.
- 1.
What is the overall complication rate for gynaecologic laparoscopic surgery?
- a)
0.6%
- b)
1.2%
- c)
1.6%
- d)
2%
- e)
2.4%
- a)
- 2.
What is the average distance between Palmer’s point and the aorta?
- a)
6 cm
- b)
8 cm
- c)
10 cm
- d)
12 cm
- e)
14 cm
- a)
- 3.
What is the most effective test described to verify correct Veress needle intraperitoneal placement?
- a)
Initial gas pressures less than 10 mmHg
- b)
Double click
- c)
Two or more passes of the Veress needle
- d)
Hanging drop test
- e)
A “free” feel to the end of the Veress needle
- a)
- 4.
Laparoscopy can be used to perform which of the following Gyn-Oncology Surgeries?
- a)
Pelvic Lymphadenectomy
- b)
Para-aortic Lymphadenectomy
- c)
Inguinal Lymphadenectomy
- d)
Radical Hysterectomy
- e)
Radical Trachelectomy
- a)
- 5.
Laparoscopy has similar complication rates when compared to open surgery for which of the following parameters?
- a)
Ureteric Injury
- b)
Bladder Injury
- c)
Bowel Injury
- d)
Nerve Injury
- e)
Blood loss
- a)
- 6.
Laparoscopy is likely to benefit from which of the following technical advances?
- a)
3D-Vision systems
- b)
4K-Vision systems
- c)
Slow Motion Replay Option
- d)
Advanced Harmonic Energy Sources
- e)
Smoke-Evacuation
- a)
- 7.
Typical complications of radical laparoscopic hysterectomy include which of the following?
- a)
Atonic bladder
- b)
Ureterovaginal Fistula
- c)
Pelvic Lymphocele
- d)
Rectal Atony
- e)
Compartment Syndrome
- a)
- 8.
Which of the following statements about surgical preoperative planning in patients with severe endometriosis with possible bowel involvement is/are true?
- a)
In patients where periumbilical adhesions are suspected, it is better to use the Veress needle to achieve pneumoperitoneum in order to minimize entry complications.
- b)
When an intestinal opening is observed the surgeon should perform the suture side-to-side.
- c)
Mechanical bowel preparation to all patients preoperatively decreases complications in segmental resection.
- d)
The occurrence of pseudomembranous colitis is an adverse effect related to the use of surgical prophylactic antibiotics
- e)
Prophylactic antibiotic use in colorectal surgery reduces surgical site infections
- a)
- 9.
Which of the following is/are true about bowel resection techniques?
- a)
The shaving technique should be performed in patients who do not wish to become pregnant, since pregnancy rates are lower compared to alternative techniques.
- b)
Double circular stapler technique (DCS) allows lesions up to 5 cm to be excised and is associated with less complications compared with segmental resection.
- c)
Anastomosis tension is a risk factor for dehiscence and mobilization of the splenic flexure may be necessary to minimize it.
- d)
Use of small diameter circular staplers is preferred for intestinal anastomosis after segmental resection.
- e)
Segmental bowel resection has the same complication rates as conservative surgical procedures.
- a)
- 10.
Which of the following is/are true about bowel endometriosis surgery?
- a)
The use of drains should be encouraged postoperatively as it can detect anastomosis leakage at an earlier stage.
- b)
There is no reliable method to evaluate intraoperative bowel anastomosis integrity.
- c)
In patients with bowel endometriosis lesions lower than 5 cm from the anal verge intestinal diversion is recommended after segmental resection.
- d)
A colostomy should be preferred over ileostomy when intestinal diversion is needed because it is associated with less complications.
- e)
In long procedures with the need for blood transfusion, the risk of anastomotic dehiscence increases.
- a)
- 11.
Which of the following statements about the postoperative period after bowel resection is/are true?
- a)
Oxygen supplementation should be used routinely after surgery.
- b)
Excessive hydration in the perioperative period is potentially associated with anastomosis complications.
- c)
Imaging tests have excellent performance for early diagnosis of intestinal dehiscence.
- d)
The use of C-reactive protein in the postoperative period may be useful for early detection of complications.
- e)
The adoption of fast track protocols after surgery reduces the length of hospital stay and morbidity.
- a)
- 12.
Which of the following is/are true in relation to medical worldwide health costs?
- a)
The expenditure for health care in Switzerland rose from 8.8 % of gross domestic product (GDP) in 1995 up to 10.9 % of the GPD in 2013.
- b)
In the USA, the mean in-hospital cost of all patients without complications was US$10000.
- c)
The occurrence of a Clavien-Dindo grade I complications creates significant additional costs of US$2793
- d)
Costs for health care in Switzerland in 2013 were about US$10 billion
- e)
10 percent of Switzerland’s total health care costs were generated by surgical departments.
- a)
- 13.
Results from the Norwegian Gynaecologic Endoscopic Register indicate which of the following?
- a)
The average intraoperative complication rate for hysteroscopy is 3.7%
- b)
The average intraoperative complication rate for laparoscopy is 2.8%
- c)
The highest incidence of postoperative complication is haemorrhage.
- d)
Diabetes Mellitus is shown to be a risk factor for postoperative detected organ damage.
- e)
Intraoperative complications significantly increase the incidence of postoperative complications.
- a)
- 14.
Further results from the Norwegian Gynaecologic Endoscopic Register regarding intraoperative complications include which of the following?
- a)
The most common complication is intraabdominal bowel injury.
- b)
The second most common complication is bladder injury (0.17%).
- c)
The most common intraoperative hysteroscopic complication is perforation of the uterus (1.79%).
- d)
The second most common postoperative hysteroscopic complication is organ damage.
- e)
The incidence of infection post-hysteroscopy is < 2%
- a)
- 15.
The following is/are true regarding Operative Registers?
- a)
There is a role for Operative Registers to survey complications
- b)
There is a role for Operative Registers to survey patient health care
- c)
Experiences from the NGER can be transferred during the establishment of other regional registers.
- d)
Obesity is a contraindication to laparoscopy as found in the register
- e)
Complications caused by equipment was a common incident found in the register
- a)
- 16.
The recent classification of the Federation International of Gynecology and Obstetrics (FIGO) identified types of fibroids as they are defined in terms of:
- a)
Their relationship with the cervix
- b)
Their relationship with each other
- c)
Their size
- d)
Their relationship with the endometrium
- e)
Their relationship with the uterine serosa
- a)
- 17.
VizAblate System ® is a new device for the treatment of symptomatic myomas which allows which of the following?
- a)
Removal of myomas under direct hysteroscopic visualization
- b)
Transcervical fibroid thermal ablation
- c)
Imaging under real-time sonography
- d)
Laparoscopic fibroid thermal ablation under laparoscopic ultrasound
- e)
Fibroid morcellation during operative hysteroscopy
- a)
- 18.
Barbed suture is a monofilament suture with tiny barbs cut into the length of the suture. In comparison to a conventional suture it has which of the following?
- a)
It maintains tension of the suture line during suturing
- b)
It facilitates laparoscopic suturing
- c)
It reduces blood loss during myomectomy
- d)
It approximates the tissue without the need for a surgical knot
- e)
It is absorbable in 10 days
- a)
- 19.
Morcellated surgical specimens can be removed via which of the following?
- a)
Vagina
- b)
Posterior Cul-de-sac
- c)
Mini-laparotomy
- d)
Cervix
- e)
Trans-rectal
- a)
- 20.
According to recommendations by the FDA, laparoscopic morcellation should be contraindicated in which of the following?
- a)
Peri-menopausal women
- b)
Post-menopausal women
- c)
Young women with fibroids greater than 6 cm
- d)
Women with fibroids suspicious for malignancy
- e)
Women with specimens that are candidates for en-bloc removal
- a)
- 21.
According to data collected by the MAUDE and MDR databases, the most common location of morcellation injuries is which of the following?
- a)
Bowel
- b)
Vascular
- c)
Bladder
- d)
Abdominal wall
- e)
Ureter
- a)
- 22.
Which of the following statements best describes resident attitudes when they finish their obstetrics and gynecology training program?
- a)
They are generally confident in performing all complex minimally invasive surgery
- b)
They have an opportunity to perform more surgeries than their predecessors
- c)
They have decreased work hours to learn the required materials
- d)
They are uniformly accessing standardized simulation curricula to hone their skills.
- e)
They do not consider further training to become more proficient surgeons.
- a)
- 23.
Which of the following statements best describes the role of surgical simulation in learning laparoscopic surgery?
- a)
Simulation shortens learning curves without compromising patient care.
- b)
We cannot justify the cost of simulation equipment for resident training.
- c)
Simulation replaces learning in the operating room
- d)
There are no simulators involving complex technology.
- e)
There is only one model available for simulation of gynaecologic minimally invasive surgery.
- a)
- 24.
Why is intra-operative surgical skill acquisition compromised in an informal experiential learning environment?
- a)
Faculty infrequently spend time identifying the learning needs of the trainee
- b)
There is rarely the opportunity for post-operative debriefing
- c)
There is lack of feedback to the learner
- d)
There is minimal use of validated assessment tools
- e)
There is a lack of training for the trainers
- a)
- 25.
Which of the following is/are principal advantages of using a generic error rating tool as feedback to surgeons?
- a)
It is an interactive intraoperative feedback tool
- b)
It provides a global rating of surgical performance
- c)
Every technical error can be analyzed and it offers a precise tool for formative feedback
- d)
It identifies only the errors that will lead to complications.
- e)
It is quick to utilize in providing feedback.
- a)
- 26.
Concerning validation of a robotic simulator:
- a)
Face validity examines how closely the simulator resembles the real task
- b)
Construct validity measures the relationship with future performance
- c)
Predictive validity applies to a simulator that is able to differentiate between novices and experts
- d)
Usefulness of tasks and movement realism can be assessed by content validation
- e)
Content validity examines if the intended content domain is actually being measured
- a)
- 27.
Concerning Robotic Simulators:
- a)
The da Vinci Skills Surgical Simulator (dVSS) is the only simulator that utilizes the same console that is used for actual operating procedures.
- b)
The RoSS simulator has demonstrated face, content, and construct validity
- c)
The RoSS simulator uses virtual reality
- d)
The RoSS simulator simulates an actual surgical experience from beginner to advanced
- e)
The Mimic dV-Trainer requires an existing surgical console for utilizing all its applications
- a)
- 28.
Which of the following statements regarding mentoring and proctoring is true?
- a)
In proctoring, a master educates and guides a trainee surgeon with the goal of improving the trainee’s skills
- b)
Proctoring can lead to credentialing
- c)
The mentoring console (dual console) developed by Intuitive Surgical allows for both surgeons to control the same robot simultaneously
- d)
The “swap mode” of the mentoring console allows both mentor and trainee the same robotic arm in tandem
- e)
When using the “nudge mode” of the mentoring console, the trainee can feel the movements of the mentor surgeon at the second console
- a)
- 29.
Regarding Robotic Curriculum Training:
- a)
There is no standardized training program for robotic surgeons
- b)
The Fundamentals of Robotic Surgery (FRS) course is specifically designed for use on the RoSS simulator
- c)
The BSTC is not simulator-specific
- d)
Studies have indicated that both Obstetrics and Gynecology residents and program directors feel that there is a lack of training and structure in robotic surgery
- e)
The European Association of Urology course includes an OR module training as a bedside assistant and console surgeon
- a)
- 30.
The following statement(s) about complications in laparoscopic supracervical hysterectomy is/are true:
- a)
Bladder lesions may occur and the risk is higher in patients with prior Caesarean section.
- b)
The rate of recurrent cervical bleeding after LASH does not depend on the length of the cervical stump and the experience of the surgeon.
- c)
Fascial closure is recommend in trocar sizes > 20 mm in order to avoid hernia.
- d)
Disseminated fragments of benign endometrial tissue cannot cause peritoneal endometrial carcinoma years after LASH.
- e)
Ureteral injuries are not correlated with higher postsurgical morbidity as most of the lesions are detected during surgery and can be treated immediately.
- a)