OB Surgeries Lecture Powerpoint

Question 1

A BMI over 40 puts a person at ASA level ___

Answer 1

III

Question 2

__% of gyn post op deaths are from pulmonary embolism

Answer 2

40%

Question 3

Clot in the calf is ___ common but ___ risk, in the thigh is ____ common but ___ risk

Answer 3

more, less, less, higher

Question 4

Does clean contaminated wounds need prophylactic antibiotics?

Answer 4

Yes, broad spectrum 1st gen cephalosporins first choice

Question 5

What type of incision is used most often in c section?

Answer 5

Transverse (iliac crest to liac crest)

Question 6

Maylard incision

Answer 6

Transverse incision that cuts the rectus muscles transversely to gain large exposure often for c section with large uterus

Question 7

Cherney Incision

Answer 7

Transverse incision that cuts the tendinous portion of the rectus muscle where it connects to the symphisis, less commonly used due to risk of osteomyelitis

Question 8

Pfannenstiel incision

Answer 8

Traverse incision that involves lateral retraction of the rectus muscles and midline** incision of the peritoneum, used for most c sections and abdominal hysterectomies

Question 9

Kustner incision

Answer 9

Traverse incision that involves lateral retraction of the rectus muscles and transverse*** incision of the peritoneum, used for most c sections and abdominal hysterectomies

Question 10

Diagnostic indications for DNC (4)

Answer 10

• abnormal bleeding
• oligomenorrhea or amenorrhea
• dysmenorrhea
• rule out endometrial disease and malignancy

Question 11

Therapeutic indications for DNC (4)

Answer 11

• menometrorrhagia (bleeding between periods)
• suspected intrauterine pathology
• postpartum bleeding and retained secundines
• retrieval of lost IUD

Question 12

Approaches to tubal sterilization (4)

Answer 12

-laparoscopy (bipolar electrocoagulation or some kind of banding or tying off the base)
-laparotomy (similar to a c section)
-colpotomy (removal thru the vagina)
-hysteroscopy
#1 contraception in women over 35

Question 13

Total hysterectomy definition

Answer 13

Uterus and cervix removal

Question 14

Partial hysterectomy definition

Answer 14

Uterus removed while retaining the cervix

Question 15

Total hysterectomy with bilateral salpingoophorectomy definition

Answer 15

Removal of the uterus, cervix, fallopian tubes, and ovaries

Question 16

Indications for hysterectomy (4)

Answer 16

• leiomyoma (most common if they cause pain or bleeding)
• endometriosis
• cancer
• adenomyosis (endometrial glands growing in muscle of the uterus itself, more rare and probably genetic but causes discomfort)

Question 17

1 approach for hysterectomy and why?

Answer 17

Vaginal (has less ileus as mostly extraperitnoeal, abdominal incision avoided, lower cost)

Question 18

Alternative for hysterectomy

Answer 18

Endometrial ablation (popular for menorrhagia or dysmenorrhea) inject liquid to uterus and heat it to near boiling to cook off the tissue

Question 19

Hysteroscopy

Answer 19

Used to analyze causes of potential pain or bleeding and remove polyps or other materials, done under anesthesia to avoid discomfort of uterine distension

Question 20

Surgical treatment for genital prolapse

Answer 20

Anterior colporrhapy (suturing it back in)

Question 21

Surgical treatment option for stress incontinence in women

Answer 21

Tension free vaginal tape (provides urethra support)