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MFSRH part 2 > surgical gynaecology > Flashcards

surgical gynaecology Flashcards

1
Q

What is the standard recommended size scope for outpatient hysteroscopy?

A

outpatient hysteroscopy should use a 2.7mm hysteroscope

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2
Q

Overall Risk of serious complication for abdominal hysterectomy for benign conditions?

A

According to the RCOG consent advice

Overall Risk serious complication for abdominal hysterectomy for benign conditions.

4%

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3
Q

Risk of Haemorrhage requiring blood transfusion for abdominal hysterectomy for benign conditions?

A

Haemorrhage requiring blood transfusion 2.3%

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4
Q

Risk of Bladder and/or ureter injury and/or long-term disturbance of bladder function for abdominal hysterectomy for benign conditions?

A

Bladder and/or ureter injury and/or long-term disturbance of bladder function

0.7%

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5
Q

Risk of Return to theatre (e.g. because of bleeding/wound dehiscence etc) for abdominal hysterectomy for benign conditions?

A

0.7%

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6
Q

Risk of VTE related to abdominal hysterectomy for benign conditions?

A

VTE 0.4%

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7
Q

Risk of Pelvic abscess/infection related to abdominal hysterectomy for benign conditions?

A

Pelvic abscess/infection: 0.2%

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8
Q

Risk of bowel injury related to abdominal hysterectomy for benign conditions?

A

Bowel injury: 0.04% (4 in 10 000)

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9
Q

Risk of death within 6 weeks of abdominal hysterectomy for benign conditions?

A

Risk of death within 6 weeks

0.03%

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10
Q

According to the RCOG advice on risk

What is the equivalent numerical ratio for the term ‘very common’

A

1/1 to 1/10

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11
Q

According to the RCOG advice on risk

What is the equivalent numerical ratio for the term ‘common’

A

1/10 to 1/100

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12
Q

According to the RCOG advice on risk

What is the equivalent numerical ratio for the term ‘uncommon’

A

1/100 to 1/1000

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13
Q

According to the RCOG advice on risk

What is the equivalent numerical ratio for the term ‘rare’

A

1/1000 to 1/10,000

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14
Q

According to the RCOG advice on risk

What is the equivalent numerical ratio for the term ‘very rare’

A

Less than 1 / 10,000

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15
Q

Post-operative foot drop is most commonly due to injury of which nerve?

A

foot drop is most commonly the result of common peroneal nerve injury
often due to compression of the nerve as it winds around the proximal fibula

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16
Q

incidence of vascular injury during laparoscopy according to the Green-top guidelines is?

A

0.1-0.2/1000

Major vessel injury is the most important potential complication at laparoscopy.

Bowel Injury is more common - 0.4/1000

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17
Q

incidence of bowel injury during laparoscopy according to the Green-top guidelines is?

A

0.4/1000

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18
Q

Overall incidence of serious complication during laparoscopy according to the Green-top guidelines is?

A

Overall risk of ‘serous complications’ is 2/1000

19
Q

Overall incidence of death related to laparoscopy according to the Green-top guidelines is?

A

Risk of death is 5 in 100,000

20
Q

Which nerves may be injured with abdominal incision and may cause pain to the groin

A

Iliohypogastric and Ilioinguinal nerves

iliohypogatsric injury - pain extends from incision laterally to the inguinal and suprapubic regions.

Ilioinguinal injury - hyperesthesia or hypoesthesia of the skin along the inguinal ligament. May radiate to lower abdomen. Pain may be localised to medial groin, labia majora and inner thigh

21
Q

What symptoms will injury to the femoral branch of the genitofemoral nerve cause?

A

hypoesthesia over anterior thigh below the inguinal ligament

22
Q

What is the maximum dose of lidocaine with adrenaline

A

maximum dose of lidocaine with adrenaline

7mg/kg

23
Q

What is the Max dose of

Lidocaine

A

Lidocaine Max dose is 3mg/kg

7mg/kg with adrenaline
1% lidocaine is 10mg/ml

24
Q

Mode of action of lidocaine

A

Lidocaine Blocks fast voltage gated sodium channels

25
Q

Half life of lidocaine

A

Lidocaine Half life

2 hours

26
Q

What is the route of metabolism of lidocaine?

A

Hepatic metabolism

27
Q

Overall incidence of significant complication during surgical evacuation of the uterus according to the Green-top guidelines is?

A

Surgical Evacuation of the Uterus
The overall significant complication rate
approx 6%

28
Q

incidence of bleeding requiring transfusion related to surgical evacuation of the uterus according to the Green-top guidelines is?

A

Bleeding necessitating transfusion

uncommon 0-3 in 1000

29
Q

incidence of infection related to surgical evacuation of the uterus according to the Green-top guidelines is?

A

Infection 4%

30
Q

incidence of retained placental or feral tissue related to surgical evacuation of the uterus according to the Green-top guidelines is?

A

Retained placental or fetal tissue 4%

31
Q

incidence of intrauterine adhesions related to surgical evacuation of the uterus according to the Green-top guidelines is?

A

19%

32
Q

incidence of uterine perforation related to surgical evacuation of the uterus according to the Green-top guidelines is?

A

Uterine perforation 1 in 1000

33
Q

incidence of Cervical trauma related to surgical evacuation of the uterus according to the Green-top guidelines is?

A

Cervical trauma <1 in 1000

34
Q

1% lidocaine is how many mg/ml

A

1% lidocaine is 10mg/ml

35
Q

Embolisation of which artery is considered by NICE as one of the 1st line surgical management options of HMB caused by fibroids?

A

Uterine

Uterine artery embolisation (UAE) is a treatment option for fibroids and adenomyosis

36
Q

What is the absorption time of monocryl sutures in days?

A

90-120 days

37
Q

What is the absorption time of Vicryl sutures in days?

A

60-90 days

38
Q

What is the absorption time of Vicryl Rapide sutures in days?

A

7-14 days

39
Q

What is the absorption time of PDS sutures in days?

A

180-210 days

40
Q

Complications of UAE

A

Complications are typically late (>30 days post procedure) and include

Vaginal discharge (16% at 12months)
Expulsion fibroid material (10%)
Endometritis (0.5%)
Amenorrhoea (age dependent <1% in women under 40 years old)
Change in sexual function (worse in 10%, improved in 26%, unchanged in most)

41
Q

Fir a diagnostic laparoscopy what is the appropriate pressure for gas insufflation prior to inserting the primary trocar?

A

20-25 mmHg

42
Q

For a diagnostic laparoscopy what is the appropriate distension pressure once the trocars have been inserted?

A

12 - 15 mmHg

43
Q

What are the reintervention rates for women undergoing UAE

A

1 in 3 by 5 years
For symptom recurrence or complication

significantly higher with UAE compared to surgery (only 4:100)

44
Q

What is Post-embolisation syndrome?

A

Post-embolisation syndrome - typically an early complication of UAE.

consists of pain, nausea, fever and malaise. +/- raised inflammatory markers and white cell count.

Usually self limiting and subsides within 10 - 14 days

MFSRH part 2 (24 decks)

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