PB128
Speroff Ch. 5
Principles of Robotic Surgery
Informed Consent/SDM and Disclosure/Discussion of adverse events
100

What does PALM-COEIN stand for?

Polyp

Adenomyosis

Leiomyoma

Malignancy

Coagulopathies

Ovulatory Dysfunction

Endometrial

Iatrogenic

Not Yet Classified

100

Where is GnRH synthesized, and how is it secreted?

Hypothalamus; secreted in pulsatile fashion.

100

What is the preferred minimally invasive route for hysterectomy?

Vaginal hysterectomy

100

What are the four pillars of medical ethics

Autonomy, benefice, nonmaleficence, justice

200

According to ACOG PB 128, which initial laboratory test should be performed in all women presenting with abnormal uterine bleeding?

Pregnancy test

200

An increase in this hormone is responsible for rescuing follicles from apotosis

FSH

200

What are the three main minimally invasive routes for hysterectomy?

Vaginal, laparoscopic, and robotic

200

What is the second-victim concept?

health-care practitioners emotionally affected by an adverse event

300

In reproductive-aged women with abnormal uterine bleeding, what is the preferred first-line imaging modality to evaluate the endometrium and structural causes?


TVUS

300

The function of the corpus luteum is crucial during the first __ weeks of pregnancy

7-9 weeks

300

List two common perioperative risks unique to robotic surgery

positioning injuries and equipment malfunction or trocar injuries

300

Give some barriers to disclosure

fear of litigation or blame

uncertainty about facts or what can be said

culture of blame/punitive environment

lack of training/communication skills

400

List at least three indications for when an endometrial biopsy should be performed in women with abnormal uterine bleeding.

  • Women ≥45 years with abnormal uterine bleeding

  • Women <45 years with risk factors for endometrial hyperplasia/cancer (e.g., obesity, chronic anovulation, PCOS, unopposed estrogen exposure)

  • Women with persistent bleeding despite medical management

400

This hormone stimulates the granulosa cell proliferation, aromatase activity, and progesterone synthesis

IGF-II

400

Name two key technological advantages of robotic surgery over conventional laparoscopy?

3D magnified visualization and articulated wrist instruments

400

What are some elements that patients typically expect when an adverse event is disclosed, per ACOG CO 681?

Timely and Honest disclosure

Acknowledgement of responsibility

Regret

Expression of Sympathy

Discussion of steps to prevent recurrence


500

What imaging modality is superior when evaluating a patient for Adenomyosis?

MRI

500

These two hormones are responsible for regulating the pituitary secretion of FSH

Activin and Inhibin. 

Both influence growth and development by modulating theca and granulosa response to the gonadotropins.

500

what are contraindications or barriers to a minimally invasive hysterectomy?

Large uterus size, severe adhesions, extensive extrauterine disease (advanced malignancy or endometriosis)

500

What does the SHARE acronym stand for?

S: Seek the patient’s participation
H: Help the patient explore and compare options
A: Assess patient’s values and preferences
R: Reach a decision together
E: Evaluate the decision made