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Principles2 > Gynecologic Surgery > Flashcards

Gynecologic Surgery Flashcards

1
Q

what are 4 common transvaginal procedures? (DC, CCB, H, H)

A
  1. dilate and curettage
  2. cervical cone biopsy
  3. hysteroscopy
  4. hysterectomy
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2
Q

what are 4 common perineal procedures? (LFoC, BCM, APR, V)

A
  1. laser fulguration of condyloma
  2. bartholin cyst marsupialization
  3. a/p repair
  4. vulvectomy
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3
Q

what are 6 common intra-abdominal procedures? (H,O,M,RE,S,C)

A
  1. hysterectomy
  2. oophorectomy
  3. myomectomy
  4. ruptured ectopic
  5. salpingectomy
  6. cystectomy
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4
Q

what is the one common transabdominal procedure? (L)

A

laparoscopy

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5
Q

what nerve can be injured with dissection in the retroperitoneum or paravaginal area? (O)

A

obturator nerve

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6
Q

surgical injury to the pelvic nerve plexus can cause what type of pain? (NP)

A

neuropathic pain

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7
Q

what 3 functions are diminished if the pelvic nerve plexus is injured? (S, V, E)

A

sexual, voiding, excretory

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8
Q

what nerve is most common injured in the lithotomy position?

A

common peroneal nerve

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9
Q

greater than how many hours in stirrups can cause ischemia?

A

4 hours

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10
Q

in the trendelenburg position, the displacement of the abd viscera pushes the diaphragm against the heart and increases or decreases BP and SV?

A

decreases

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11
Q

Category A, B, C, D or X:
Adequate and well-controlled
studies have failed to demonstrate a risk to the
fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

A

Category A

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12
Q

Category A, B, C, D or X:
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnancy women despite potential risks.

A

Category B

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13
Q

Category A, B, C, D or X:
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

A

Category C

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14
Q

Category A, B, C, D or X:
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

A

Category D

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15
Q

Category A, B, C, D or X:
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

A

Category X

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16
Q

What category are fentanyl, vecuronium, and succs in?

A

C

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17
Q

what category are ACE inhibitors and versed in?

A

D

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18
Q

what 3 medications are used to increase uterine tone? (P, M, P)

A

pitocin, methergine, prostaglandins

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19
Q

what to meds decreases hemorrhage postpartum and after abortion? (P, M)

A

pitocin, methergine

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20
Q

what med decreases bleeding during a cervical cone biopsy? (V)

A

vasopressin

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21
Q

where is vasopressin injected into?

A

the cervix

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22
Q

how many mg and what 2 routes is methergine given?

A

0.2 mg IM/PO

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23
Q

what are the 5 risks of pitocin? (UH, UR, H, RT, A)

A

uterine hyperactivity, uterine rupture, hypotension, reflex tachycardia, anaphylaxis

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24
Q

what are the 3 risks of vasopressin? (CV, STC, GISMS)

A

coronary vasospasms, ST changes, GI smooth muscle stimulation

25
Q

what are the 4 risks of methergine? (PV, H, S, S)

A

peripheral vasoconstriction, HTN, seizures, stroke

26
Q

what are the 2 abbreviations for prostaglandins?

A

PGE2 and PGF2

27
Q

what is the prostaglandin med? (C)

A

carboprost

28
Q

Prostaglandins are used to induce what in early pregnancy?

A

abortions

29
Q

what route is prostaglandins given?

A

intra-amniotic

30
Q

what are the 4 risks of prostaglandins? (NV, B, UT, H)

A

N/V, bronchospasm, uterine tetany, hypotension

31
Q

what dermatome level range is adequate for most intra-abdominal procedures?

A

T4-T6

32
Q

what type of anesthesia block for cervical procedures like D&C, cone bx and cysto-procto?

A

spinal

33
Q

what LA, what mg range and in what solution as a spinal for cervical procedures (D&C, cone bx, cysto-procto)?

A

0.75% Bupivacaine 10-15 mg in 7.5% dextrose

34
Q

what block name can be used for vulva procedures? (SB)

A

saddle block

35
Q

Saddle block:

  1. what part of the spinal cord?
  2. spinal or epidural?
  3. what type of solution?
A
  1. sacral
  2. spinal
  3. hyperbaric
36
Q

what are 3 procedures to correct urinary incontinence? (MMK, TFVT, PS)

A

marshall marchetti krantz, tension-free vaginal tape, pubovaginal sling

37
Q

what level block is needed for a cervix procedure (cone biopsies, LEEP)?

A

T10

38
Q

Are spinal blocks or epidural blocks used for elective procedures?

A

spinal blocks

39
Q

what nerve supplies sensory to the vagina? (P)

A

pudendal nerve

40
Q

Dilation and Curettage (D&C): what block level range is needed to block vaginal sensory and what block level is needed to block cervical dilation?

A

S2-4; T10

41
Q

During hysteroscopy, frequent and accurate irrigant absorbed recordings are needed. If greater than 200-300 mL of fluid is absorbed, what lab should be checked?

A

Na+

42
Q

what are 2 possible complications of a hysterectomy? (WI, VAE)

A

water intoxication, venous air embolism

43
Q

what block level is needed to deal with uterine tractions of a vaginal hysterectomy?

A

T6

44
Q

Tubal pregnancy surgery can result in what emergency? (H)

A

hemoperitoneum

45
Q

what organ does each chemo effect?

  1. adriamycin
  2. bleomycin
  3. cis-platinum
A
  1. heart
  2. lungs
  3. kidneys
46
Q

manys pts undergoing a tumor debulking may have a small bowel obstruction require what two types of intubation?

A

awake or RSI

47
Q

radical hysterectomy can lose up to how many liters of blood?

A

2L

48
Q

what gynecologic malignancies is the most lethal? (OC)

A

ovarian carcinoma

49
Q

what procedure involves an en bloc resection of all pelvic tissues including the uterus, cervix, vagina, bladder and rectum, and can be up to a 10 hour case? (PE)

A

pelvic exenteration

50
Q

what procedure uses a wire loop electrode to transmit electric current to cut away tissue?

A

loop electrosurgical excision procedure (LEEP)

51
Q

what position is used for robotic procedures?

A

steep trendelenburg

52
Q

what vent setting should you consider for pts in steep trendelenburg?

A

pressure control

53
Q

what are the 3 category C drugs? (F, V, S)

A

fentanyl, vecuronium, succs

54
Q

what are the 2 category D drugs? (A, V)

A

ace inhibitors, versed

55
Q

what are the 2 category X drugs? (T, P)

A

thalidomide, pitocin

56
Q

never give methergine IV d/t what risk? (RD)

A

retinal detachment

57
Q

what is the other name for vasopressin? (P)

A

pitressin

58
Q

how many units of vasopressin are injected into the cervix?

A

20 units

59
Q

how many units of pitocin are in a 1 liter bag of IVF?

A

20 units

Principles2 (21 decks)

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