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Chapter 30. Obstetrics and Gynecology

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

A. Superior gluteal

B. Inferior gluteal

C. Lateral sacral

D. Iliolumbar

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.

Describe the relationship of ureter in reference to the cervix.

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

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

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

D. Supracervical hysterectomy is only performed to avoid ureteral injury

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.

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

A. 500 mrad

B. 5 rad

C. 50 mrad

D. 100 mrad

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

The incidence of hypertensive disease in pregnancy.

A. 7%

B. 10%

C. 12% to 22%

D. 2%

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

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

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