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ABOG written boards > GYN > Flashcards

GYN Flashcards

1
Q

Hypotonic media fluid deficit for hysteroscopy

A

1000 mL

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2
Q

Redating GA via US <9w

A

> 5d

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3
Q

Redating GA via US 9w to <16w

A

> 7d

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4
Q

Redating GA via US 16w to <22w

A

> 10d

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5
Q

Redating GA via US 22w to <28w

A

> 14d

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6
Q

Redating GA via US 28w +

A

> 21d

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7
Q

Septic abortion treatment

A

Amp/gent/clinda
Covers gram positives, resistant gram neg aerobes, gram neg anaerobes

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8
Q

Ovarian torsion risk factors

A

Ovarian mass >5 cm
Reproductive age
Pregnancy, ovulation induction
- progesterone supplementation needed until 10w if corpus luteum removed
Adolescents with normal ovaries (46% of cases)
2-12% risk of recurrence

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9
Q

Ovarian torsion ultrasound findings

A

Edematous ovary (sn 86%, sp 18%)
Heterogeneous appearing (sn 85%, sp 18%)
Peripheral follicles, abnormal location
Decreased doppler flow (sn 85%, sp 37%)
Whirlpool sign of ovarian vessels

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10
Q

Perioperative medication management

A

Continue: beta blockers, statins, SSRIs, corticosteroids, thyroid hormone
Discontinue: diuretics, ARBs, ACE-I, oral anticoagulation, NSAIDs, herbal supplements
Adjust dosing: insulin
Individualize: aspirin, clopidogrel

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11
Q

Femoral triangle borders

A

Inguinal ligament
Adductor longus (medial)
Sartorius (lateral)
Contains femoral n/a/v (lateral to medial)

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12
Q

Endometrial ablation relative contraindications

A

Increased risk of endometrial CA (anovulation, obesity, tamoxifen, Lynch)
Postmenopausal
Patient desires amenorrhea
Myometrial thinning after uterine surgery
Uterine anomalies

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13
Q

Chronic pelvic pain definition, prevalence

A

Pain lasting 6+ months
6-25% of reproductive aged women

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14
Q

Features of partial mole

A

69 XXX/XXY
small for dates
hCG <100k
GTN rate 1-5%
Fetal parts present, focal villous edema
+p57 (trophoblast atypia)

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15
Q

Features of complete mole

A

46 XX
large for dates
Theca-lutein cysts up to 30%
hCG >100k
GTN rate 15-20%
absent fetal parts, widespread villous edema
negative p57 stain

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16
Q

Adnexal mass findings suspicious for malignancy

A

Multilocular
Papillary excrescences
Solid components
Ascites
Doppler flow

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17
Q

MTX relative contraindications

A

Cardiac activity
High initial hCG (>5k)
Ectopic >4 cm
Declines blood products

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18
Q

Pre-op labs for htn, diabetes

A

HTN: BUN/creatinine, + electrolytes if on ACE/ARB/diuretics
DM: serum glucose

19
Q

Common peroneal nerve injury finding

A

Footdrop
Caused by incorrect positioning/stirrups
L4-S2
Lateral calf, dorsum foot

20
Q

Femoral nerve injury finding

A

Can’t climb stairs, anteromedial thigh numbness
L2-4, quadriceps muscle

21
Q

Obturator nerve injury finding

A

Inability to adduct
L2-4, adductor longus
Superomedial thigh

22
Q

Genitofemoral nerve injury finding

A

Loss of sensation at vulva/labia majora, anterior superior thigh (or burning)
L1-2, retractor compression

23
Q

Cell salvage contraindications

A

Absolute:
- hypotonic fluids (rbc hemolysis), toxic solutions (antibiotics, iodine, alcohol)
- contamination with hemostatic agents or bone cement

Relative:
- Bacterial infection of wound, active malignancy in surgical field

24
Q

Ilioinguinal nerve injury

A

Inferior abdominal wall, labia majora, mons

25
Q

Iliohypogastric nerve injury

A

Inferior abdominal wall, superolateral gluteal

26
Q

Tibial nerve injury

A

Plantar surface of foot

27
Q

Dermoid cyst characteristics

A
  • Hyperechoic lines (dermoid mesh)
  • Rokitansky protuberance
  • Solid components with shadowing in background, ie. hair, aka “tip of the iceberg”
  • Points - solid components causing hyperechoic points
28
Q

Indirect inguinal hernia

A

Most common
Internal inguinal ring (where round ligament/vas deferens exits abdomen); borders include transversalis fascia and inferior epigastric vessels

29
Q

Direct inguinal hernia

A

More common in men
Hesselbach triangle; borders include inferior epigastric vessels (laterally), inguinal ligament, rectus fascia

30
Q

Perineal body components

A

Superficial transverse perineal
Bulbospongiosus
External anal sphincter

31
Q

Bladder injury management

A
  • <2mm: expectant management
  • 2mm-1cm: expectant or 1-2 layer closure with absorbable suture, foley in place 5=7d
  • > 1 cm: 1-2 layer repair
  • > 3 cm: 2 layers of delayed absorbable suture, foley in 5-14d
32
Q

Lidocaine max doses

A

Without epi: 4mg/kg
With epi: 7mg/kg

33
Q

Lidocaine toxicity

A

Oral: metallic taste, circumoral numbness, tongue paresthesias
CNS: change in alertness/restlessness, seizures, tinnitus

34
Q

Bowel injury management

A

Superficial sharp/thermal injury: primary oversewing
Partial thickness seromuscular: single layer closure
Full thickness <1 cm: double layer closure
Full thickness >1 cm: primary repair or resection
Large delayed thermal injury: resection, drain, consider diverting ostomy

35
Q

Surgicel

A

Oxidized regenerated cellulose
Plant derived
Activates extrinsic coagulation pathway/platelet aggregation

36
Q

Arista

A

aka Microporous polysaccharide hemospheres
Absorbs water, concentrates platelets and blood proteins
Plant derived
Only agent approved for arterial bleeding

37
Q

Gelfoam/surgifoam

A

aka Gelatin matrix
Absorbs blood and fluid> mechanical hemostasis and matrix for clot formation
Porcine derived

38
Q

Floseal/surgiflo

A

aka Thrombin
Bovine/human/recombinant derived
Converts fibrinogen to fibrin

39
Q

Postoperative fever days 1-2

A

Wind
Pneumonia, aspiration, atelectasis if <24h

40
Q

Postoperative fever days 3-5

A

Water
UTI

41
Q

Postoperative fever days 4-6

A

Walking
DVT or PE

42
Q

Postoperative days 5-7

A

Wound
Surgical site infection

43
Q

Postoperative day 7+

A

Wonder drugs
Drug fever

44
Q

Pelvic ureter injury management

A

Within 6 cm of bladder - ureteroneocystostomy preferred
- with or without psoas hitch, consider boari flap

ABOG written boards (5 decks)

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