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Obstetric And Gynecology > FISTULA > Flashcards

FISTULA Flashcards

1
Q

Define a fistula and name two common types of fistulas in obstetrics.

A

A fistula is a communication between two epithelial surfaces. Common types are vesicovaginal fistula (VVF) and rectovaginal fistula (RVF).

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2
Q

Fill in the gap: A vesicovaginal fistula (VVF) leads to continuous leakage of _______ via the vagina.

A

Urine.

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3
Q

What distinguishes a rectovaginal fistula (RVF) from a VVF in terms of symptom presentation?

A

VVF leads to continuous urine leakage, whereas RVF involves intermittent passage of stool that can be controlled.

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4
Q

List three factors that affect the success of VVF repair.

A

Good nursing care, correct surgical technique, and surgeon experience.

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5
Q

Fill in the gap: Globally, there are _______ VVF patients awaiting surgical intervention.

A

2000000

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6
Q

What percentage of fistula cases are isolated VVFs?

A

0.85

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7
Q

Explain the role of pressure necrosis in the development of fistulas.

A

Pressure necrosis occurs when tissues are compressed for prolonged periods, leading to devitalization and eventual fistula formation.

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8
Q

Fill in the gap: Posterior pressure necrosis often affects the _______ compressed between the sacral promontory and the fetal presenting part.

A

Rectum.

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9
Q

Name two obstetric procedures that can result in fistula formation.

A

Forceps delivery and Caesarean section.

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10
Q

What role does radiation therapy play in the development of fistulas?

A

Radiation therapy, such as intracavity radium for cervical cancer, can cause tissue necrosis and fistula formation.

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11
Q

State two components of conservative management for early urinary fistula treatment.

A

In-dwelling catheterization and correcting anaemia.

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12
Q

Fill in the gap: Conservative management of fistulas includes maintaining an indwelling catheter for _______ weeks.

A

Six.

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13
Q

Name one benefit of early fistula management.

A

Improved local blood supply and better tissue planes.

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14
Q

Describe the clinical presentation of a patient with a VVF.

A

Total urinary incontinence.

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15
Q

Fill in the gap: In patients with fistulas, _______ nerve damage can cause foot drop.

A

Peroneal.

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16
Q

List three patient profile characteristics commonly associated with fistulas.

A

Poor socio-economic status, low education, obstructed labour.

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17
Q

What is the purpose of a digital vaginal examination in fistula assessment?

A

To assess the extent and location of the fistula.

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18
Q

Fill in the gap: _______ is used to assess haemoglobin levels in patients with fistulas.

A

Haemoglobin test.

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19
Q

What imaging study is used to rule out pulmonary tuberculosis in fistula patients?

A

Chest X-ray.

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20
Q

Explain the term “cup and saucer” in the context of fistula management.

A

Describes a specific appearance of a fistula seen during examination.

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21
Q

Fill in the gap: A small fistula is classified as less than _______ cm in size.

A

2 cm.

22
Q

How is a juxta-urethral fistula anatomically defined?

A

Located at the bladder neck and proximal urethra.

23
Q

Describe the Kees Waaldijk classification Type I fistula.

A

Does not involve the closing mechanism.

24
Q

What is the primary goal of preoperative treatment for fistulas?

A

To improve the patient’s general health and tissue quality.

25
Q

Fill in the gap: Iron supplementation aims to achieve haemoglobin levels of _______ gm/dl before surgery.

A

≥10.

26
Q

List two topical treatments for vulvar dermatitis in fistula patients.

A

Zinc or castor oil.

27
Q

Name the two types of anaesthesia commonly used in fistula repair.

A

Spinal and general.

28
Q

Fill in the gap: In fistula repair, the bladder defect is closed in _______ layers.

A

Two.

29
Q

Why might a graft or urinary diversion be required in fistula repair?

A

In complex or extensive fistula cases.

30
Q

State the duration for postoperative catheter drainage after fistula repair.

A

10–14 days.

31
Q

Fill in the gap: Postoperative urine output should be _______ liters per 24 hours.

A

2–3.

32
Q

What is the purpose of a bladder drill before catheter removal?

A

To prepare the bladder for normal function post-catheter.

33
Q

Name one instruction patients should follow after fistula repair.

A

No sexual activity for three months.

34
Q

What is the difference between high and low RVF?

A

High RVF is above the pelvic floor; low RVF is below it.

35
Q

Fill in the gap: Bowel preparation for RVF repair begins _______ days before surgery.

A

Three.

36
Q

What is the primary goal of liquid paraffin in RVF management?

A

To soften the stool.

37
Q

Describe one common postoperative complication of fistula repair.

A

Urinary infection.

38
Q

Fill in the gap: Prevention of fistulas includes efficient _______ care during labour.

A

Obstetrics.

39
Q

Why is surgical competence crucial in preventing fistulas?

A

To avoid preventable surgical injuries leading to fistulas.

40
Q

Explain why subsequent delivery via caesarean section is recommended after fistula repair.

A

To prevent strain on the repaired site.

41
Q

Name two methods for identifying prolonged labour to prevent fistula formation.

A

Monitoring uterine contractions and cervical dilation.

42
Q

Fill in the gap: Control of _______ with antibiotics is essential in fistula prevention.

A

Sepsis.

43
Q

What surgical technique is used to avoid tension in fistula repair?

A

Closing the fistula without tension.

44
Q

How is a high RVF surgically repaired?

A

Under anaesthesia with good lighting.

45
Q

Fill in the gap: The repair of RVF involves _______ preparation starting three days prior to surgery.

A

Bowel.

46
Q

What is the role of antibiotics in the management of RVFs?

A

To reduce infection risk.

47
Q

Explain the significance of light in RVF primary repair.

A

Ensures precision during the procedure.

48
Q

What dietary advice is given to a patient before RVF surgery?

A

Low-residue diet.

49
Q

Fill in the gap: The success of VVF repair depends on nursing, surgical technique, and _______.

A

Experience of the surgeon.

50
Q

List two reasons why patients with VVF might experience social challenges.

A

Social stigma and isolation.

Obstetric And Gynecology (27 decks)

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