Comprehensive and Detailed Explanation:

Postmenopausal women with abdominal distension, bloating, a complex pelvic mass, and elevated CA-125 are highly suggestive of epithelial ovarian cancer, especially serous cystadenocarcinoma—the most common type.

Toronto Notes 2023 – Gynecology / Oncology:

“Serous epithelial ovarian carcinoma presents with vague abdominal symptoms, ascites, complex pelvic mass, and elevated CA-125.”

MCCQE1 Objectives (Gynecology > 82-5: Ovarian Masses):

“Candidates must recognize signs and investigations of ovarian cancer, including elevated tumor markers and imaging findings.”

Ovarian hyperstimulation (A) occurs in fertility treatments. Colorectal cancer (C) may mimic these symptoms but typically causes rectal bleeding and has lower CA-125 levels. Uterine adenocarcinoma (D) usually causes bleeding. Hematosalpinx (E) presents with pelvic pain, not ascites.

This infant has evidence of urinary outflow obstruction on ultrasound. The most common cause in male infants is posterior urethral valves. Poor urinary stream is a hallmark symptom of bladder outlet obstruction in neonates.

Toronto Notes 2023 – Pediatrics, “Pediatric Urology” Section:

“Posterior urethral valves should be suspected in male infants with recurrent UTIs, hydronephrosis, and a weak urinary stream. Diagnosis is confirmed by voiding cystourethrogram.”

MCCQE1 Objectives (Pediatrics > 78-4: Urinary Tract Abnormalities):

“Candidates must identify congenital causes of urinary obstruction. Poor stream and hydronephrosis are classic features of posterior urethral valves.”

Crying with urination (E) is nonspecific. Hematuria (B) and malodorous urine (D) are common with infections. Circumcision (A) is unrelated.

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The most important factor in determining the surveillance interval in Barrett esophagus is the presence and grade of dysplasia (e.g., none, low-grade, high-grade). High-grade dysplasia requires more frequent monitoring or intervention due to the risk of progression to esophageal adenocarcinoma.

Toronto Notes 2023 – Gastroenterology, Barrett Esophagus:

“Surveillance intervals depend on histologic findings. No dysplasia: q3–5 years; low-grade: q6–12 months; high-grade: consider endoscopic resection or ablation.”

MCCQE1 Objectives – Internal Medicine > Gastroenterology:

“Candidates must identify the risk of progression in Barrett esophagus and apply appropriate surveillance strategies based on dysplasia.”

Length of the segment (A) may influence risk but not surveillance frequency alone. Other options (B, C, E) are less determinative.

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