Multiple-Choice Questions on Laparoscopy, Hysterectomy, Myomectomy, and Hysteroscopy
Laparoscopy Basics
1. What is the primary advantage of laparoscopic surgery compared to open abdominal surgery?
- A) Longer operating time
- B) Shorter hospital stay and faster return to normal activities 1
- C) Higher infection rates
- D) Greater postoperative pain
2. In laparoscopic procedures for large uteri obscuring the umbilical port, which alternative insertion point is recommended?
- A) Suprapubic region
- B) Lee-Huang point (midpoint between umbilicus and xiphoid) 2
- C) Right lower quadrant
- D) Left upper quadrant
3. What is a major risk when performing laparoscopic myomectomy with morcellation?
- A) Increased fertility
- B) Retained fibroid fragments causing complications 3
- C) Decreased operating time
- D) Improved cosmetic outcomes
Hysterectomy
4. Which hysterectomy approach is associated with the shortest operating time and fastest return to normal activities?
- A) Abdominal hysterectomy
- B) Vaginal hysterectomy 1, 4
- C) Robotic-assisted hysterectomy
- D) All approaches are equivalent
5. What is a significant long-term complication associated with hysterectomy that must be considered?
- A) Improved bone density
- B) Decreased cardiovascular risk
- C) Increased risk of dementia and cardiovascular disease 4
- D) Enhanced quality of life in all cases
6. When is abdominal hysterectomy preferred over other approaches?
- A) For all benign indications
- B) When the patient requests it
- C) It should generally be avoided due to longer hospital stays, greater pain, and higher infection risk 1, 4
- D) For cosmetic reasons
Myomectomy
7. Which type of fibroid is most appropriately treated with hysteroscopic myomectomy?
- A) Large subserosal fibroids
- B) Intracavitary and submucosal fibroids 1
- C) Deeply intramural fibroids
- D) Pedunculated serosal fibroids
8. What is the most critical technical challenge in laparoscopic myomectomy?
- A) Patient positioning
- B) Achieving satisfactory hemostasis with appropriate sutures 5
- C) Anesthesia selection
- D) Postoperative pain management
9. Compared to open myomectomy, laparoscopic myomectomy demonstrates:
- A) Higher postoperative fever rates
- B) Longer hospital stays
- C) Lower postoperative fever rates and less postoperative pain 6
- D) Increased blood loss
10. What is a major postoperative complication risk following myomectomy?
- A) Improved fertility in all cases
- B) Development of postoperative adhesions 1
- C) Decreased uterine size
- D) Enhanced menstrual regularity
Hysteroscopy Basics
11. What is the primary indication for hysteroscopic myomectomy?
- A) Multiple large intramural fibroids
- B) Submucosal fibroids in patients desiring uterus preservation 1
- C) Subserosal fibroids causing bulk symptoms
- D) Fibroids with concomitant severe adenomyosis
12. Which complication can be detected in real-time when laparoscopy is combined with hysteroscopy?
- A) Postoperative adhesions
- B) Uterine perforation 7
- C) Future fertility issues
- D) Hormonal imbalances
13. What is a limitation of hysteroscopic myomectomy for submucosal fibroids?
- A) It is effective for all fibroid sizes
- B) It is ineffective when the tumor is predominantly within the myometrial wall 1
- C) It requires general anesthesia in all cases
- D) It has higher complication rates than open surgery
Integrated Clinical Scenarios
14. A 38-year-old woman with symptomatic fibroids desires future fertility. What is the most appropriate initial surgical approach for multiple intramural and subserosal fibroids?
- A) Immediate hysterectomy
- B) Hysteroscopic myomectomy
- C) Laparoscopic or open myomectomy 1
- D) Uterine artery embolization only
15. When comparing laparoscopic myomectomy to open myomectomy, what is the expected difference in postoperative pain at 48 hours?
- A) No significant difference
- B) Laparoscopic approach results in approximately 2 points lower pain score on a 0-10 VAS scale 6
- C) Open approach has less pain
- D) Pain scores are identical at all time points