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FLS |\exam |\questions |\with |\correct |\answers
What |\are |\the |\laparoscope |\diameters? |- |\CORRECT |\ANSWERS |\✔✔2- 10mm Which |\degree |\scope |\is |\best |\for |\a |\field |\in |\line |\with |\port? |- |\CORRECT |
ANSWERS |\✔✔ 0 |\degree How |\to |\prevent |\fogging |\of |\scope? |- |\CORRECT |\ANSWERS |\✔✔Use |\anti |\fog |\solution |\or |\put |\scope |\in |\hot |\water/hot |\bath What |\is |\the |\most |\commonly |\used |\light |\source? |- |\CORRECT |
ANSWERS |\✔✔ 300 |\W |\Xenon |\lamp What |\if |\there |\is |\initial |\low |\pressure |\and |\high |\flow |\rate |\at |\entry? |- |
CORRECT |\ANSWERS |\✔✔Leak |\in |\insufflator |\circuit, |\make |\sure |
everything |\plugged |\in |\correctly Benefits |\of |\monopolar |- |\CORRECT |\ANSWERS |\✔✔Tissue |\is |\heated |
quickly, |\less |\thermal |\damage/coagulation Monopolar |\voltage/frequency |- |\CORRECT |\ANSWERS |\✔✔Low |
voltage/High |\frequency
What |\does |\coagulation |\mode |\do? |- |\CORRECT |\ANSWERS |\✔✔Repid |
surface |\heating |\with |\shallow |\depth |\of |\necrosis, |\intermittent |\wave |
form |\with |\higher |\voltage Risk |\of |\monopolar |- |\CORRECT |\ANSWERS |\✔✔Current |\can |\be |\diverted |\through |\unintentional |\pathways, |\leading |\to |\inadvertent |\tissue |
injury. |\Don't |\use |\hybrid |\ports |\that |\mix |\metal |\with |\plastic Why |\do |\you |\need |\a |\grounding |\pad |\for |\monopolar? |- |\CORRECT |
ANSWERS |\✔✔Capacitative |\coupling |- |\transfer |\of |\energy |\between |
two |\conductors |\separated |\by |\an |\insulator, |\transfer |\to |\passive |
electrode. |\Can |\release |\with |\tissue |\injury, |\but |\no |\issue |\if |\ground |
plate |\is |\working |\as |\capacitor |\can't |\store |\the |\charge Benefits |\of |\bipolar |- |\CORRECT |\ANSWERS |\✔✔lower |\energy, |\producing |\less |\lateral |\tissue |\damage |\and |\necrosis. |\Don't |\need |\a |\grounding |
pad Risk |\of |\bipolar |- |\CORRECT |\ANSWERS |\✔✔Risk |\of |\cutting |\patient |
vessels |\before |\adequate |\sealing, |\and |\device |\doesn't |\work |\if |\there |\is |\metal |\between |\the |\jaws
- |\Low |\frequency
- |\Intermittent |\waveform
- |\Rapid |\tissue |\heating, |\shallow |\depth |\of |\necrosis
- |\Non-contact: |\relies |\on |\sparking |\to |\tissue Capacitive |\coupling |- |\CORRECT |\ANSWERS |\✔✔Transfer |\current |\from |
active |\electrode |\through |\insulation |\to |\passive |\electrode- |\electrode |
to |\plastic |\part |\another |\LSC |\instrument - |\if |\constant |\contact |\w/ |\tissue |\will |\not |\store |\energy |\and |\no |\injury Direct |\coupling |- |\CORRECT |\ANSWERS |\✔✔monopolar |\instrument |\in |
direct |\contact |\w/ |\metal |\portion |\of |\another |\instrument Besides |\capacitative |\coupling |\and |\direct |\coupling, |\other |\hazards |\of |
electrocautery |- |\CORRECT |\ANSWERS |\✔✔- |\Current |\diversion - |\Narrow |\return |\circuit Bipolar |- |\CORRECT |\ANSWERS |\✔✔- |\forceps |\w/ |\two |\twins |(one |\active |
other |\return) - |\no |\pt |\return |\electrode |\required)
- |\no |\capacitative |\coupling
- |\works |\in |"wet" |\operative |\field
- |\less |\thermal |\spread |\compared |\to |\monopolar
bipolar |\seals |\vessels |\up |\to |_____ |\mm |\in |\diameter |- |\CORRECT |
ANSWERS |\✔✔ 7 |\mm ultrasonic |\coagulation |\shears |\seals |\vessels |\up |\to |____ |\mm |\in |
diameter |- |\CORRECT |\ANSWERS |\✔✔ 5 |\mm ultrasonic |\coagulation |\shears |- |\CORRECT |\ANSWERS |\✔✔- |\combo |
compression |\and |\friction
- |\ONE |\active |\blade
- |\monopolar |\capacity |\w/ |\the |\one |\blade
- |\no |\capacitative |\coupling
- |\high |\power |(MAX): |\cut
- |\low |\power |(MIN): |\coag How |\many |\days |\prior |\to |\surgery |\does |\warfarin |\has |\to |\be |
discontinued? |- |\CORRECT |\ANSWERS |\✔✔ 3 |\days ASA |\ 2 |- |\CORRECT |\ANSWERS |\✔✔Mild |\to |\moderate |\systemic |\disease ASA |\ 3 |- |\CORRECT |\ANSWERS |\✔✔severe |\systemic |\disease |\that |\limits |
patient |\activity, |\may |\or |\may |\not |\be |\related |\to |\reason |\for |\surgery
- |\Large |\abd/pelvic |\mass
- |\Massive |\incarcerated |\ventral |\and |\inguinal |\hernias
- |\Severe |\cardiopulmonary |\dz NOT |\C/I |\to |\LSC |\Sx |- |\CORRECT |\ANSWERS |\✔✔- |\Diaphragm |\injury
- |\GI |\bleed
- |\Performed |\viscus
- |\Bowel |\obstruction
- |\Abd |\trauma |\if |\HD |\stable
- |\COPD
- |\Renal |\insufficiency Preop |\precautions |- |\CORRECT |\ANSWERS |\✔✔Be |\aware |\of
- |\Visceral |\arterial |\aneurysm |(risk |\injury |\w/ |\trocar |\insertion)
- |\prior |\ventral |\hernia |\repair |\w/ |\mesh |(NO |\blind |\entry |\w/ |\veress |\or |
trocar |\through |\mesh!) - |\H/o |\peritonitis |(risk |\adhesions |\and |\enterotomy)
- |\Cirrhosis |(increased |\risk |\of |\bleeding |\and |\ascites |\leak |\through |
ports/wounds) - |\Intestinal |\obstruction
GETA |\pre-meds |- |\CORRECT |\ANSWERS |\✔✔BZ, |\atropine/glycopyrrolate |
(prevent |\bradyarrhythmia |\from |\pneumoperitoneum), |\H2 |\blocker CO2 |\benefits |- |\CORRECT |\ANSWERS |\✔✔- |\Rapidly |\absorbed
- |\Easily |\eliminated |(diffusion |\coefficient |\20x |\CO2)
- |\Suppresses |\combustion
- |\Readily |\available
- |\Inexpensive Chemical |\effects |\of |\CO2 |- |\CORRECT |\ANSWERS |\✔✔- |\Increase |\arterial |
and |\end |\tidal |\CO - |\Decrease |\serum |\pH |\w/ |\greatest |\change |\in |\first |\ 20 |\min |(SS |\after |
1h) Pressure |\effects |\of |\CO2 |- |\CORRECT |\ANSWERS |\✔✔Pulm |- |\Reduced |\functional |\residual |\capacity |- |\Reduced |\pulmonary |\compliance |- |\Increased |\peak |\airway |\pressure CV |- |\Increase |\preload |\and |\afterload, |\DECREASE |\CO |- |\Brady, |\PVC |- |\increased |\VC |\resistance |\and |\decrease |\venous |\flow, |\theoretically |
increase |\risk |\VTE
LSC |\examination |\of |\small |\bowel |- |\CORRECT |\ANSWERS |\✔✔place |
monitors- |\one |\near |\head |(ligament |\treitz), |\one |\near |\feet |(ileocecal |
valve place |\ports |\along |\left |\abd IN |\SBO |\pt, |\start |\at |\ILEOCECAL |\valve |(most |\distal, |\should |\be |\most |
decompressed) FNA |\uses |______G |\needle |- |\CORRECT |\ANSWERS |\✔✔20-22 |\G Core |\biopsy |\uses |\a |_____G |\needle |- |\CORRECT |\ANSWERS |\✔✔14-16 |\G LSC |\suturing |\technique |- |\CORRECT |\ANSWERS |\✔✔- |\ports |\at |\least |\ 10 |
cm |\apart |\to |\allow |\intracorporeal |\knot |\tying
- |\10-12 |\mm |\trocar |\accommodates |\standard |\SH |\needle Length |\of |\suture |\for |\intracorporeal |\knot |\tying |- |\CORRECT |\ANSWERS |
✔✔ 6 |\inches |(15 |\cm) Length |\of |\suture |\for |\extracorporeal |\knot |\tying |- |\CORRECT |\ANSWERS |\✔✔ 30 |\inches |(76 |\cm) 2-2.5 |\mm |\staples |\used |\for |- |\CORRECT |\ANSWERS |\✔✔- |\white/grey |\in |
color
- |\vascular, |\thinner |\tissue 3-3.5 |\mm |\staples |- |\CORRECT |\ANSWERS |\✔✔- |\blue
- |\for |\majority |\GI |\tract 4-4.5 |\mm |\staples |- |\CORRECT |\ANSWERS |\✔✔- |\green
- |\for |\distal |\stomach, |\thickened |\portions |\of |\GI |\tract Monopolar |\cautery |- |\CORRECT |\ANSWERS |\✔✔- |\smaller |\vessels, |\slow |
rate |\bleeding, |\need |\relatively |\dry |\operative |\field Days |\until |\full |\diet |\tolerated |- |\CORRECT |\ANSWERS |\✔✔1-2d |\for |
fundoplication 3-6d |\for |\colon |\resection Postop |- |\vascular |\injury |\smaller |\vessels |- |\CORRECT |\ANSWERS |\✔✔- |
usu |\superior/inferior |\epigastric |\vessels, |\mesenteric |\arteries/veins --> |\abd |\wall |\or |\peritoneal |\hematomas. |\ - |\Surgery |\if |\con't |\bleeding, |\infxn, |\HD |\instability In |\the |\event |\of |\a |\blank |\screen, |\which |\is |\NOT |\a |\likely |\problem |\site? |- |\CORRECT |\ANSWERS |\✔✔FRED |\anti-fog |\solution
(instrument |\can |\store |\the |\charge |\and |\then |\transmit |\to |\tissue |\next |
time |\it |\touches |\something) when |\using |\the |\ultrasonic |\shears, |\the |\entire |\portion |\of |\the |\active |
blade |\is |\exposed. |\In |\order |\to |\avoid |\inadvertent |\delivery |\of |\energy |
to |\tissue |\in |\contact |\with |\the |\bottom |\portion |\of |\the |\active |\blade, |
one |\should |\do |\the |\following: |- |\CORRECT |\ANSWERS |\✔✔be |\aware |\of |
the |\contact |\points |\the |\blade |\is |\engaging, |\grab |\the |\target |\tissue |\and |\elevate |\it, |\and |\keep |\the |\active |\blade |\upwards |\in |\view |\of |\the |
surgeon ASA |\class |\ 3 |- |\CORRECT |\ANSWERS |\✔✔severe |\systemic |\disease |\that |
limits |\the |\patient's |\activity |\and |\may |\or |\may |\not |\be |\related |\to |\the |
reason |\for |\surgery initial |\consultation |\should |\include |\which |\of |\the |\following? |- |
CORRECT |\ANSWERS |\✔✔possibility |\of |\conversion |\to |\open |\surgery which |\of |\the |\following |\is |\a |\relative |\contraindication |\to |\laparoscopic |
surgery? |- |\CORRECT |\ANSWERS |\✔✔previous |\abdominal |\surgery which |\of |\these |\is |\NOT |\an |\absolute |\contraindication |\to |\laparoscopic |
surgery? |- |\CORRECT |\ANSWERS |\✔✔bowel |\obstruction |
(contraindications |\include |\uncorrectable |\hypovolemic |\shock, |\lack |\of |
proper |\surgical |\training, |\and |\inability |\to |\tolerate |\laparotomy)
which |\procedure |\may |\be |\performed |\using |\local |\anesthesia |\alone |\or |\with |\mild |\sedation? |- |\CORRECT |\ANSWERS |\✔✔diagnostic |\laparoscopy important |\features |\in |\patient |\positioning |\for |\laparoscopic |\surgery |
include: |- |\CORRECT |\ANSWERS |\✔✔avoidance |\of |\position |\related |
complications, |\prevention |\of |\DVT, |\and |\location |\of |\target |\organ the |\most |\commonly |\used |\anesthetic |\for |\laparoscopic |\procedures |\is |
general |\anesthesia. |\all |\of |\the |\following |\are |\true |\EXCEPT |- |\CORRECT |
ANSWERS |\✔✔there |\are |\fewer |\hemodynamic |\changes |\compared |\to |\a |\local |\anesthetic |(true |\answers |\are |\it |\allows |\for |\complete |
neuromuscular |\relaxation, |\it |\provides |\good |\control |\of |\ventilation, |\an |\tit |\allows |\for |\more |\flexibility |\of |\patient |\positioning) what |\is |\the |\most |\common |\site |\for |\initial |\trocar |\insertion? |- |
CORRECT |\ANSWERS |\✔✔umbilicus When |\checking |\placement |\of |\Veress |\needle, |\which |\of |\the |\following |
is |\the |\most |\accurate |\method |\to |\detect |\proper |\intraperitoneal |
placement? |- |\CORRECT |\ANSWERS |\✔✔insufflator |\display |\revealing |
flow |\of |\CO2 |\and |\low |\initial |\pressure umbilical |\Veress |\needle |\insertion |\and |\blind |\tracer |\insertion |\is |
contraindicated |\in |\all |\of |\the |\following |\EXCEPT? |- |\CORRECT |\ANSWERS
What |\is |\the |\reason |\fascia |\at |\trocar |\sites |\is |\sutured |(closed)? |- |
CORRECT |\ANSWERS |\✔✔prevention |\of |\hernia Why |\is |\CO2 |\the |\preferred |\gas |\for |\establishment |\of |
pneumoperitoneum? |- |\CORRECT |\ANSWERS |\✔✔rapidly |\absorbed Easily |\eliminated Supresses |\combustion Readily |\available Relatively |\inexpensive CO2 |\pneumoperitoneum |\chemical |\effects |- |\CORRECT |\ANSWERS |
✔✔Increase |\arterial |\CO2 |\concentration Increase |\end |\tidal |\CO Decrease |\serum |\pH Vigilant |\moitoring |\in |\patients |\with |\severe |\cardiopulmonary |\disease --> |\end-tidal |\CO2 |\monitoring |\essential --> |\greatest |\change |\in |\first |\ 20 |\minutes CO2 |\pneumoperitoneum |\pressure |\effects |- |\CORRECT |\ANSWERS |
✔✔Cardiovascular Pulmonary Renal Integrated |\with |\chemical |\effects
Pulmonary |\physiology |\with |\pneumoperitoneum |- |\CORRECT |
ANSWERS |\✔✔Increase |\minute |\ventilation |\to |\eliminate |\absorbed |\CO Reduced |\functional |\residual |\capacity |(FRC) Increase |\peak |\airway |\pressure Reduced |\pulmonary |\compliance Reduced |\diaphragmatic |\excursion Additional |\CHEMICAL |\cardiovascular |\effects |\of |\pneumoperitoneum |- |
CORRECT |\ANSWERS |\✔✔Systemic |\vascular |\changes Cerebral |\auto-regulation |\of |\blood |\flow Vagal |\responsiveness |\to |\reverse |\Trendelenburg |\position Additional |\PRESSURE |\cardiovascular |\effects |\of |\pneumoperitoneum |- |
CORRECT |\ANSWERS |\✔✔Lower |\initial |\insufflation |\rate |\and |\set |
pressure |\associated |\with |\slightly |\less |\postoperative |\abdominal |\and |
shoulder |\pain Which |\are |\the |\alternatives |\to |\CO2 |\for |\establishment |\of |
pneumoperitoneum? |- |\CORRECT |\ANSWERS |\✔✔Nitrous |\oxide |(N2O) Air Helium Argon
Decreased |\cardiac |\output --> |\hypotension, |\cardiac |\arrhythmia, |\decreased |\urine |\output, |
increased |\end |\tidal |\CO2 |(signs |\and |\symptoms |\of |\reduced |\tissue |
perfusion) Cardiac |\arrhythmias |\due |\to |\pneumoperitoneum |- |\CORRECT |
ANSWERS |\✔✔Sinus |\tachycardia Premature |\ventricular |\contractions Bradycardia How |\much |\does |\venous |\flow |\rates |\drop |\during |\pneumperitoneum? |- |\CORRECT |\ANSWERS |\✔✔26-39% What |\is |\the |\incidence |\of |\VTE |\following |\laparoscopic |\colocystectomy? |- |\CORRECT |\ANSWERS |\✔✔0.5% Renal |\effects |\of |\pneumoperitoneum |- |\CORRECT |\ANSWERS |
✔✔Intraoperative |\oliguria |(increased |\intraabdominal |\pressure |--> |
decreases |\renal |\blood |\flow |--> |\decrease |\filtration |\and |\urine |\output |--> |\2ry |\release |\of |\renin |\and |\ADH |--> |\sodium |\and |\free |\water |
reabsorption |--> |\oliguria) Postoperative |\oliguria |\usually |\resolves |\within |\a |\couple |\hours
Strategies |\to |\avoid |\hypothermia |- |\CORRECT |\ANSWERS |\✔✔Warmed |
IV |\fluids Forced |\air |\body |\surface |\warmer Warm |\room |\temperature Warm |\irrigation |\fluid What |\is |\the |\Incidence |\of |\gas |\embolism |\during |\LSC |\Sx? |- |\CORRECT |
ANSWERS |\✔✔<1% Gas |\embolism |\diagnosis |- |\CORRECT |\ANSWERS |\✔✔Severe |
hypotension, |\JVD, |\tachycardia, |\Mill |\wheel |\murmur |(characteristic) |
[R/o |\other |\source |\of |\hypotension: |\bleeding, |\pneumothorax, |\1ry |
cardiac |\failure) Gas |\embolism |\treatment |- |\CORRECT |\ANSWERS |\✔✔Abrupt |\cessation |
of |\insufflation Vacuation |\of |\pneumoperitoneum Place |\patient |\in |\Trendelenburg, |\Lt |\side |\down |\position Rapid |\fluid |\administration Central |\line |\placement |\into |\the |\Rt |\atrium |\to |\evacuate |\or |\break |\up |
embolus |\in |\Rt |\heart |\chambers
