decrease in libido or erections, endorses morning erections, but an inability to ejaculate. He is an avid cyclist and exercises regularly. His past medical history includes depression and diabetes, for which he takes citalopram and metformin, respectively. A physical examination is unremarkable. What is the most likely explanation for this patient’s symptoms?
ATestosterone deficiency
BAutonomic neuropathy secondary to systemic disease
CPsychological stress
DDamage to the pudendal nerve
EMedication side effect
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