Exam Content

Level 2 Lifelong Learning - FPM-RS Subspecialty

The Life Long Learning Exam for FPM-RS Subspecialty Consists of:

Core Urology (45 Questions)

  • all applicants (including FPMS) with the exception of the Pediatric Urology Subspecialty applicants, will take the core exam - the core is included in Pediatric Urology exam
    • Approximately 30% of these questions will be taken from the past 5 years SASP
    • Approximately 20% of these questions will be taken from pertinent AUA guidelines and white papers

Subspecialty LLL

Topics that will be covered on the various modular exams including the core are listed below:

Core Urology - 37% of Exam

  1. Office Based Urology - 12% of exam
    1. Urinary Tract Infection: Cystitis, Prostatitis, Pyelonephritis
      1. Guidelines
      2. Dx, (Chemical Analysis), Rx
    2. Dx and Rx of sexually transmitted disease
    3. Microscopic hematuria -Guidelines
    4. Proteinuria – Dx and Evaluation
    5. LUTS -Guidelines
    6. When and how to use PSA screening
    7. Antibiotic prophylaxis - Guidelines
    8. DVT Prophylaxis
  2. Postoperative Complications & Trauma - 15% of exam
    1. Ureteroscopy complications
    2. ESWL complications
    3. TRUS prostate biopsy complications
    4. Traumatic Renal, bladder and urethral injuries;
      1. Dx and Triage
    5. Vesicovaginal- ureterovaginal fistula
      1. Dx and Triage
    6. Penile fracture: Dx and Triage
    7. Nerve injuries
      1. Positional nerve injuries
      2. Nerve injuries following surgery
        1. obturator, illioinguinal, femoral, etc
      3. Metabolic urgencies and emergencies
        1. Hyponatremia
        2. Myoglobinuria (positional)
        3. Postop Addisonian crisis, etc
  3. Imaging, radiation and patient safety - 10% of exam
    1. methods to reduce exposure of physician to radiation
    2. How to alter ultrasound techniques for better visibility
    3. Patient safety- outpatient concerns
      1. Sterilization of scopes etc.
      2. Dx and treatment of autonomic dysreflexia
    4. Opioid abuse

Female Pelvic Medicine - 63% of Exam

  1. Urinary Incontinence, urethral diverticulum, OAB, Painful bladder syndrome - 33% of exam
    1. Urinary Incontinence
      1. Evaluation: Hx, PE, UDS questions here
    2. Stress Incontinence
      1. Behavioral and functional treatment
      2. Surgical treatment ( bulking agents, mid urethral and pubovaginalis sling, retropubic coloposuspension)
      3. Complications of surgery including mesh complications and obstruction
    3. Urge Urinary Incontinence/OAB
      1. Behavioral management
      2. Pharmacological management
      3. Options for refractory UUI/OAB (OnabotulinumtoxinA, neuromodulation)
    4. Painful Bladder syndrome including interstitial cystitis
      1. Diagnosis & managment
    5. Urethral diverticulum
      1. Dx & management
    6. Urethral strictures
      1. Diagnosis & Management
    7. Artificial urinary sphincters
      1. Indications
      2. Placement and complications
  2. Pelvic Organ Prolapse, Pelvic Floor Physiology, Fecal Incontinence and Defecation Disorders - 15% of exam
    1. Pelvic Organ Prolapse
      1. Evaluation; History and physical, staging, radiologic evaluation
      2. Nonsurgical treatment
      3. Surgical treatment
    2. Pelvic Floor Physiology (No neural questions see below)
      1. Anatomy
        1. Normal
        2. Loss of support related to pelvic prolapse
      2. Function of urethral sphincter normal and with incontinence
      3. Influence of hormones on physiology
    3. Fecal Incontinence and Defecation Disorders
      1. Evaluation
      2. Nonsurgical treatment
      3. Surgical treatment
  3. Neurourology, Neural supply to bladder, Congenital Anomalies of UG tract affecting FPMS, Female Sexual Dysfunction - 15% of exam
    1. Neural innervation to bladder
      1. Normal
      2. Alterations related to specific disease process
    2. Neurogenic bladder (includes DM, Parkinson’s, MS, CP,SCI, CVA)
      1. Evaluation including UDS
      2. Pharmacotherapy
      3. Surgical intervention ( Botox for NGB Not OAB , Augments, urinary diversion)
        1. Indications for urinary augmentation and urinary diversion
      4. Complications of Bladder augmentations and urinary diversion
        1. Surgical complications, e.g. rupture of augment, stones, ureteroenteric strictures, stomal and mid loop stenosis
        2. Metabolic complications
      5. Congenital female abnormalities that could impact FPMS
        1. Dx
        2. Management
      6. Imperforate or duplicated vagina
        1. Dx
        2. Management
      7. Female sexual Dysfunction
        1. Dx
        2. Management
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