AAGL EMIG STUDY GUIDE (OBGYN
AAGL EMIG COGNITIVE EXAM)
QUESTIONS WITH CORRECT
ANSWERS!!
,1 of 35
Term
A 43yo with AUB is undergoing TLH. The procedure is initiated by
insufflating the abdomen with CO2. The main advantage of CO2
as the insufflation gas is:
A. chemically unstable
B.excretion through respiration
C. flammable
D.low diffusion capacity
E. slow systemic absorption
Give this one a try later!
C. inject cervix with vasopressin
3.8 Hysteroscopy Fluid Absorption
Fluid absorption: surgical disruption of venous sinuses (usually during operative),
high intrauterine
pressure
- Decrease absorption by: using non conductive/isotonic if possible (i.e. NaCl),
monitor fluid
deficit, minimize IUP, limit operative time, pre-op GnRh agonist, intracervical
vasopressin (< 0.4
u/ml)
B. excretion through respiration
3.7 Use of CO2 in Laparoscopy
Ideal insufflation gas: low cost, non-flammable, colorless, easily excreted,
non-toxic
CO2: low cost, non-flammable, colorless, stable, high diffusion capacity,
rapid absorption and excretion
, via lungs
Risks: hypercapnia acidosis, cardiopulm complications (pulm
edema, tachyarrhythmias),
peritoneal irritation
C. Hysteroscopy D&C
1.3 Indications and contra indications to hysteroscopy
- Many indications...
- Contraindications: pregnancy, pelvic infection (including if active
vulvar infection),
cervical or uterine cancer, inadequate experience or equipment
- Pre op: pregnancy test and bimanual exam
B. expectant management
2.6 Functional Ovarian Cysts
Physiologic cysts related to ovulation, usually < 3 cm in diameter
- Follicular cysts: from ovarian follicle, thin walled and fluid filled, on US
unilocular, thin walled
and anechoic
- Corpus luteal cyst: thick walled and yellow, US internal echos, central lucency
and thickened
walls
Aspiration: 30% risk of recurrence
Don't know?
2 of 35
Term
After placement of RLQ trocar, brisk bleeding is noted from the
abdominal wall. The bleeding is likely the result of vascular injury to:
A. Common iliac artery
, B.External iliac artery
C. Inferior epigastric artery
D.Internal iliac artery
E.Superficial epigastric artery
Give this one a try later!
C. Hysteroscopy D&C
1.3 Indications and contra indications to hysteroscopy
- Many indications...
- Contraindications: pregnancy, pelvic infection (including if active
vulvar infection),
cervical or uterine cancer, inadequate experience or equipment
- Pre op: pregnancy test and bimanual exam
D. increase fluid outflow and suction
3.4 Poor visualization during hysteroscopy
Optimal visualization: procedure performed during early proliferative phase of
menstrual cycle, correct
equipment set up
Hematometrium: adjust outflow port (increase outflow), increase distension
pressure
C. Inferior epigastric artery
2.1 Abdominal and Pelvic Anatomy
- Inferior epigastric vessels: immediately medial to round ligament
- Medial umbilical ligament/obliterated umbilical artery: termination
of internal iliac artery, can be
used to help identify origin of uterine artery
AAGL EMIG COGNITIVE EXAM)
QUESTIONS WITH CORRECT
ANSWERS!!
,1 of 35
Term
A 43yo with AUB is undergoing TLH. The procedure is initiated by
insufflating the abdomen with CO2. The main advantage of CO2
as the insufflation gas is:
A. chemically unstable
B.excretion through respiration
C. flammable
D.low diffusion capacity
E. slow systemic absorption
Give this one a try later!
C. inject cervix with vasopressin
3.8 Hysteroscopy Fluid Absorption
Fluid absorption: surgical disruption of venous sinuses (usually during operative),
high intrauterine
pressure
- Decrease absorption by: using non conductive/isotonic if possible (i.e. NaCl),
monitor fluid
deficit, minimize IUP, limit operative time, pre-op GnRh agonist, intracervical
vasopressin (< 0.4
u/ml)
B. excretion through respiration
3.7 Use of CO2 in Laparoscopy
Ideal insufflation gas: low cost, non-flammable, colorless, easily excreted,
non-toxic
CO2: low cost, non-flammable, colorless, stable, high diffusion capacity,
rapid absorption and excretion
, via lungs
Risks: hypercapnia acidosis, cardiopulm complications (pulm
edema, tachyarrhythmias),
peritoneal irritation
C. Hysteroscopy D&C
1.3 Indications and contra indications to hysteroscopy
- Many indications...
- Contraindications: pregnancy, pelvic infection (including if active
vulvar infection),
cervical or uterine cancer, inadequate experience or equipment
- Pre op: pregnancy test and bimanual exam
B. expectant management
2.6 Functional Ovarian Cysts
Physiologic cysts related to ovulation, usually < 3 cm in diameter
- Follicular cysts: from ovarian follicle, thin walled and fluid filled, on US
unilocular, thin walled
and anechoic
- Corpus luteal cyst: thick walled and yellow, US internal echos, central lucency
and thickened
walls
Aspiration: 30% risk of recurrence
Don't know?
2 of 35
Term
After placement of RLQ trocar, brisk bleeding is noted from the
abdominal wall. The bleeding is likely the result of vascular injury to:
A. Common iliac artery
, B.External iliac artery
C. Inferior epigastric artery
D.Internal iliac artery
E.Superficial epigastric artery
Give this one a try later!
C. Hysteroscopy D&C
1.3 Indications and contra indications to hysteroscopy
- Many indications...
- Contraindications: pregnancy, pelvic infection (including if active
vulvar infection),
cervical or uterine cancer, inadequate experience or equipment
- Pre op: pregnancy test and bimanual exam
D. increase fluid outflow and suction
3.4 Poor visualization during hysteroscopy
Optimal visualization: procedure performed during early proliferative phase of
menstrual cycle, correct
equipment set up
Hematometrium: adjust outflow port (increase outflow), increase distension
pressure
C. Inferior epigastric artery
2.1 Abdominal and Pelvic Anatomy
- Inferior epigastric vessels: immediately medial to round ligament
- Medial umbilical ligament/obliterated umbilical artery: termination
of internal iliac artery, can be
used to help identify origin of uterine artery
