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NBME 16 Answers

nbme16/Block 1/Question#39 (7.7 difficulty score)
A 28-year-old woman comes to the physician ...
UreterπŸ”
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 +2 
submitted by bingcentipede(208),

It's a little bit of anatomy, a little bit of knowing what the question wants us to know.

Here's a nice pic of the ureter under the ovary: https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20180930192054-59433-mediumThumb-66713fig4_6.jpg?pub-status=live

Specifically, you want to protect the ureter during surgery. "Bridge over water" kind of applies here, knowing that uterine artery is also being ligated during ovary removal. It's so important for surgeons to be able to differentiate the arteries (which are ok to be sacrificed if you're doing a hysterectomy/oophorectomy) but the ureter must be kept intact.

i_hate_it_here  Isn't the round ligament of the uterus inferior to the ovary? Why would that not want to be preserved as well? +1  
flvent2120  It is inferior, but I think it comes down to what the question is trying to ask. To me I was stuck on that fact as well, but it came down to "what has a significant function and therefore needs to be protected?". The round ligament doesn't have any arteries and whatnot, whereas damaging the ureter has significant consequences. With that, the question seemed to be hinting at "ureter" +