EBCOG Part-1 High Yield Questions Core Surgical Skills

1. Which absorbable suture has the greatest tensile strength?

A. Polydiaxonone (PDS)
B. Polyglactic 910 (Vicryl rapide)
C. Polyglactin (Vicryl)
D. Polyglecaprone (Monocryl)
E. Polyglycolic acid (Dexon)

2. What proportion of ureteric injuries are recognised intraoperatively during laparoscopic surgery?

A. 10%
B. 25%
C. 33%
D. 50%
E. 67%

3. Which nerve is particularly susceptible to damage when self- retaining retractors are used in gynaecological surgery?

A. Femoral nerve
B. Genitofemoral nerve
C. Iliohypogastric nerve
D. Obturator nerve
E. Pudendal nerve

4. During a primary caesarean section, at what point during the operation is a bladder injury most likely to occur?

A. Closure of the uterine incision
B. Delivery of the baby
C. Dissection of bladder from the lower segment
D. During catheterisation
E. Entry into the peritoneal cavity

5. Taking all surgical procedures into consideration, which organism is most commonly implicated in inpatient surgical- site infections in England?

A. Enterobacteriaceae
B. Enterococcus spp
C. Methicillin-resistant Staphylococcus aureus (MRSA)
D. Pseudomonas spp
E. Staphylococcus aureus

6. Urinary catheter size is identified by Charrière (Ch) or French gauge (Fg) or French (F).
What does the gauge represent?

A. External diameter
B. Flow rate
C. Internal diameter
D. Length
E. Volume of retaining balloon

7. What proportion of women in the UK have a body mass index (BMI) of >30 kg/m2?

A. 6%
B. 11%
C. 16%
D. 21%
E. 26%

8. For an obese woman with no co- morbidities who has been unsuccessful in reducing her weight with dietary modification and exercise, what is the threshold BMI where bariatric surgery should be considered?

A. 32 kg/m2
B. 35 kg/m2
C. 38 kg/m2
D. 40 kg/m2
E. 45 kg/m2

9. What is the overall approximate risk of serious complications from an abdominal hysterectomy?

A. 1 in 100
B. 2 in 100
C. 3 in 100
D. 4 in 100
E. 5 in 100

10. You are about to consent a patient for diagnostic laparoscopy. Her body mass index is 22 kg/m2 and has no history of previous abdominal surgery. The patient wishes to know about the serious complications associated with laparoscopy. She is anxious as her friend required an open operation to repair her bowel followinga laparoscopic sterilisation. In counselling her you should include:

A. A serious complication like a bowel injury is recognised at the time of surgery and dealt with immediately
B. Wound gaping and infection can lead to serious intraperitoneal infection .
C. Serious complications associated with bowel injury during entry can be avoided if the open technique entry is used
D. The overall risk of serious complications is low: approximately 2 in 1000 women
E. A serious complication like a blood vessel injury in her case is reduced as easy entry to the abdominal cavity is anticipated

11. You are asked to include the risk of return to theatre’ as one of the complications following hysterectomy in patient information leaflet and consent form. Which one of the following figures should be quoted in the consent form?

A. 2 in 100
B. 15 in 1000
C. 7 in 1000
D. 5 in 10000
E. 1 in 100 following hysterectomy for malignant disease

12. Which of the following operations is associated with the highest incidence of postoperative fever?

A. Vaginal hysterectomy
B. Laparoscopic hysterectomy
C. Abdominal hysterectomy
D. Sacrospinous colpopexy
E. Anterior and posterior repair

13. Of the following operations which one is associated with the highest incidence of vault haematoma?

A. Laparoscopic hysterectomy
B. Abdominal hysterectomy
C. Abdominal myomectomy
D. Vaginal hysterectomy
E. Robotic hysterectomy

14. What is the risk of death as a result of complications during a laparoscopic procedure?

A. 5-8 in 10000
B. 2 in 100000
C. 3-8 in 100000
D. 1 in 1000
E. 1 in 10000

15. Your consultant has asked you to identify and name the blood vessel in the abdominal wall which is most likely to be injured during lateral port insertion during laparoscopy.

A. Superficial epigastric
B. Inferior epigastric
C. Superficial circumflex iliac
D. External iliac
E. Superior epigastric

16. Hassan’s entry technique or Palmer’s point is not recommended in which of the following?

A. Very thin women
B. Morbidly obese women
C. Previous vertical abdominal incision
D. Previous caesarean section
E. Previous multiple laparoscopies

17. The highest risk of vascular injury during laparoscopy is in which of the following?

A. Multiparous thin women
B. Thin nulliparous women
C. Morbidly obese and nulliparous women
D. Patients with multiple laparotomies
E. Morbidly obese and multiparous women

18. One of the following statements is true about hysteroscopic distension media?

A. Normal saline causes more vasovagal symptoms than CO,
B. Normal saline has better image quality than CO
C. CO, use leads to a quicker procedure
D. CO, has better image quality than normal saline
E. Normal saline is usually used for monopolar diathermy

19. A thin 51-year-old woman undergoes total laparoscopic hysterectomy for dysfunctional uterine bleeding. The procedure is uneventful with minimal blood loss. The patient is fully mobile and is discharged home the next day. How long will you advice postoperative thromboprophylaxis for this patient?

A. 14 days
B. 7 days
C. 28 days
D. 42 days
E. None

20. An 18-year-old woman, who is 5 weeks pregnant, complains of severe lower abdominal pain and vaginal bleeding. On examination, she is noted to have a blood pressure of 80/60 mmHg and heart rate of 110 bpm. The serum B-hCG level is 600 mIU/mL and the transvaginal ultrasound shows no intrauterine pregnancy and no obvious adnexal masses. There is some anechoic free fluid in the pouch of Douglas. Which of the following is the best management for this patient?

A. Measure the patient's serum progesterone level
B. Laparoscopy + salpingectomy
C. Laparotomy + salpingectomy
D. Intramuscular methotrexate at a dose of 50 mg/m2
E. Repeat serum B-hCG in 48 hours