Deck 14: General Surgery

Question 1

The triangle of Calot is an anatomical space bounded by structures in which surgical procedure?

A) appendectomy
B) cholecystectomy
C) herniorrhaphy
D) thyroidectomy

Answer 1

B

Question 2

What is achieved by insufflation of carbon dioxide into the abdominal cavity?

A) pneumocephalus
B) pneumocystosis
C) pneumoperitoneum
D) pneumothorax

Answer 2

C

Question 3

A typical end-to-end bowel anastomosis is accomplished with which of the following suturing techniques?

A) one-layer, continuous technique for seromuscular approximation with absorbable suture
B) one-layer, interrupted technique for mucosal approximation only with silk suture
C) two-layer, continuous technique for seromuscular approximation with absorbable, interrupted for mucosa with silk suture
D) two-layer, interrupted technique for seromuscular approximation with silk; continuous for mucosa with absorbable suture

Answer 3

D

Question 4

For which surgical procedure would the Buie pile forceps be used?

A) appendectomy
B) breast biopsy
C) cholecystectomy
D) hemorrhoidectomy

Question 5

What term describes a benign condition of breast enlargement in men?

A) gynecomastia
B) hypoplasia
C) macromastia
D) micromastia

Question 6

Which potentially life-threatening disease or condition can result from untreated thyrotoxicosis?

A) Crohn's disease
B) Grave's disease
C) Hashimoto's disease
D) thyroid storm

Question 7

During cholangiography, bubbles in the contrast media would likely:

A) cause a pulmonary embolus
B) give the appearance of a stone on x-ray
C) pass undetected through the biliary system
D) rupture the cystic duct from pressure exerted during injection

Question 8

Another name for a thyroid tenaculum is a:

A) Braun
B) Jacobs
C) Lahey
D) Schroeder

Question 9

In which of the following abdominal incisions would the linea alba be opened down to the peritoneum?

A) Kocher subcostal
B) McBurney
C) median vertical
D) transverse

Question 10

HBV, HCV, and alcohol abuse are precursors to which of the following diseases?

A) cirrhosis
B) cholelithiasis
C) diverticulitis
D) duodenal ulcer

Question 11

A Whipple procedure is done for treatment of a tumor in which abdominal organ?

A) liver
B) pancreas
C) rectum
D) spleen

Question 12

Tetany is a serious potential post-op complication of which type of surgical intervention?

A) appendectomy
B) colon resection
C) gastrectomy
D) thyroidectomy

Question 13

Which of the following is NOT a region of the pancreas?

A) body
B) capsule
C) head
D) tail

Question 14

A Maloney bougie dilator is used in which anatomical structure?

A) common bile duct
B) esophagus
C) urethra
D) cervix

Question 15

Doyen, Kocher, Dennis, and Allen are names of which type of instrument?

A) abdominal retractors
B) intestinal clamps
C) laparoscopic graspers
D) tissue scissors

Question 16

Which stage of breast cancer is characterized by evidence of distal metastasis?

A) Stage I
B) Stage II
C) Stage III-b
D) Stage IV

Question 17

Which anatomical structure is the largest mass of lymphatic tissue in the body?

A) axillary sentinel node
B) palatine tonsils
C) spleen
D) thymus

Question 18

What is the name of the fibrous and serous capsule that covers the liver?

A) Bowman's
B) Glisson's
C) Tenon's
D) articular

Question 19

Where is the gallbladder located in relation to the liver?

A) inferior surface of the left lobe
B) superior surface of the left lobe
C) inferior surface of the right lobe
D) superior surface of the right lobe

Question 20

Which incision is traditionally used for open appendectomy?

A) McBurney
B) median vertical
C) paramedian
D) Pfannenstiel

Question 21

A gastrostomy can be created by all of the following methods EXCEPT:

A) open
B) endovascular
C) laparoscopic
D) percutaneous

Question 22

What does TEP stand for in general surgery?

A) totally endoscopic pancreatectomy
B) totally endoscopic pyloroplasty
C) totally extraperitoneal patch
D) totally extraperitoneal prolapse

Question 23

Which suturing technique is often used on the appendiceal stump?

A) interrupted
B) horizontal mattress
C) vertical mattress
D) pursestring

Question 24

The skin incision for a thyroidectomy will follow which anatomical lines?

A) anterior axillary
B) Langer's
C) midclavicular
D) semilunar

Question 25

Which type of intestinal obstruction involves a telescoping of a portion of the intestine into another portion?

A) adhesive stricture
B) fecal impaction
C) intussusception
D) volvulus

Question 26

Which handheld retractors are frequently used to retract tissues during thyroidectomy?

A) Green
B) Harrington
C) malleable
D) Weinberg

Question 27

What term is used for surgical opening of the abdominal or peritoneal cavity?

A) gastrectomy
B) gastrostomy
C) laparoscopy
D) laparotomy

Question 28

What is another way of saying "cephalad to caudad"?

A) back to front
B) front to back
C) head to tail
D) inside to outside

Question 29

What type of hernia protrudes through the transversalis fascia in the area of Hesselbach's triangle?

A) direct
B) femoral
C) indirect
D) umbilical

Question 30

What do the parathyroid glands regulate in the body?

A) blood calcium concentration
B) growth hormones
C) immune response
D) insulin release

Question 31

Which type of hernia occurs below the abdominocrural crease and more frequently in females?

A) femoral
B) epigastric
C) direct inguinal
D) indirect inguinal

Question 32

Where are the parathyroid glands located in relation to the thyroid?

A) anterior midline
B) posterior midline
C) dorsal, superior and inferior
D) ventral, superior and inferior

Question 33

What is another name for an acquired ventral hernia through the linea semilunaris?

A) epigastric
B) femoral
C) inguinal
D) Spigelian

Question 34

Great care is taken to identify and preserve the long thoracic and thoracodorsal nerves in which surgical procedure?

A) laparoscopic cholecystectomy
B) laparoscopic Nissen fundoplication
C) modified radical mastectomy
D) subtotal gastrectomy

Question 35

For which type of hernia repair could a Penrose drain be used as a method of gentle traction of the spermatic cord?

A) laparoscopic Nissen fundoplication
B) McVay inguinal herniorrhaphy
C) totally extraperitoneal patch (TEP)
D) ventral/incisional herniorrhaphy

Question 36

What is the name for the type of hernia in which both direct and indirect defects are present?

A) diaphragmatic
B) epigastric
C) incisional
D) pantaloon

Question 37

A vagotomy is a surgical treatment option for:

A) appendicitis
B) ductal carcinoma
C) gastric ulcers
D) pancreatitis

Question 38

What is the name of a gastric mass of indigestible vegetable fiber and hair that may require surgical excision?

A) bezoar
B) calculus
C) polyp
D) ulcer

Question 39

What type of hernia results from a failure of the deep internal ring to close during fetal development and allows intestinal protrusion into the scrotum?

A) direct
B) femoral
C) indirect
D) umbilical

Question 40

Which fascial sheet is attached to the iliac crest, linea alba, and pubis?

A) innominate
B) interparietal
C) Scarpa's
D) transversalis

Question 41

What is the name for the first lymph node in the axillary chain that is frequently biopsied in conjunction with a breast biopsy, lumpectomy, or mastectomy?

A) attendant
B) guardian
C) leader
D) sentinel

Question 42

Which surgical position is used exclusively for anorectal surgical procedures?

A) Kraske
B) supine
C) Trendelenburg
D) reverse Trendelenburg

Question 43

Which statement is CORRECT regarding polyps and diverticula in the colon?

A) Both protrude inward into the lumen of the intestine.
B) Both protrude outward from the lumen of the intestine.
C) Polyps protrude inward, and diverticula protrude outward from the intestine.
D) Diverticula protrude inward, and polyps protrude outward from the intestine.

Question 44

Due to the vascular and friable nature of the liver, a surgeon may choose to use suture on which type of needle?

A) taper
B) blunt
C) spatula
D) cutting

Question 45

Which handheld retractor is specifically designed for use in open cholecystectomy to elevate the liver?

A) Army-Navy (USA)
B) Green
C) Harrington
D) Parker

Question 46

"Bowel technique" refers to steps used by the surgical team to prevent postoperative:

A) adhesion formation
B) hemorrhage
C) incisional hernia formation
D) surgical site infection

Question 47

Which type of viewing instrument would be used for surgical treatment of hemorrhoids?

A) anoscope
B) colonoscope
C) laparoscope
D) sigmoidoscope

Question 48

Which of the following is the MOST common permanent colostomy?

A) end
B) loop
C) end-loop
D) sigmoid

Question 49

A T-tube or wound drain left in place following laparoscopic cholecystectomy would MOST likely exit through:

A) a left subcostal stab wound
B) the umbilical port site incision
C) one of the 5 mm right port site incisions
D) the subxiphoid 10 mm port site incision

Question 50

Which of the following are endocrine-secreting glands of the pancreas that make up only 1% of the organ?

A) acini
B) ampulla of Vater
C) islets of Langerhans
D) uncinate process

Question 51

End-to-end, end-to-side, side-to-side, and Roux-en-Y are techniques for:

A) bowel anastomosis
B) mastectomy wound closure
C) mesh placement in herniorrhaphy
D) surgical skin prep solution application

Question 52

What type of incision is made for excisional biopsy of a centrally located breast mass involving the lactiferous ducts?

A) circumareolar
B) elliptical
C) inframammary
D) paramedian

Question 53

Which type of surgical procedure is used to release abnormal tissue connections in the abdominal viscera and layers?

A) anastomosis
B) fundoplication
C) herniorrhaphy
D) lysis of adhesions

Question 54

The hepatic and splenic flexures are located proximally and distally in which part of the large intestine?

A) ascending
B) descending
C) sigmoid
D) transverse

Question 55

What is the reason for injecting saline through the cholangiogram catheter prior to the contrast media?

A) The saline will dilute the contrast dye.
B) The saline will dilate the common duct.
C) The saline will push any stones in the cystic duct through.
D) The saline will test patency of the cystic duct prior to injecting the contrast.

Question 56

What is the incision routinely used for open cholecystectomy?

A) McBurney
B) Pfannenstiel
C) left subcostal
D) right subcostal

Question 57

An intestinal stoma is created at a point below the costal margin, above the belt line, and at the lateral edge of which muscle?

A) external oblique
B) internal oblique
C) rectus abdominus
D) transversus abdominus

Question 58

Pancreaticoduodenectomy is also known as which of the following procedures?

A) Bassini-Shouldice
B) McVay
C) Nissen
D) Whipple

Question 59

In a laparoscopic appendectomy, all of the following methods could be used for dissection of the appendix EXCEPT:

A) endoscopic linear stapler
B) ligating loop instrument
C) intraluminal circular stapler
D) intracorporeal suturing instrument

Question 60

A needle-localization procedure may be performed in radiology for assistance in locating discrete masses in the:

A) breast
B) groin
C) liver
D) pancreas

Question 61

Dilation of the submucosal and subcutaneous venous plexus that lines the anal canal is called:

A) anal fissure
B) fistula-in-ano
C) hemorrhoid
D) pilonidal cyst

Question 62

Surgical skin preps for breast procedures for carcinoma should be performed vigorously and thoroughly to prevent postoperative surgical site infections in immunocompromised patients.

Question 63

A surgical technologist may "run" or operate the laparoscopic camera during minimally invasive procedures to free up the hands of the surgeon and surgical first assistant.

Question 65

The upper-hand and Thompson retractors are complex self-retaining retractors frequently used in major abdominal procedures.

Question 66

Bifurcated drains and fluffy pressure dressings are used following mastectomy primarily to:

A) make the change in chest contour less obvious
B) prevent formation of hematoma and seroma
C) provide comfort for the patient when she moves
D) keep adhesions from forming between the skin and muscle

Question 67

The surgeon may request which of the following for irrigation to aid in destroying any residual tumor cells after dissection?

A) heparin
B) hydrogen peroxide
C) normal saline
D) sterile water

Question 68

The Hasson technique for establishing pneumoperitoneum requires the use of a Verres needle.

Question 69

Conversion from a laparoscopic procedure to an open procedure is always a possibility that the surgical technologist should be prepared for.

Question 70

If a mastectomy is scheduled to follow a breast biopsy and frozen section results indicate carcinoma, what is done?

A) Protect the field until second procedure begins.
B) Bring up a Mayo stand with new instruments for the mastectomy.
C) Use same instruments, but be sure to change all gloves first.
D) Re-prep, redrape patient; team changes gowns and gloves; and use new instruments.

Question 71

Surgical removal of the entire breast without any lymph nodes is a(n):

A) excisional biopsy
B) simple mastectomy
C) segmental mastectomy
D) modified radical mastectomy