CRQ General Surgery Flashcards

1
Q

Bariactric surgery treats

A) ulcers

B) obesity

C) thyroid disease

D) carcinoma of the pancreas

A

B) obesity

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2
Q

Fogarty biliary catheters are used to

A) drain the gallbladder

B) drain the common bile duct

C) instill contrast medium

D) facilitate stone removal

A

D) facilitate stone removal

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3
Q

Which muscles are incised in the midline of the neck once the skin flaps are completed during a thyroidectomy?

A) sternocliedomastoid

B) strap

C) sternothyroid

D) sternoclavicular

A

B) strap

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4
Q

Intra-abdominal pressure during the instillation of CO2 for creation of pneumoperitoneum is 10-15mm Hg. A pressure reading higher than this may indicate that the needle may be

A) buried in fatty tissue

B) buried in omentum

C) in a lumen of intestines

D) all of the above

A

D) all of the above

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5
Q

A benign anal wall “slit” type of lesion requiring excision is a/n

A) hemorrhoid

B) anal fistula

C) anal fissure

D) pilonodal sinus

A

C) anal fissure

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6
Q

Which incision would require cutting through Scarpa’s fascia?

A) Subcostal

B) Inguinal

C) Pfannenstiel

D) McBurney

A

B) Inguinal

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7
Q

Free jejunal tissue transfers are frequently successful as adjunct surgical revisions following

A) laryngoesophagectomy

B) esophagectomy

C) iliectomy

D) Both A and B

A

D) Both A and B

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8
Q

Hirschsprung disease is synonymous with

A) bowel obstruction

B) malrotation

C) ileal stenosis

D) Meckel diverticulum

A

A) bowel obstruction

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9
Q

During an appendectomy, a purse-string suture is placed around the appendix stump to

A) amputate the appendiceal base

B) retract the appendix

C) tie off the appendix

D) invert the stump of the appendix

A

D) invert the stump of the appendix

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10
Q

During laparoscopic cholecystectomy, the camera operator usually stands

A) across from the surgeon

B) to the right of the surgeon

C) to the right of the first assistant

D) behind the Mayo stand

A

C) to the right of the first assistant

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11
Q

Which hernia leaves the abdominal cavity at the internal inguinal ring and passes with the cord structures down the inguinal canal?

A) Direct

B) Umbilical

C) Spigelian

D) Indirect

A

D) Indirect

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12
Q

The instrument most commonly used to grasp the mesoappendix during an appendectomy is a

A) Kelly

B) Kocher

C) Babcock

D) Allis

A

C) Babcock

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13
Q

Intraoperative cholangiograms can be performed either through open abdominal or laparoscopic procedures using a contrast medium directly into the common bile duct through a

A) cystocath

B) cholangiocath

C) T-tube

D) red rubber catheter

A

B) cholangiocath

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14
Q

A Whipple operation is surgically termed a

A) pancreatectomy

B) pancreatoduodenectomy

C) pancreatic cyst marsupialization

D) transduodenal sphincterotomy

A

B) pancreatoduodenectomy

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15
Q

When bowel technique for an intestinal procedure is utilized

A) two Mayo stands are used

B) drapes and gloves do not need to be changed

C) contaminated instruments are discarded, gloves are changed

D) a seperate setup is used for the closure

A

C) contaminated instruments are discarded, gloves are changed

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16
Q

A common staple gun used to transect the stomach is _______ and the _______ gun is used to transect and anastamose the jejunum during a Bilroth II procedure.

A) EEA, LDS

B) TA, GIA

C) Hemaclip, GIA

D) Purstring, LDS

A

B) TA, GIA

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17
Q

A device that may obliviate the need for an abdominoperineal resection because a low anterior anastomosis can be performed is a/n

A) end- to- end anastomosis (EEA)

B) GIA

C) TA55

D) LDS

A

A) end- to- end anastomosis (EEA)

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18
Q

In surgery, cancer technique refers to

A) the administration of an anticancer drug directly into the cancer site.

B) the discarding of instruments coming in contact with tumor after each use

C) the use of radiation therapy at the time of surgery

D) the identification of the lesion

A

B) the discarding of instruments coming in contact with tumor after each use

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19
Q

In which hernia does the herniation protrude into the inguinal canal but NOT the cord?

A) Incisional

B) Femoral

C) Direct

D) Indirect

A

C) Direct

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20
Q

What kind of tube is used to decompress the stomach or as a means of feeding the patient?

A) Nasogastric tube

B) Esophageal Tube

C) Gastrostomy Tube

D) T-Tube

A

C) Gastrostomy Tube

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21
Q

The intestinal layer in order, from inside to outside, is

A) serosa, mucosa, musculature

B) mucosa, submucosa, serosa

C) serosa, musculature, mucosa

D) mucosa, serosa, musculature

A

B) mucosa, submucosa, serosa

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22
Q

A condition that causes bowel obstruction when one section of intestine telescopes over another and mostly occurs in children is

A) evisceration

B) Crohn disease

C) gastroschisis

D) intussusceptions

A

D) intussusceptions

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23
Q

Following a hemorrhoidectomy

A) dry dressing of 4x4s is packed in the rectum

B) petroleum gauze packing is placed in the anal canal

C) stent dressing is applied

D) steri-strip dressing is used

A

B) petroleum gauze packing is placed in the anal canal

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24
Q

All of the following statements refer to pilonidal cyst surgery EXCEPT

A) it is performed with an elliptical incision

B) the wound frequently heals by granulation

C) probes are required on setup

D) the cyst is removed, but the tract remains

A

D) the cyst is removed, but the tract remains

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25
Q

The telescoping of the proximal intestine into the lumen of the distal intestine is called

A) volvulus

B) intussusception

C) pyloric stenosis

D) ileal atresia

A

B) intussusception

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26
Q

In a pilonidal cystectomy, the defect frequently is too large to close and requires use of a/n

A) skin graft

B) traction suture

C) implant

D) packing and pressure dressing

A

D) packing and pressure dressing

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27
Q

The term transduodenal sphincterotomy indicates surgery of the

A) hepatic duct

B) proximal end of the common bile duct

C) distal end of the common bile duct

D) pyloric sphincter

A

C) distal end of the common bile duct

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28
Q

Arrange the large intestine in correct order from proximal to distal is 1)rectum, 2) transverse colon ,3) ascending, 4) sigmoid, 5) descending

A) 1,2,3,4,5

B) 3,2,5,4,1

C) 2,3,4,1,5

D) 2,3,4,5,1

A

B) 3,2,5,4,1

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29
Q

The needle used to instill the gas during a laparoscopy is a

A) Silverman

B) Crile

C) Hegar

D) Verres

A

D) Verres

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30
Q

The use of noninvasive high-energy shock waves to pulverize gallstones into small fragments for easy passage through the common bile duct and out of the body is called

A) choledochoscopy

B) cholelithotripsy

C) choledochostomy

D) choledochotomy

A

B) cholelithotripsy

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31
Q

A congenital defect where the abdominal contents are outside the body at birth is

A) hiatal hernia

B) diverticular disease

C) Crohn disease

D) omphalocele

A

D) omphalocele

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32
Q

In a thyroidectomy, a loop retractor retracts the

A) platysma muscle

B) cervical fascia

C) thyroid veins

D) sternocliedomastoid muscle

A

D) sternocliedomastoid muscle

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33
Q

The pancreatic duct (the duct of wirsung) and the common bile duct from the liver drain their contents into this section of the intestine:

A) jejunum

B) ileum

C) cecum

D) duodenum

A

D) duodenum

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34
Q

The procedure traditionally performed to treat gastric ulcers and gastric carcinoma and is currently used to treat morbid obesity is

A) Roux en y

B) band gastroplasty

C) Bilroth I

D) None of the above

A

A) Roux en y

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35
Q

An inguinal hernia containing a Meckel’s diverticulum is called a

A) Richter’s

B) Littre’s

C) Maydl’s

D) spigelian

A

B) Littre’s

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36
Q

Gastrointestinal decrompression during a general surgical procedure can be effected by the use of a

A) Levine tube

B) Miller-Abbot tube

C) Vari-Dyne

D) Both A and B

A

D) Both A and B

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37
Q

Thrombosed vessels of the rectum are known surgically as

A) polyps

B) hemorrhoids

C) fistulas

D) anorectal tumors

A

B) hemorrhoids

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38
Q

During a thyroidectomy the surgeon identifies and preserves which of the following structure(s):

A) recurrent laryngeal

B) parathyroid glands

C) superior laryngeal

D) all of the above

A

D) all of the above

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39
Q

During a laparotomy, the surgeon packs the abdominal contents away from the diseased area with

A) Raytec 4x4s

B) Moist laps

C) Gelfoam and thrombin

D) Dry laps

A

B) Moist laps

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40
Q

What is the correct order from the outer most to the innermost tissue layers that make up the wall of the stomach: 1)serosa 2)mucosa 3)muscularis 4)submucosa

A) 1,2,3,4

B) 4,3,2,1

C) 3,2,1,4

D) 2,3,4,1

A

A) 1,2,3,4

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41
Q

An esophageal diverticulum is also known as

A) hiatal hernia

B) GERD

C) Hirschsprung disease

D) Zenker diverticulum

A

D) Zenker diverticulum

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42
Q

An advanced inflammation of the bowel could be conservatively treated with which procedure?

A) Temporary colostomy

B) Anterior resection

C) Hemicolectomy

D) Abdominal perineal resection

A

A) Temporary colostomy

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43
Q

The maximum pressure allowed to prevent the possible intraoperative complications of bradycardia, blood pressure changes, or potential gas emboli during a laparoscopic procedure is

A) 8mmHg

B) 10mmHg

C) 15mmHg

D) 20mmHg

A

C) 15mmHg

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44
Q

Portal pressure measurement is indicated in

A) liver transplant

B) splenectomy

C) hepatic resection

D) Whipple operation

A

C) hepatic resection

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45
Q

The pancreatic duct is also known as

A) Ampula of Vater

B) Duct of Wirsung

C) Sphincter of Oddi

D) Circle of Willis

A

B) Duct of Wirsung

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46
Q

Morbid obesity is defined as BMI (body mass index) greater than

A) 30

B) 40

C) 10

D) 25

A

B) 40

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47
Q

When both direct and indirect hernias occur in the same inguinal area, the defect is termed

A) sliding

B) pantaloon

C) femoral

D) spigelian

A

B) pantaloon

48
Q

When viscera has protruded outside of the body, this condition is called

A) dehiscence

B) evisceration

C) ischemia

D) fistula

A

B) evisceration

49
Q

An irreducible hernia whose abdominal contents have become trapped in the extraabdominal sac is called a/n

A) incarcerated hernia

B) sliding hernia

C) spigelean hernia

D) strangulated hernia

A

A) incarcerated hernia

50
Q

The Sengstaken-Blakemore tube is used for

A) esophageal hemorrhage

B) tonsillar hemorrhage

C) uterine hemorrhage

D) nasal hemorrhage

A

A) esophageal hemorrhage

51
Q

Place tissue layers of the abdominal wall in their correct order from the outside in: 1)fascia 2)skin 3)peritoneum 4)subcutaneous 5) Muscle.

A) 1,2,3,4,5

B) 2,3,4,5,1

C) 2,4,1,5,3

D) 3,5,1,4,2

A

C) 2,4,1,5,3

52
Q

A subphrenic abscess occurs in the

A) pancreas

B) spleen

C) lung

D) liver

A

D) liver

53
Q

A palliative invasive procedure done to prevent malnutrition or starvation is known as

A) percutaneous endoscopic gastrostomy

B) gastrotomy

C) gastrostomy

D) gastrojejunostomy

A

C) gastrostomy

54
Q

Surgical enlargement of the passage between the prepylorus of the stomach and the duodenum is a

A) pyloromyotomy

B) pyloroplasty

C) Billroth I

D) Billroth II

A

B) pyloroplasty

55
Q

A procedure done to give the colon a rest and is then reversed is

A) temporary colectomy

B) temporary colostomy

C) abdominoperineal resection

D) McVey procedure

A

B) temporary colostomy

56
Q

A catheter commonly used in a gastrostomy is a

A) mushroom

B) Rehfus

C) Cantor

D) Sengstaken-Blakemore

A

A) mushroom

57
Q

Intraabdominally, lap pads are most often used

A) dry

B) moistened with saline

C) moistened with water

D) moistened with glycine solution

A

B) moistened with saline

58
Q

Which gallbladder procedure ALWAYS requires intraoperative X-rays?

A) Choledochoscopy

B) Cholelithotripsy

C) holedochoduodenostomy

D) Cholangiogram

A

D) Cholangiogram

59
Q

An important consideration during cholangiogram is to

A) irrigate with distilled water

B) remove all air bubbles from the cholangiocath

C) flash sterilize the choledochoscope

D) dip the catheter in lubricating jelly

A

B) remove all air bubbles from the cholangiocath

60
Q

The proper method of removing the gallbladder specimen after complete dissection and irrigation of the operative site in a laparopscopic cholecystectomy is to

A) utilize an endobag

B) pull gallbladder through the largest port

C) decompress the gallbladder by suctioning bile before removal

D) all of the above

A

D) all of the above

61
Q

A left subcostal incision indicates surgery of the

A) gallbladder

B) pancreas

C) spleen

D) common bile duct

A

C) spleen

62
Q

The portion of the small intestine where a Meckles Diverticulum arises is the

A) Duodenum

B) jejunum

C) pylorus

D) distal ileum

A

D) distal ileum

63
Q

The position which facilitates a symmetrical outcome during a mastopexy is

A) supine

B) dorsal recumbent

C) Fowler’s

D) lateral

A

C) Fowler’s

64
Q

An imperforate anus

A) anal opening is absent

B) anus is closed

C) anal sphincter is too tight

D) anal sphincter is too loose

A

B) anus is closed

65
Q

Failure of the intestines to encapsulate within the peritoneal cavity of a newborn is called

A) umbilical hernia

B) omphalocele

C) hydrocele

D) intestinal extrophy

A

B) omphalocele

66
Q

A sheet of vascular tissue that supplies blood and lymph to the lower section of the small intestines is

A) omentum

B) stoma

C) mesentery

D) cecum

A

C) mesentery

67
Q

An abdominal wall defect may be reconstructed using

A) Gore-Tex patch

B) Heavy interrupted silk

C) Shouldice repair

D) Bassini Repair

A

A) Gore-Tex patch

68
Q

A selective alternative to a conventional ileostomy that denies spontaneous stool exiting from the stoma and requires catheterization of the stoma daily to evacuate the contents is a/n

A) cecostomy

B) ileoanal pull-through

C) ileal conduit

D) Kock pouch

A

D) Kock pouch

69
Q

Which breast procedure removes the entire breast and axillary contents but preserves the pectoral muscles?

A) Lumpectomy

B) Wedge resection

C) Modified radical mastectomy

D) Radical mastectomy

A

C) Modified radical mastectomy

70
Q

“Scratch” marking is done in surgery of the

A) chin

B) eye

C) breast

D) thyroid

A

D) thyroid

71
Q

In what procedure is a portion of the stomach removed with an anastamosis created between the stomach and a jejunum?

A) Bilroth I

B) Bilroth II

C) Jejunectomy

D) Gastrectomy

A

B) Bilroth II

72
Q

A common postoperative patient complaint folllowing a laparopscopic procedure is

A) headache

B) diarrhea

C) gastric upset

D) shoulder pain

A

D) shoulder pain

73
Q

Which organ is removed either because of trauma, a blood condition, or as a staging procedure for malignancy?

A) Adrenals

B) Spleen

C) Liver

D) Pancreas

A

B) Spleen

74
Q

McBurney is an incision used for

A) appendectomy

B) cholecystectomy

C) herniorrhaphy

D) pilonidal cystectomy

A

A) appendectomy

75
Q

A hernia occuring in Hasselback’s triangle is called

A) indirect

B) spigelean

C) direct

D) femoral

A

C) direct

76
Q

The disposable circular staple designed to hold two tubular structures together after resection is known as

A) TA linear

B) LDS

C) EEA

D) GIA

A

C) EEA

77
Q

In a gastrointestinal closure, the mucosa of the intestinal tract is closed with

A) chromic 4-0 or 3-0

B) silk 4-0 or 3-0

C) dacron 3-0 or 2-0

D) Novafil 3-0 or 2-0

A

A) chromic 4-0 or 3-0

78
Q

Drainage of an incision following a simple or modified radical mastectomy is accomplished by a

A) Penrose

B) sump

C) closed-wound drainage

D) cigarette drain

A

C) closed-wound drainage

79
Q

The procedure where a hooked wire is inserted under flouroscopy into the suspicious tissue is called

A) a hook wire

B) wire localization

C) staging

D) frozen section

A

B) wire localization

80
Q

Which type of suture would be used to invert the stump of an appendix?

A) buried

B) purse string

C) mattress

D) tension

A

B) purse string

81
Q

Inherited deficiencies of coagulation in which bleeding occurs spontaneously after minor trauma is

A) Tay-Sachs Disease

B) hemophilia

C) pernicious anemia

D) erythroblastosis fetalis

A

B) hemophilia

82
Q

During a laparoscopic cholecystectomy, the surgeon generally stands

A) at the right side of the patient

B) at the bottom of the patients table

C) at the left side of the patient

D) in front of the first assistant

A

C) at the left side of the patient

83
Q

Which type of endoscopy camera produces the truest color?

A) One-chip

B) two-chip

C) three-chip

D) four chip

A

C) three-chip

84
Q

Transduodenal sphincterotomy refers to the incision made into the______to relieve stenosis.

A) Cardiac sphincter

B) Ileocecal sphincter

C) Sphincter of Oddi

D) Phyloric sphincter

A

C) Sphincter of Oddi

85
Q

What is the technique used on a laparoscopic direct inguinal hernia repair where the peritoneal space is inflated with a balloon dissector?

A) TEP(total extraperitoneal)

B) Hasson

C) TAPP(transabdominal preperitoneal)

D) Open

A

A) TEP(total extraperitoneal)

86
Q

A Nissen Fundoplication procedure is done to correct

A) repeated attacks of volvulus

B) antireflux disease

C) bladder prolapse

D) gastroesophageal stenosis

A

B) antireflux disease

87
Q

Intestinal obstruction by twisting of the intestines is

A) pyloric stenosis

B) volvulus

C) neuroblastoma

D) encephalocele

A

B) volvulus

88
Q

An entire tumor/ mass removal is termed

A) needle biopsy

B) staging biopsy

C) excisional biopsy

D) incisional biopsy

A

C) excisional biopsy

89
Q

In a Cholecystectomy, which structures are ligated and divided?

A) Cystic duct and cystic artery

B) Common bile duct and hepatic duct

C) Cystic duct and common bile duct

D) Hepatic duct and cystic artery

A

A) Cystic duct and cystic artery

90
Q

In which hernia is the blood supply of the trapped sac contents compromised and in danger of necrosing?

A) Direct

B) Indirect

C) Strangulated

D) Reducible

A

C) Strangulated

91
Q

Before handing a penrose drain to the surgeon

A) place it on a Allis clamp

B) attach a safety pin to it

C) cut it to the desired length

D) moisten it in saline

A

D) moisten it in saline

92
Q

Pathologic enlargement of the male breast is called

A) subcutaneous adenoma

B) gynecomastia

C) hypoplasia

D) cystic mastitis

A

B) gynecomastia

93
Q

Vaporization and coagulation of hemorrhoidal tissue can be accomplished with

A) cautery, bipolar

B) cautery, monopolar

C) CO2 laser

D) cryosurgery

A

C) CO2 laser

94
Q

The breast procedure performed to remove extensive benign disease is a/an

A) axillary node dissection

B) simple mastectomy

C) radical mastectomy

D) modified radical mastectomy

A

B) simple mastectomy

95
Q

Blunt dissection of the gallbladder from the sulcus of the liver requires the use of a

A) Metzenbaum

B) Kelly

C) tampon

D) peanut

A

D) peanut

96
Q

Direct visualization of the common bile duct is accomplished with a

A) cholangiocath

B) cholangiogram

C) choledochoscope

D) trocar

A

C) choledochoscope

97
Q

Twisting of the bowel is known as

A) strangulation

B) intussuseption

C) volvulus

D) paralytic ileus

A

C) volvulus

98
Q

A choledochoduodenostomy is an anastamosis between the

A) pancreas and common bile duct

B) common bile duct and duodenum

C) gallbladder and duodenum

D) Both B and C

A

B) common bile duct and duodenum

99
Q

All of the following statements concerning the obese surgical patient are true EXCEPT

A) obesity may delay the healing process because of poor vascularity

B) obese patients have an increased incidence of postoperative wound infection

C) adipose tissue retains anesthetic drugs longer

D) obese patients are more prone to hyperglycemia

A

D) obese patients are more prone to hyperglycemia

100
Q

A lower oblique incision is a/an

A) Pfannenstiel

B) inguinal

C) paramedian

D) midabdominal

A

B) inguinal

101
Q

Why are gowns, gloves, drapes, and instruments changed following a breast biopsy and before a mastectomy?

A) To respect individual surgeon’s choice

B) To follow aseptic principles

C) To accommodate two seperate incisions

D) To protect margins of healthy tissue from tumor cells.

A

D) To protect margins of healthy tissue from tumor cells.

102
Q

What incision is indicated for an esophagogastrectomy?

A) left paramedian

B) Upper vertical midline

C) Thoracoabdominal

D) Full midabdominal

A

C) Thoracoabdominal

103
Q

The simplest abdominal incision offering good exposure to any part of the abdominal cavity is the

A) right subcostal

B) Kocher’s

C) midabdominal transverse

D) vertical midline

A

D) vertical midline

104
Q

Which tube may be inserted to produce a continuous postoperative drainage of the common bile duct?

A) Nasogastric tube

B) Levine tube

C) T-tube

D) Foley

A

C) T-tube

105
Q

An instrument used to elevate the thyroid lobe during surgical excision is a

A) Babcock

B) Lahey

C) Green

D) Jackson

A

B) Lahey

106
Q

During a laparotomy procedure, the duties of the STSR include:

A) 4x4s and needles must be mounted on appropriate clamps on Mayo stand

B) Keep the ESU free of debris and in its holster

C) Keep surgical field free of instruments not in use

D) All of the above

A

D) All of the above

107
Q

A gastroplasty

A) reduces stomach size

B) corrects gastric junction stenosis

C) releases adhesions

D) provides avenue for hyperalimentation

A

A) reduces stomach size

108
Q

Bowel technique is also known as

A) abdominal technique

B) isolation technique

C) resection technique

D) both A and C

A

B) isolation technique

109
Q

Gastrointestinal technique is required in all of the following procedures EXCEPT

A) cholecystectomy

B) low anterior colon resection

C) appendectomy

D) hemicolectomy

A

A) cholecystectomy

110
Q

What procedure involves injection of dye and/ or a radioactive material into the breast mass to track the lymph nodes?

A) Stereotaxis

B) Excisional biopsy

C) Staging

D) Sentinel node biopsy

A

D) Sentinel node biopsy

111
Q

A Whipple procedure consists of removal of

A) ancreas,duodenum,jejunum,stomach, and common bile duct

B) portion of pancreas, duodenum, portion of jejunum, distal stomach, and distal portion of common bile duct

C) duodenum,jejunum, distal stomach, and gallbladder

D) head of pancreas, portion of liver, gallbladder, and common bile duct

A

B) portion of pancreas, duodenum, portion of jejunum, distal stomach, and distal portion of common bile duct

112
Q

White balancing a video camera in endoscopy requires the scrub person to focus the camera on

A) a white sponge

B) a white wall

C) a glove wrapper

D) Any of the above

A

D) Any of the above

113
Q

Defogging the video camera is usually the responsibility of the

A) circulator

B) surgeon

C) scrub person

D) camera operator

A

D) camera operator

114
Q

Which structures are identified and preserved in thyroid surgery?

A) Parathyroid glands

B) Hyoid bone

C) Thyroglossal duct

D) Thyroid lobe

A

A) Parathyroid glands

115
Q

Which item retracts the spermatic cord structure in herniorrhaphy?

A) Army-Navy retractor

B) Penrose drain

C) Green retractor

D) Silk suture

A

B) Penrose drain

116
Q

In an extreme patient emergency, a sponge count

A) may be omitted

B) may be done by the scrub alone

C) must be done before the case is allowed to begin

D) must be done before closure

A

A) may be omitted