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Chapter 30. Obstetrics and Gynecology

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Which artery if transected during uterine artery ligation can result in gluteal ischemia?

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A. Superior gluteal

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B. Inferior gluteal

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C. Lateral sacral

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D. Iliolumbar

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Choice A is the major blood supply to gluteus maximus and minimus. Choice B provides branches to gluteus maximus and an anastomotic branch contributes to the cruciate anastomosis of the back of the thigh. Choice C supplies the sacrum and coccyx. Choice D supplies the bone and muscles of the iliac fossa.

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Describe the relationship of ureter in reference to the cervix.

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A. The ureter can be found extremely lateral from the internal cervical os

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B. At approximately 2 cm from the cervix, the uterine artery crosses above and in front of the ureter

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C. At approximately 2 cm from the cervix, the uterine artery crosses below and in front of the ureter

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D. Supracervical hysterectomy is only performed to avoid ureteral injury

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The ureter runs under the uterine artery (remember, “water under the bridge”) and they cross at a point approximately 2 cm from the cervix. This point is also called point A in radiation oncology (2 cm anterior and 2 cm lateral from the cervical os). A is incorrect because the ureter runs near the internal cervical os. C is incorrect because the uterine artery crosses above the ureter (the correct choice B). There are a number of reasons to opt to perform a supracervical hysterectomy but the sole reason is not to avoid ureteral injury.

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What level of radiation exposure is thought to be safe in pregnancy?

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A. 500 mrad

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B. 5 rad

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C. 50 mrad

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D. 100 mrad

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Less than 5 rad has not been associated with an increase in fetal anomalies or pregnancy loss.

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The incidence of hypertensive disease in pregnancy.

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A. 7%

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B. 10%

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C. 12% to 22%

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D. 2%

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Depending on the study population, studies have shown that the incidence of hypertensive disease (gestational hypertension, preeclampsia, eclampsia) is 12% to 22%.

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Tumor marker used to assess progression of disease in ovarian cancer:

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