358 Obstetrics and Gynecology Board Review •••
❍ After intravascular fluid equilibration, what change in hematocrit usually corresponds to a blood loss of
500 mL?
Usually a reduction in the hematocrit of 3% to 5%.
❍ What is the mechanism whereby hypogastric artery ligation helps in pelvic hemorrhage?
Decrease in the pulse pressure, allowing a stable clot to form over the injured pelvic vessels.
❍ What flow of blood is required to visualize a bleeding vessel for angiographic embolization?
At least 1 mL per minute.
❍ Which artery is most likely to be injured in performing a transverse muscle cutting incision
(Maylard incision)?
The inferior epigastric artery.
❍ Gynecologic procedures that carry a significant risk of postoperative infection include?
Vaginal hysterectomy, abdominal hysterectomy, surgical treatment of pelvic abscess, pregnancy termination, or
radical surgery of gynecologic cancers.
❍ Factors that place patients at risk of post hysterectomy infection include?
Low socioeconomic class, duration of surgery >2 hours, presence of malignancy, and increased number of surgical
procedures performed.
❍ A UTI is defined as?
Growth of > 105 organisms/mL of urine.
❍ Most UTIs are caused by the growth of which bacteria?
E. coli, Klebsiella, Proteus, Enterobacter, and Staphylococcus.
❍ Symptoms of a wound infection most commonly occur after what postoperative day?
Fourth.
❍ Standard therapy for intra-abdominal abscess?
Surgical evacuation or drainage by interventional radiology combined with administration of intravenous
broad-spectrum antibiotics.
❍ The organisms most likely to cause postabortive endometritis include?
Neisseria gonorrheae, Chlamydia trachomatis, and Streptococcus agalactiae.
❍ What type of fascial closure technique has been shown to result in the lowest incidence of wound dehiscence
and hernia formation?
A loosely approximated mass closure using a slowly absorbable monofilament suture with a suture: wound length
ratio of at least 4:1 (achieved by placing suture 1.5 cm from fascial edge with 1 cm between each placement).