The primary purpose of a robotic device designed to hold and maneuver a laparoscope is to
eliminate tremor associated with operating an endoscope.
Which of the following are the MOST important considerations when preventing wound infection in the surgical patient?
1. pathogen transmittal
2. portal of entry into the susceptible host
3. anesthetic options for the patient's operative process
4. invasio
B. 1, 2, and 4 only
Which of the following tendon autografts is MOST typically utilized when performing ACL reconstruction?
patellar
What is the normal range of red blood cells in a complete blood count for an adult male?
4.6 - 6.2 million/nl
Which of the following organisms normally found on the skin can cause wound infections?
Staphylococcus aureus
Which of the following is the desired effect when applying a partially threaded cancellous screw to a bone fragment
A. distraction
B. rotation
C. compression
D. subluxation
compression
When transferring a thoracotomy patient to recovery, the chest drainage system should be
maintained below the patient's chest level
Which of the following bones make up the pelvic girdle?
1. coccyx
2. acetabulum
3. sacrum
4. os coxae
coccyx, sacrum, os coxae
During a carotic endarterectomy, the arteries are unclamped and reclamped before arteriotomy closure is performed to
flush free debris from the carotid
Injury to which of the following arteries is commonly seen in the temporal lobes, where the skull is the thinnest and meningeal blood vessels are numerous, and is the usual cause of epidural hematomas?
middle meningeal
Epidural hematoma is typically caused by trauma to what artery?
middle meningeal
During arterial cannulation in cardiopulmonary bypass (CPB), the cannula tip must be directed into which of the following arteries?
aorta
Which of the following is an example of a high level disinfection agent?
A. glutaraldehyde
B. isopropyl alcohol
C. quaternary ammonium
D. iodophor solution
glutaraldehyde
A wound that is known to be infected at the time of surgery and is left open to be closed at a later date is categorized as
delayed primary closure
first intention
Primary closure of a wound.
secondary intention (granulation)
secondary intention (granulation)Allowing a wound to close on it's own.
A long-term complication of a cemented total hip arthroplasty is
loosening of the prosthesis
When preforming compression hip screw fixation, the lag screw is inserted
within 1 cm of the femoral articular surface
After receiving a preoperative epidural catheter, a patient is given a bolus of local anesthetic intraoperatively. The patient then demonstrates signs of hypotension and complete respiratory failure. Which of the following is the MOST likely cause
migration of the epidural catheter through the dura
The main consideration in surgical needle selection is
to minimize trauma
During a posterolateral approach to the hip, which of the following structures usually found superficially to the obturator and gemelli should be identified and protected?
sciatic nerve
Tetralogy of Fallot includes which of the following defects?
1. ventricular septal defect
2. aortic stenosis
3. pulmonary valve stenosis
4. right ventricular hypertrophy
1, 3, and 4
Tetralogy of Fallot
A congenital heart defect which is classically understood to involve four anatomical abnormalities of the heart that include ventricular septal defect, pulmonary valve stenosis, right ventricular hypertrophy, and transposition of the aorta (although only
Pulling on the wrist to reduce a radius fracture incorporates which principle of surgical assisting?
traction-countertraction
If a Kelly clamp is left in a patient who underwent a cholecystectomy, which legal charges can be filed
res ipsa loquitur
Res ipsa loquitur
or the thing speaks for itself
Primum non nocere
or first do no harm
During a posterolateral approach for an intracapsular hip fracture, which of the following muscles would be released along with the short external rotators and capsule from the posterior aspect of the femur as a single musculocapsular flap?
piriformis
When an open appendectomy is performed, it is necessary to identify the
cecum and ileocecal valve
In patients who develop fever, abdominal pain, and profuse diarrhea, the MOST frequently seen antibiotic-associated enterocolitis is due to which organism?
clostridium difficile
Taper point needles are generally used in which of the following tissue types?
1. gastrointestinal
2. tendons
3. adipose
4. vascular
1, 3, and 4
A patient who is opposed to the acceptance of blood transfusion on the religious principle is undergoing a hysterectomy. During surgery, there was significant blood loss causing hematocrit to drop to 30% with a resulting drop in oxygen saturation. Under t
Increase IV fluid drip to allow hemodilution
Which of the following conditions is MOST common when insulation failure occurs in laparoscoopic surgery?
A. hypothermia
B. wound infection
C. tissue injury
D. adhesions
tissue injury
An adult male is injured in an automobile accident at 2 AM. An exploratory laparotomy for possible perforated bowel is initiated at 5AM. Which of the following is the best wound classification in this scenario?
contaminated
Clean wound
Operative wound in which no re4spiratory, alimentary, or genitourinary tracts are entered and no break in sterile technique.
Clean contaminated wound
Operative wound in which the respiratory, alimentary, or genitourinary tract is entered under controlled conditions.
Contaminated wound
Wounds that include traumatic wounds of less than 4 hours duration and those in which operations with major breaks in aseptic technique and gross spillage from the gastrointestinal tract are also included.
Dirty or infected wound
Old, physically induced wounds with retained devitalized tissue with existing infection like an abscess or delayed primary closure from a ruptured appendix.
Which of the following angled plates is MOST frequently chosen for a compression hip screw fixation?
135 degrees
Foman, Cottle, and Aufricht retractors are all considered which of the following kinds of instrument?
ENT
An Exmarch bandage is MOST frequently used for which of the following types of surgery?
Podiatric
Which of the following techniques demonstrate a proven benefit in the prevention of postoperative wound infections?
1. administering appropriate antibiotics within 1 hour of incision time
2. maintaining suitable antibiotic coverage for 48-72 hours postope
1 and 3 only
Immediately follow an arthroscopic assisted ACL reconstruction, a patient's knee is typically placed in
a hinged knee brace
When should the patient's chest tubes be attached to te drainage system during a thoracotomy?
after the thoracic cavity is closed
Which of the following is considered a non-impregnated, nonadherent dressing?
a. adaptic
b. vaseline gauze
c. telfa
d. xeroform
telfa
Which of the following tumors is most commonly found in the cerebellum of children and in the cerebrum of adults and is the most common primary brain tumor?
astrocytoma
A threaded cortical screw cannot provide compression of bone fragments unless the
near cortex is overdrilled
When removing a tumor, isolation technique is used to
prevent mechanical metastasis
Which of the following is the primary node associated with metastatic disease?
sentinel
When a loop of jejunum is anastomosed end to side with the esophagus in a total gastrectomy, a jejunojejunostomy may be done to
prevent regurgitation esophagitis
What is the purpose of a jejunojejunostomy?
to prevent the reflux of bile and pancreatic fluids into the esophagus.
During total hip arthroplasty through an anterolateral approach, which of the following maneuvers is needed to dislocate the femoral head?
adduction and external rotation
Which of the following types of laser is used in retinal surgery?
argon
When opening the aneurysmal sac during resection of an abdominal aortic aneurysm (AAA), which of the following arteries is ligated?
lumbar
Which of the following should be considered when positioning a patient?
1. Patency of the airway is the prime concern when positioning a patient
2. Pressue injuries are most common after surgical procedures lasting one hour or longer.
3. An anesthetized p
1, 2, and 4 only
Which of the following fractures runs between the maxillary and orbital floors and may involve the medial and lateral walls of the maxillary sinuses and the pterygoid processes of the sphenoid?
Le Fort I
Which of the following are rotator cuff muscles?
1. teres major and teres minor
2. supraspinatus and teres minor
3. levator scapulae and infraspinatus
4. infraspinatus and subscapularis
2 and 4 only
During a carotid endarterectomy, the patient's heart rate drops to 30 bpm. This is likely due to the stimulation of the
vagus nerve
Which of the following are reasons for keeping the OR at a relative humidity level between 50-50%?
1. reduced risk of infection
2. lower levels of patient discomfort
3. minimization of static electricity
4. depressed waste anesthesia gas
1 and 3
During digital reanastomosis, which of the following items is commonly used?
operative miscroscope
Which of the following are requirements for a sharps container?
1. self-closing lid to prevent overfilling
2. biohazard labels and color coding
3. durable, closable, leakproof, and puncture resistant
4. lids which allow sharps to enter by gravity
2, 3, and 4 only
A 70-year-old patient who underwent an 8-hour colon resection is at the greatest risk for what?
postoperative infection
After a mitral valve replacement, a patient coming off bypass shows signs of cardiac ischemia. Which of the following MOST likely happened during the procedure to cause this?
A. ligation of the inferior vena cava
B. occlusion of the circumflex artery
C. o
occlusion of the circumflex artery
Which of the following lasers is used to vaporize a portion of the residual lens capsule after cataract surgery?
Nd: YAG
Which of the following complications is MOST critical when positioning a patient for surgery?
respiratory compromise
During a low anterior colon resection, the anvil of the EEA is inserted into the
sigmoid
Which of the following suturing techniques is used for aortic and atrial cannulation for cardiopulmonary bypass
purse-string
During a Nissen fundoplication, care should be taken when placing medial traction on the stomach to prevent avulsion of the
gastric arteries
Calot's Triangle is formed by the
common hepatic duct, cystic duct, and cystic artery
Medication given to combat malignant hypothermia is
dantrolene (2-3mg/kg)
Comparatively, which of the following patients is at greatest risk for anesthesia complication during the operative phase?
A. a patient who is undernourished
B. a patient who is immunosuppressed
C. a patient with COPD
D. a patient with diabetes
patient with COPD
Which nerve innervates the latissimus dorsi muscle?
thoracodorsal
What is the desired outcome for the Bankart procedure?
preventing recurrence of dislocation, reducing arthritic changes, and restoring joint motion
The third ventricle empties into the fourth ventricle through which small duct, which is the only exit for the third and lateral ventricles?
aqueduct of Sylvius
What degree of endoscope is MOST commonly used during a laparoscopic cholecystectomy?
30
When assisting on a pancreaticoduodenectomy, the surgical first assistant should be prepared for reconstruction of which of the following structures?
1. duct of Wirsung
2. duct of Santorini
3. common bile duct
4. common hepatic duct
1, 2, and 3 only
What is a common complication when transporting a post-anesthesia patient?
decreased cardiac output
Postoperatively, what is closely monitored immediately after a loop colostomy is performed?
ischemia
What are the most common lasers used in gynecological surgery?
CO2 and Nd: YAG
The MOST common structure involved in a sliding left indirect hernia is the
sigmoid
During a routine shoulder arthroscopy on a patient wiht instability, a surgeon notices that the patient has a type II SLAP lesion. What is the appropriate treatment for this finding?
repair the glenoid labrum
What arteries may be detached and reanastomosed to the graft during a AAA resection?
renal
A suture ligature is also referred to as
a stick tie
What is a good way to prevent hypothermia in the OR
forced air warming blanket
What is the MOST likely cause for varicose veins?
incompetent valves
A 60 year old obese patient with a history of diabetes and renal insufficiency has undergone drainage of an abdominal abscess through a midline incision, what type of stitch should be considered for wound closure?
interrupted retention suture
Which of the following statements is true concerning hypophysectomy?
1. Replacement of the adrenal steroid therapy is usually required.
2. Diabetes may result
3. Growth will be increased.
4. Cessation of menses and infertility may result.
1, 2, and 4 only
What is an effective way to estimate proper femoral nail diameter and length of an acute, severely comminuted femur fracture?
preoperative radiographs of the unaffected leg.
During ulnar nerve transposition, the nerve is relocated to the
anterior aspect of the medial epicondyle
Which of the following sterilants is utilized by the Steris System I sterilizer?
peracetic acid
Which of the following cranial nerves innervates the heart?
CN X
What is the # 5 cranial nerve and what does it innervate?
Trigeminal, face
What is the #10 cranial nerve and what does it innervate?
Vagus, organs of the thoracic and abdominal cavities
What is the #6 cranial nerve and what does it innervate?
abducens, eyes
What is the #12 cranial nerve and what does it innervate?
hypoglossal, tongue
Which of the following hemodynamic concepts describes the resistance the heart must overcome to pump blood into the systemic circulation?
afterload
What chamber of the heart ejects deoxygenated blood into the pulmonary artery for oxygenation by the lungs?
right ventricle
During dissection of the internal mammary artery (IMA), what solution should be used to dilate the artery and reduce muscle spasm?
papaverine
Following inflammation, what is the correct sequence of the stages of bone healing?
1. callus formation
2. cellular proliferation
3. ossification
4. remodeling
2, 1, 3, 4
Winged scapula is a condition brought on by an injury to what nerve?
long thoracic
What dressing is derived from bovine, equine, or porcine sources and is effective in recalcitrant wounds?
collagen
What study is used to determine Zenker's diverticulum?
barium swallow
After completion of an ORIF of the distal radius utilizing a volar plate and screws, the dressing application should include what splint?
posterior wrist
The initial reaction to invasion of a foreign body or a local injury is called
inflammation.
Positive assurance that sterilization conditions have been achieved can only be obtained through
biological indicators
What characteristics of sutures is described as the amount o force necessary to break suture?
tensile strength
What is the inherent ability to regain the original form and length after being restructured?
elasticity