surgical gynaecology Flashcards

(44 cards)

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
Half life of lidocaine
Lidocaine Half life | 2 hours
26
What is the route of metabolism of lidocaine?
Hepatic metabolism
27
Overall incidence of significant complication during surgical evacuation of the uterus according to the Green-top guidelines is?
Surgical Evacuation of the Uterus The overall significant complication rate approx 6%
28
incidence of bleeding requiring transfusion related to surgical evacuation of the uterus according to the Green-top guidelines is?
Bleeding necessitating transfusion | uncommon 0-3 in 1000
29
incidence of infection related to surgical evacuation of the uterus according to the Green-top guidelines is?
Infection 4%
30
incidence of retained placental or feral tissue related to surgical evacuation of the uterus according to the Green-top guidelines is?
Retained placental or fetal tissue 4%
31
incidence of intrauterine adhesions related to surgical evacuation of the uterus according to the Green-top guidelines is?
19%
32
incidence of uterine perforation related to surgical evacuation of the uterus according to the Green-top guidelines is?
Uterine perforation 1 in 1000
33
incidence of Cervical trauma related to surgical evacuation of the uterus according to the Green-top guidelines is?
Cervical trauma <1 in 1000
34
1% lidocaine is how many mg/ml
1% lidocaine is 10mg/ml
35
Embolisation of which artery is considered by NICE as one of the 1st line surgical management options of HMB caused by fibroids?
Uterine Uterine artery embolisation (UAE) is a treatment option for fibroids and adenomyosis
36
What is the absorption time of monocryl sutures in days?
90-120 days
37
What is the absorption time of Vicryl sutures in days?
60-90 days
38
What is the absorption time of Vicryl Rapide sutures in days?
7-14 days
39
What is the absorption time of PDS sutures in days?
180-210 days
40
Complications of UAE
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
Fir a diagnostic laparoscopy what is the appropriate pressure for gas insufflation prior to inserting the primary trocar?
20-25 mmHg
42
For a diagnostic laparoscopy what is the appropriate distension pressure once the trocars have been inserted?
12 - 15 mmHg
43
What are the reintervention rates for women undergoing UAE
1 in 3 by 5 years For symptom recurrence or complication significantly higher with UAE compared to surgery (only 4:100)
44
What is Post-embolisation syndrome?
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