Chapter 20 Flashcards

1
Q

Which structure is ligated and transected first in a radical nephrectomy or laparoscopic simple nephrectomy, following isolation of the vessels and ureter?
A. Renal artery
B. Renal vein
C.proximal ureter
D. Gerota’s fascia

A

A. Renal artery

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2
Q

Which of the following comparisons of normal or typical kidney anatomy is CORRECT?
A. The left kidney is smaller and slightly lower than the right
B. The right kidney is larger and slightly lower than the left
C. The left kidney is larger and slightly higher than the right
D. The right kidney is smaller and slightly higher than the left

A

C. The left kidney is larger and slightly higher than the right

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3
Q

What does the adrenal medulla secrete?
A. Catecholamines
B. Testosterone
C. Insulin
D. Urine

A

A. Catecholamines

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4
Q

At approximately what age or period Would a patient MOST likely be diagnosed with a Wilms tumor?
A. Second trimester of gestation
B. Between ages 3 and 8 years
C. Onset of puberty
D. Over age 60

A

B. Between ages 3 and 8 years

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5
Q

Which of the following is NOT a type of pubovaginal or suburethral sling?
A. Allograft fascia lata
B. Autograft fascia lata
C. Polypropylene mesh tape
D. Radiopaque vaginal packing

A

D. Radiopaque vaginal packing

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6
Q

What structure of male anatomy is divided into three sections: prostatic, membranous, and spongy ?
A. Ejaculatory duct
B. Spermatic cord
C. Urethra
D. Ureter

A

C. Urethra

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7
Q

Which dilating instrument is used to dilate the corpora for placement of penile prosthesis?
A. Boogie
B. Hegar
C. Van buren
D. Walther

A

B. Hegar

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8
Q

Cystoscopy and ureterscopy procedures are performed in which position ?
A. Lateral
B. Low-lithotomy
C. Supine
D. Trendelenburg

A

B. Low-lithotomy

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9
Q

Which of the following is used to ensure patency of the ureters or allow for drainage of urine from the kidneys?
A. Foley catheter
B. Suprapubic catheter
C. Jackson Pratt drain
D. Double J or pigtail stent

A

D. Double J or pigtail stent

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10
Q

Which suture configuration is used to anastomose vessels in transplants?
A. Fine, absorbable, single-armed
B. Fine, nonabsorable, double-armed
C. Heavy, absorbable, single-armed
D. Heavy, nonabsorbable, double- armed

A

B. Fine, nonabsorable, double-armed

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11
Q

What is the medical term for the procedure of connecting a donor ureter to a recipient bladder?
A. Ureteroscopy
B. Reimplantation
C. Suprapubic cystostomy
D. Ureteroneocystostomy

A

D. Ureteroneocystostomy

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12
Q

Into which anatomical area of the abdomen will a transplanted donor kidney be implanted?
A. Left lower quadrant
B. Left upper quadrant
C. Right lower quadrant
D. Right upper quadrant

A

C. Right lower quadrant

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13
Q

What is done with the edge of the ilium that is brought out through the abdominal wall for stoma creation?
A. The edges are everted and affixed to the skin
B. A purse string suture is placed to cinch it shut
C. It is cut into four sections and tacked to the skin
D. A pie rose drain is inserted and pulled over the edge

A

A. The edges are everted and affixed to the skin

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14
Q

Marshall-Marchetti-Krantz (MMK) is a traditional version of which general type of procedure?
A. Inguinal hernia repair
B. Repair of cystic eel and rectocele
C. Shock wave destruction of calculi
D. Suprapubic vesicourethral suspension

A

D. Suprapubic vesicourethral suspension

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15
Q

What is the MOST serious post-op complication of penile implant surgery?
A. Edema
B. Impotence
C. Premature ejaculation
D. Surgical site infection

A

D. Surgical site infection

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16
Q

What type of lights is used for illumination in endoscopic equipment?
A. Fiber-optic
B. Fluorescent
C. Incandescent
D. Ultraviolet

A

A. Fiber-optic

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17
Q

What is the medical term for excision of the urinary bladder?
A. Colporrhaphy
B. Corpectomy
C. Cystectomy
D. Cystostomy

A

C. Cystectomy

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18
Q

which incisional approach is used for access to the lower ureter and may be used for donor kidney implantation
A. Flank
B. Gibson
C. Inguinal
D. Scrotal

A

B. Gibson

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19
Q

In which surgical approach would the latissimus dorsi, internal, and external oblique muscle be transected for access to the operative site?
A. Inguinal oblique
B. Suprapubic
C. Subcostal flank
D. Transverse abdominal

A

C. Subcostal flank

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20
Q

Flank, Gibson, inguinal, and scrotal are example of
A. Drapes sheets
B. Operative approaches
C. Post op dressings
D. Wound drains

A

B. Operative approaches

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21
Q

Cryptorchidism is more commonly known as:
A. Kidney stones
B. Nocturnal bedwetting
C. Undescended testicles
D. Urinary tract infections

A

C. Undescended testicles

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22
Q

Which instrument is used in TURP or TURBT and includes the sheath, obturator, working element, and ESU loops?
A. Cystoscope
B. Nephroscope
C. Resectoscope
D. Ureteroscope

A

C. Resectoscope

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23
Q

Which of the following procedures could be done in either a male or female patient?
A. Hydrocelectomy
B. Orchiectomy
C. TURBT
D. TURP

A

C. TURBT

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24
Q

which part of the kidney becomes the proximal ureter?
A. Bowman’s capsule
B. Cortex
C. Medulla
D. Renal pelvis

A

D. Renal pelvis

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25
Q

What is the name of the basic structure composed of renal corpuscles and tubules and numbers over a million?
A. adrenal
B. hilum
C. nephron
D.psoas

A

C. nephron

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26
Q

Which of the following is the term for the inability to retract the foreskin of the penis?
A. balanitis
B. hypospadias
C. phimosis
D. sclerosis

A

C. phimosis

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27
Q

Diabetes, vascular disorder, nerve damage, and trauma are all possible causes of:
A. epispadias
B. hypospadias
C. impotence
D. prostate cancer

A

C. impotence

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28
Q

What is there term for an abnormal accumulation of serous fluid around the test contained within the tunica vaginalis?
A. cystocele
B. hydrocele
C. omphalocele
D. rectocele

A

B. hydrocele

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29
Q

Which irrigation or distention fluid would be contraindicated during cystoscopy for fulguration of bladder tumor?
A. glycine
B. saline
C. sorbitol
D. water

A

B. saline

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30
Q

What anatomical structure is the bladder attached to in males?
A. rectum
B. prostate
C. scrotum
D. symphysis pubis

A

B. prostate

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31
Q

In radical cystectomy with the ideal conduit on a male patient, what tissue will be sent for frozen section to verify clear margins?
A. sections of both testicles
B. segments of bilateral ureters
C. lateral edges of the tunica vaginalis
D. distal segments of the seminal vesicles

A

B. segments of bilateral ureters

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32
Q

Which of the following is given IV after the donor kidney is removed to reverse the heparinization?
A. thrombin
B. furosemide
C. protamine sulfate
D. ringers lactate

A

C. protamine sulfate

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33
Q

What might the donor kidney be placed into to reduce possibility of injury during handling and transplantation?
A. laparoscopic entrapment sack
B. Lahey intestinal bag
C. plastic incise drape
D. woven stockinette

A

D. woven stockinette

34
Q

How is the anesthetic jelly that is inserted into the male urethra prior to cystoscopy kept from leaking out?
A. a cotton-tipped applicator is inserted in the external meatus
B. a sterile tight-fitting condom is applied to the penis
C. A flexible penile clamp is applied to the head of the penis
D. a gloved finger is held firmly against the head of the penis

A

C. A flexible penile clamp is applied to the head of the penis

35
Q

Which signal should alert the surgical team that prostate capsule perforation is imminent and may conclude the procedure?
A. coughing
B. flatulence
C. groaning
D. leg jerking

A

D. leg jerking

36
Q

Which self retaining retractor is used for open suprapubic prostatectomy?
A. gelpi
B. judd-mason
C. adson-beckman
D. O’sullivan-O’connor

A

B. judd-mason

37
Q

When is a patient classified as being in end-stage renal failure?
A. when both kidneys are functioning at or below 25% of normal
B. when both kidneys are functioning at or below 10% of normal
C. when one kidney is normal and the other is functioning at or below 25% of normal
D. when one kidney is normal and the other if functioning at or below 10% of normal

A

B. when both kidneys are functioning at or below 10% of normal

38
Q

When of the following items would likely be needed if the pleural cavity is unintentionally entered during nephrectomy?
A. chest tube with drainage system
B. flexible bronchoscope
C. 1 inch Penrose drain
D. fibrin glue

A

A. chest tube with drainage system

39
Q

Which of the following is NOT a form of polycystic kidney disease?
A. autosomal dominant
B. autosomal recessive
C. acquired
D. traumatic

A

D. traumatic

40
Q

Suprarenal glands are more commonly known as:
A. adrenal
B. parotid
C. prostate
D. thymus

A

A. adrenal

41
Q

Approximately how many lobules comprise the average prostate gland?
A. 2
B. 4
C. 20
D. 50

A

D. 50

42
Q

What is the common diagnose of a patient undergoing transurethral resection of the prostate?
A. benign prostatic hypertrophy
B. carcinoma of the prostate
C. erectile dysfunction
D. stress incontinence

A

A. benign prostatic hypertrophy

43
Q

Vesicourethral suspension and pubovaginal slings are performed to mainly treat moderate to severe:
A. vaginal dryness
B. uterine prolapse
C. stress incontinence
D. urinary tract infection

A

C. stress incontinence

44
Q

What is one of the main objectives of procedures for female stress incontinence?
A. increase overall bladder capacity
B. reduce bladder spasms and irritability
C. restore the posterior urethrovesical angle
D. tighten and enhance bladder sphincter tone

A

C. restore the posterior urethrovesical angle

45
Q

What measure is taken to reduce the metabolic needs and prevents tubular necrosis of a kidney?
A. cooling with collins solution or ice slush
B. spraying with reconstituted topical thrombin
C. warming with sterile isotonic saline solution
D. infusion with warmed lactated ringer’s solution

A

A. cooling with collins solution or ice slush

46
Q

Where in the genitourinary system do calculi originate?
A. kidney
B. bladder
C. prostate
D. testicles

A

A. kidney

47
Q

Which cutting instruments should the surgical technologists have ready for anastomosis of the renal vessels into the recipient?
A. #15 blade and knight scissors
B. #10 blade and curved mayo scissors
C. #11 blade and 45 degree angle potts scissors
D. #12 blade and straight tenotomy scissors

A

C. #11 blade and 45 degree angle potts scissors

48
Q

How many suture ligatures or free ties should the surgical technologist have prepared for ligation of the renal artery and vein prior to transaction and removal?
A. one
B. three
C. five
D. seven

A

B. three

49
Q

what is the morcellator used for in a laparoscopic simple nephrectomy?
A. excising Gerota’s fascia from around the kidney
B. cutting between the ligaclips placed on the renal vessels
C. insufflating the peritoneal cavity after initial port placement
D. chopping the kidney and ureter into small pieces for suctioning

A

D. chopping the kidney and ureter into small pieces for suctioning

50
Q

Adenocarcinoma has a direct correlation to each of the following EXCEPT:
A. genetic predisposition
B. end stage renal disease
C. liver cirrhosis
D. tobacco use

A

C. liver cirrhosis

51
Q

simple nephrectomy is routinely performed in which position
A. lateral
B. low-lithotomy
C. prone
D. supine

A

A. lateral

52
Q

Which procedure is performed for testicular cancer, trauma or necrosis secondary to torsion?
A. circumcision
B. hydrocelectomy
C. orchiectomy
D. penectomy

A

C. orchiectomy

53
Q

What is the medical term for the free fold of skin that covers the glans penis?
A. epididymis
B. prepuce
C. scrotum
D. tunica

A

B. prepuce

54
Q

What does specialized tissue within the seminiferous tubules produced?
A. mucus
B. sperm
C. testosterone
D. urine

A

B. sperm

55
Q

What device is used through the ureteroscope to capture an intact calculus or fragments if fractured by laser?
A. babcock forceps
B. basket stone forceps
C. entrapment sack
D. vessel loops

A

B. basket stone forceps

56
Q

Which of the following is responsible for emptying of the bladder and closure of the bladder orifice?
A. detrusor muscle
B. external sphincter
C. urogenital diaphragm
D. vesical trigone

A

A. detrusor muscle

57
Q

The vesical arteries that supply the bladder arise from the:
A. ascending aorta
B. external iliac artery
C. internal iliac artery
D. renal arteries

A

C. internal iliac artery

58
Q

What procedure is performed to remove a calculus lodged in the area of the hilum?
A. cystoscopy
B. orchiectomy
C. pyelolithotomy
D. urethrotomy

A

C. pyelolithotomy

59
Q

In what position is the patient placed for proximal pyelolithotomy?
A. lateral
B. lithotomy
C. prone
D. trendelenburg

A

A. lateral

60
Q

What is the name of a continent urinary reservoir that may be performed following cystectomy?
A. hydrocele
B. ileal conduit
C. koch pouch
D. orchiopexy

A

C. koch pouch

61
Q

What is the name of the connective tissue that forms the umbilical ligament and is used for traction in radical cystectomy?
A. urachus
B. symphysis
C. vas deferens
D. diastasis recti

A

A. urachus

62
Q

Which distention fluid is non electrolytic and will lyse malignant tumor cells because of cellular uptake?
A. glycine
B. saline
C. sorbitol
D. water

A

D. water

63
Q

What is the more common name for ureteroileocutaneous diversion?
A. colostomy
B. ideal conduit
C. bladder prolapse
D. pubovaginal sling

A

B. ideal conduit

64
Q

What is used to resect the prostate gland tissue through the resectoscope?
A. endoshears
B. wire loop snare
C. ESU loop electrode
D. #11 blade on #7 handle

A

C. ESU loop electrode

65
Q

Which type of catheter is placed postoperatively following TURP?
A. 2-way 16 Fr. foley with 5 ml balloon
B. 2-way 22 Fr. foley with 30 ml balloon
C. 3-way 16 Fr. foley with 5 ml balloon
D. 3-way 22 Fr. foley with 30 ml balloon

A

D. 3-way 22 Fr. foley with 30 ml balloon

66
Q

Which of the following are male urethral dilators or sounds?
A. hanks
B. pratt
C. van buren
D. walther

A

C. van buren

67
Q

Baumrucker, Iglesias, stern-mccarthy, and nesbit are types of:
A. catheters
B. resectoscopes
C. evacuators
D. incisions

A

B. resectoscopes

68
Q

Which of the following structures enclose the kidneys and suprarenal glands?
A.Gerota’s fascia
B. tunica vaginalis
C. peritoneal sac
D. costal periosteum

A

A.Gerota’s fascia

69
Q

radical nephrectomy is usually performed with the patient in which position?
A. lateral
B. low-lithotomy
C. prone
D. supine

A

D. supine

70
Q

Where is the hilum of the kidney located?
A. superior pole
B. inferior pole
C. lateral midsection
D. medial midsection

A

D. medial midsection

71
Q

Just before the surgeon clamps the renal vessels of the donors kidney, what does the anesthesia provider put in the IV?
A. heparin and mannitol
B. protamine sulfate
C. ringers lactate
D. furosemide

A

A. heparin and mannitol

72
Q

Dialysis and kidney transplant are the only two treatment for which of the following?
A. end-stage renal disease
B. testicular carcinoma
C. type I diabetes mellitus
D. wilms tumor

A

A. end-stage renal disease

73
Q

Which of the following studies is a radiologic procedure in which contrast media is injected through a cystoscope?
A. KUB
B. PSA
C. IV urogram
D. retrograde urogram

A

D. retrograde urogram

74
Q

Which component of the rigid endoscopic system for cystoscopy is blunt ended and minimizes mucosal trauma during insertion?
A. deflecting mechanism
B. obturator
C. sheath
D. telescoping bridge

A

B. obturator

75
Q

What procedure is performed for penile carcinoma resistant to chemotherapy or radiation?
A. hydrocelectomy
B. orchiectomy
C. penectomy
D. vasectomy

A

C. penectomy

76
Q

Which of the following is a glass or plastic evacuator used to remove tissue and debris during TURP?
A. Ellik
B. Malecot
C. pezzer
D. toomey

A

A. Ellik

77
Q

Omnipaque, Renografin, and Isovue are used in cystoscopy as:
A. antibiotics
B. contrast media
C. distention fluids
D. topical analgesics

A

B. contrast media

78
Q

What is a unique feature of the OR table in cystoscopy suite?
A. it is radiolucent
B. stirrups can be attached to rails
C. it has a mesh drain attachment
D. it can be adjusted for fluoroscopic exams

A

C. it has a mesh drain attachment

79
Q

An elevated serum PSA exam might prompt the additional investigation of a(n)
A. intravenous urogram
B. prostate biopsy
C. PAP smear
D. urinalysis

A

B. prostate biopsy

80
Q

Bonanno, Malecot, and Pezzer are types of:
A. suprapubic catheters
B. urethral catheters
C. active wound drains
D. passive wound drain

A

A. suprapubic catheters