Obstetrics and Gynecology Board Review Pearls of Wisdom

(Elliott) #1

254 Obstetrics and Gynecology Board Review •••


❍ Name two goals of surgery for endometriosis.
Restoration of normal anatomy and elimination of pelvic pain. Ninety percent of patients note some degree of
pain relief with surgery.


❍ Total abdominal hysterectomy-bilateral salpingo-oophorectomy has generally been considered an excellent
way to treat endometriosis definitively. If hormone replacement therapy is given, what is the expected rate of
recurrence of endometriosis?
8%.


❍ Endometriosis of the bladder has been reported in males. What treatment regimen are these men on?
High-dose estrogen for prostate cancer.


❍ Presacral neurectomy is advocated for treating what condition associated with endometriosis?
Dysmenorrhea; midline pain only (it is not a treatment for infertility).


❍ True or False: Provera at 30 mg/day was as effective as danazol in treatment of endometriosis.
True.


❍ The Gilliam suspension utilizes which anatomic structure of the uterus?
The round ligament.


❍ How would you diagnosis ovarian remnant syndrome?
Check an FSH.


❍ To prevent adhesions after conservative surgery for endometriosis, name two parameters that must be
satisfied.
(1) Impeccable hemostasis.
(2) Lack of tissue necrosis.


❍ What is intercede?
It is a physical barrier composed of oxidized regenerated cellulose.


❍ What is Seprafilm?
Sodium hyaluronate-carboxy methyl cellulose absorbable adhesion barrier.


❍ What medication causes the estradiol level to be <20 pg/mL?
Depo GnRH.


❍ Name a model that proposes a preexisting congenital or learned vulnerability that heightens the risk for
chronic pain.
The diathesis-stress model.

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