Surgical Technology Examination Appleton & Lange Pg109-124 CST Exam Prep

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

Buried

Purse-string

Mattress

Tension

A purse-string suture would be used to invert the stump of an appendix. This type of suture involves placing a circular stitch around the stump and then tightening it, creating a purse-like closure. This technique is commonly used to close off the opening of the appendix after it has been removed during an appendectomy. By inverting the stump, the risk of leakage or infection is reduced, promoting proper healing.

Explanation

A purse-string suture would be used to invert the stump of an appendix. This type of suture involves placing a circular stitch around the stump and then tightening it, creating a purse-like closure. This technique is commonly used to close off the opening of the appendix after it has been removed during an appendectomy. By inverting the stump, the risk of leakage or infection is reduced, promoting proper healing.

2. 810. Bariatric surgery treats

Ulcers

Obesity

Thyroid disease

Carcinoma of the pancreas

Bariatric surgery is a type of surgery that is specifically designed to treat obesity. It involves making changes to the digestive system to help people lose weight. This surgery is typically recommended for individuals who have tried other weight loss methods without success and have a body mass index (BMI) above a certain threshold. Bariatric surgery can help individuals achieve significant weight loss and improve obesity-related health conditions such as diabetes, high blood pressure, and sleep apnea.

Explanation

Bariatric surgery is a type of surgery that is specifically designed to treat obesity. It involves making changes to the digestive system to help people lose weight. This surgery is typically recommended for individuals who have tried other weight loss methods without success and have a body mass index (BMI) above a certain threshold. Bariatric surgery can help individuals achieve significant weight loss and improve obesity-related health conditions such as diabetes, high blood pressure, and sleep apnea.

3. 766. Pathologic enlargement of the male breast is called

Subcutaneous adenoma

Gynecomastia

Hypoplasia

Cystic mastitis

Gynecomastia is the term used to describe the pathologic enlargement of the male breast. It is characterized by the development of glandular tissue in the breast, leading to a swollen or enlarged appearance. This condition can be caused by hormonal imbalances, medication side effects, or underlying medical conditions. Gynecomastia is different from pseudogynecomastia, which refers to the accumulation of fat in the breast area. Treatment options for gynecomastia may include medication, surgery, or addressing the underlying cause.

Explanation

Gynecomastia is the term used to describe the pathologic enlargement of the male breast. It is characterized by the development of glandular tissue in the breast, leading to a swollen or enlarged appearance. This condition can be caused by hormonal imbalances, medication side effects, or underlying medical conditions. Gynecomastia is different from pseudogynecomastia, which refers to the accumulation of fat in the breast area. Treatment options for gynecomastia may include medication, surgery, or addressing the underlying cause.

4. 730. Which condition regarding sterile technique is NOT recommended?

Sterile tables are set up just before the operation

Sterile tables may be set up and safely covered until time of surgery

Once sterile packs are open, someone must remain in the room to maintain vigilance

Sterile persons pass each other back to back

Sterile tables should not be set up and covered until the time of surgery because covering the sterile tables can compromise their sterility. It is recommended to set up sterile tables just before the operation to ensure that they remain sterile and free from any contaminants.

Explanation

Sterile tables should not be set up and covered until the time of surgery because covering the sterile tables can compromise their sterility. It is recommended to set up sterile tables just before the operation to ensure that they remain sterile and free from any contaminants.

5. 731. Which of the following conditions is not an acceptable aseptic technique?

Scrub nurse standing on a platform or standing stool

Scrub nurse keeps hands below shoulder level

Scrub nurse folds arms with hands at axillae

Scrub nurse's hands are at or above waist level

The correct answer is "scrub nurse folds arms with hands at axillae." This is not an acceptable aseptic technique because folding the arms with hands at the axillae can potentially contaminate the sterile field. Aseptic technique requires keeping the hands above waist level to minimize the risk of touching non-sterile surfaces and introducing pathogens into the sterile field. Standing on a platform or standing stool, keeping hands below shoulder level, and keeping hands at or above waist level are all acceptable aseptic techniques.

Explanation

The correct answer is "scrub nurse folds arms with hands at axillae." This is not an acceptable aseptic technique because folding the arms with hands at the axillae can potentially contaminate the sterile field. Aseptic technique requires keeping the hands above waist level to minimize the risk of touching non-sterile surfaces and introducing pathogens into the sterile field. Standing on a platform or standing stool, keeping hands below shoulder level, and keeping hands at or above waist level are all acceptable aseptic techniques.

6. 734. Which of the following is considered a break in technique?

A sterile person turns his or her back to a nonsterile person or area when passing

Sterile persons face sterile areas

A sterile person sits or leans against a nonsterile surface

Nonsterile persons avoid sterile areas

Sitting or leaning against a nonsterile surface is considered a break in technique because it can potentially contaminate the sterile person and compromise the sterile field. Sterile persons are expected to maintain a distance from nonsterile surfaces to prevent the transfer of microorganisms.

Explanation

Sitting or leaning against a nonsterile surface is considered a break in technique because it can potentially contaminate the sterile person and compromise the sterile field. Sterile persons are expected to maintain a distance from nonsterile surfaces to prevent the transfer of microorganisms.

7. 753. Another name for the Kraske position is

Prone on an adjustable arch

Lateral

Knee-chest

Jackknife

The correct answer is jackknife. The Kraske position is also known as the jackknife position. In this position, the patient is lying face down with the hips flexed and the chest resting on an adjustable arch. This position is commonly used in surgery, particularly for procedures involving the rectum or anus. It allows for better access and visualization of the surgical site.

Explanation

The correct answer is jackknife. The Kraske position is also known as the jackknife position. In this position, the patient is lying face down with the hips flexed and the chest resting on an adjustable arch. This position is commonly used in surgery, particularly for procedures involving the rectum or anus. It allows for better access and visualization of the surgical site.

8. 820. 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

Choledochoscopy

Cholelithotripsy

Choledochostomy

Choledochotomy

Cholelithotripsy is the correct answer because it refers to the use of noninvasive high-energy shock waves to break down gallstones into smaller fragments. This procedure allows the fragments to pass through the common bile duct and be eliminated from the body more easily. Choledochoscopy, choledochostomy, and choledochotomy are all different procedures that involve the manipulation or exploration of the common bile duct, but they do not specifically involve the use of shock waves to break down gallstones.

Explanation

Cholelithotripsy is the correct answer because it refers to the use of noninvasive high-energy shock waves to break down gallstones into smaller fragments. This procedure allows the fragments to pass through the common bile duct and be eliminated from the body more easily. Choledochoscopy, choledochostomy, and choledochotomy are all different procedures that involve the manipulation or exploration of the common bile duct, but they do not specifically involve the use of shock waves to break down gallstones.

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

Direct

Indirect

Strangulated

Reducible

In a strangulated hernia, the blood supply of the trapped sac contents is compromised and in danger of necrosing. This means that the blood flow to the tissues within the hernia is restricted, which can lead to tissue death if not treated promptly. Strangulated hernias require immediate medical attention to prevent serious complications.

Explanation

In a strangulated hernia, the blood supply of the trapped sac contents is compromised and in danger of necrosing. This means that the blood flow to the tissues within the hernia is restricted, which can lead to tissue death if not treated promptly. Strangulated hernias require immediate medical attention to prevent serious complications.

10. 799. Thrombosed vessels of the rectum are known surgically as

Polyps

Hemorrhoids

Fistulas

Anorectal tumors

Thrombosed vessels of the rectum are known surgically as hemorrhoids. Hemorrhoids are swollen blood vessels that develop in the rectum or anus, causing discomfort and sometimes bleeding. When these blood vessels become thrombosed, it means that a blood clot has formed inside them, leading to more severe symptoms such as pain, swelling, and a hard lump near the anus. Surgical intervention may be required to treat thrombosed hemorrhoids and provide relief to the patient.

Explanation

Thrombosed vessels of the rectum are known surgically as hemorrhoids. Hemorrhoids are swollen blood vessels that develop in the rectum or anus, causing discomfort and sometimes bleeding. When these blood vessels become thrombosed, it means that a blood clot has formed inside them, leading to more severe symptoms such as pain, swelling, and a hard lump near the anus. Surgical intervention may be required to treat thrombosed hemorrhoids and provide relief to the patient.

11. 813. Which item retracts the spermatic cord structure in herniorrhaphy?

Army-navy retractor

Penrose drain

Green retractor

Silk suture

A penrose drain is used to retract the spermatic cord structure during herniorrhaphy. This drain is a soft, flexible tube made of latex or silicone that is placed around the spermatic cord to gently retract it, allowing the surgeon to access and repair the hernia. The penrose drain is preferred for this purpose because it is non-traumatic and does not cause damage to delicate structures. The other options listed, such as the army-navy retractor, Green retractor, and silk suture, are not specifically designed for this purpose and may not provide the same level of gentle retraction.

Explanation

A penrose drain is used to retract the spermatic cord structure during herniorrhaphy. This drain is a soft, flexible tube made of latex or silicone that is placed around the spermatic cord to gently retract it, allowing the surgeon to access and repair the hernia. The penrose drain is preferred for this purpose because it is non-traumatic and does not cause damage to delicate structures. The other options listed, such as the army-navy retractor, Green retractor, and silk suture, are not specifically designed for this purpose and may not provide the same level of gentle retraction.

12. 728. Before handing a Penrose drain to the surgeon

Place it on an Allis clamp

Attach a safety pin to it

Cut it to the desired length

Moisten it in saline

Before handing a Penrose drain to the surgeon, it is necessary to moisten it in saline. This is because a Penrose drain is a soft, flexible tube that is used to remove fluid or air from a surgical site. By moistening it in saline, the drain becomes lubricated and easier to insert into the patient's body. Additionally, moistening the drain in saline helps to prevent it from sticking to tissues or causing discomfort to the patient during insertion. Therefore, moistening the Penrose drain in saline is an important step in preparing it for use in surgery.

Explanation

Before handing a Penrose drain to the surgeon, it is necessary to moisten it in saline. This is because a Penrose drain is a soft, flexible tube that is used to remove fluid or air from a surgical site. By moistening it in saline, the drain becomes lubricated and easier to insert into the patient's body. Additionally, moistening the drain in saline helps to prevent it from sticking to tissues or causing discomfort to the patient during insertion. Therefore, moistening the Penrose drain in saline is an important step in preparing it for use in surgery.

13. 743. Why are gowns, gloves, drapes, and instruments changed following a breast biopsy and before incision for a mastectomy?

To respect individual surgeon's choice

To follow aseptic principles

To accommodate two separate incisions

To protect margins of healthy tissue from tumor cells

The reason gowns, gloves, drapes, and instruments are changed following a breast biopsy and before incision for a mastectomy is to protect the margins of healthy tissue from tumor cells. By changing these items, any potential contamination from the biopsy is eliminated, reducing the risk of spreading tumor cells to healthy tissue during the mastectomy procedure. This helps to ensure that the surgery is as effective as possible in removing the tumor while minimizing the chances of recurrence or further complications.

Explanation

The reason gowns, gloves, drapes, and instruments are changed following a breast biopsy and before incision for a mastectomy is to protect the margins of healthy tissue from tumor cells. By changing these items, any potential contamination from the biopsy is eliminated, reducing the risk of spreading tumor cells to healthy tissue during the mastectomy procedure. This helps to ensure that the surgery is as effective as possible in removing the tumor while minimizing the chances of recurrence or further complications.

14. 759. Which of the following specimens is NOT placed in preservative solution?

Stones

Curettings

Tonsils

Uterus

Stones are not typically placed in a preservative solution because they do not require preservation for further analysis or examination. Unlike curettings, tonsils, and uterus, which are biological specimens that may need to be preserved in order to maintain their integrity and prevent degradation, stones are generally solid inorganic materials that do not undergo biological processes. Therefore, they do not need to be placed in a preservative solution.

Explanation

Stones are not typically placed in a preservative solution because they do not require preservation for further analysis or examination. Unlike curettings, tonsils, and uterus, which are biological specimens that may need to be preserved in order to maintain their integrity and prevent degradation, stones are generally solid inorganic materials that do not undergo biological processes. Therefore, they do not need to be placed in a preservative solution.

15. 784. An important consideration during cholangiogram is to

Irrigate with distilled water

Remove all air bubbles from the cholangiocath

Flash sterilize the choledocoscope

Dip the catheter in lubricating jelly

During a cholangiogram, it is important to remove all air bubbles from the cholangiocath. Air bubbles can interfere with the visualization of the bile ducts and can lead to inaccurate results. Removing the air bubbles ensures that the cholangiogram is clear and accurate, allowing for proper diagnosis and treatment.

Explanation

During a cholangiogram, it is important to remove all air bubbles from the cholangiocath. Air bubbles can interfere with the visualization of the bile ducts and can lead to inaccurate results. Removing the air bubbles ensures that the cholangiogram is clear and accurate, allowing for proper diagnosis and treatment.

16. 822. intra-abdominal pressure during the instillation of CO2 for creation of pneumoperitoneum is 8-10 mmHg. A pressure reading higher than this may indicate that the needle may be

Buried in fatty tissue

Buried in the omentum

In a lumen of intestines

All of the above

A pressure reading higher than the recommended range during the instillation of CO2 for creation of pneumoperitoneum may indicate that the needle may be buried in fatty tissue, buried in the omentum, or in a lumen of intestines. This can occur when the needle is not properly inserted into the peritoneal cavity and instead gets stuck in these different anatomical structures.

Explanation

A pressure reading higher than the recommended range during the instillation of CO2 for creation of pneumoperitoneum may indicate that the needle may be buried in fatty tissue, buried in the omentum, or in a lumen of intestines. This can occur when the needle is not properly inserted into the peritoneal cavity and instead gets stuck in these different anatomical structures.

17. 740. Which of the following is NOT an acceptable technique when draping a patient?

Hold the drapes high until directly over the proper area

Protect the gloved hands by cuffing the end of the drape over them

Unfold the drapes before bringing them to the OR table

Place the drapes on a dry area

Unfolding the drapes before bringing them to the OR table is not an acceptable technique when draping a patient. Drapes should be unfolded over the patient to ensure proper coverage and to minimize the risk of contamination. Unfolding them before bringing them to the OR table may increase the chances of the drapes coming into contact with unsterile surfaces and compromising the sterile field. It is important to maintain the integrity of the sterile field throughout the draping process to prevent infection and ensure patient safety.

Explanation

Unfolding the drapes before bringing them to the OR table is not an acceptable technique when draping a patient. Drapes should be unfolded over the patient to ensure proper coverage and to minimize the risk of contamination. Unfolding them before bringing them to the OR table may increase the chances of the drapes coming into contact with unsterile surfaces and compromising the sterile field. It is important to maintain the integrity of the sterile field throughout the draping process to prevent infection and ensure patient safety.

18. 761. McBurney is an incision used for

Appendectomy

Cholecystectomy

Herniorrhaphy

Pilonidal cystectomy

McBurney is an incision used for appendectomy. This means that the incision is made in the lower right side of the abdomen to remove the appendix. This is a common surgical procedure done to treat appendicitis, which is the inflammation of the appendix. The McBurney incision allows for easy access to the appendix and is often preferred due to its location and minimal scarring.

Explanation

McBurney is an incision used for appendectomy. This means that the incision is made in the lower right side of the abdomen to remove the appendix. This is a common surgical procedure done to treat appendicitis, which is the inflammation of the appendix. The McBurney incision allows for easy access to the appendix and is often preferred due to its location and minimal scarring.

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

Adrenals

Spleen

Liver

Pancreas

The spleen is an organ that can be removed due to various reasons such as trauma, blood conditions, or as a staging procedure for malignancy. Trauma to the spleen can result in severe bleeding and may require surgical removal. Certain blood conditions, such as idiopathic thrombocytopenic purpura (ITP) or hereditary spherocytosis, may necessitate spleen removal to manage the condition. Additionally, the spleen may be removed as a staging procedure for malignancy, particularly in cases of lymphoma or certain types of cancer.

Explanation

The spleen is an organ that can be removed due to various reasons such as trauma, blood conditions, or as a staging procedure for malignancy. Trauma to the spleen can result in severe bleeding and may require surgical removal. Certain blood conditions, such as idiopathic thrombocytopenic purpura (ITP) or hereditary spherocytosis, may necessitate spleen removal to manage the condition. Additionally, the spleen may be removed as a staging procedure for malignancy, particularly in cases of lymphoma or certain types of cancer.

20. 726. Intraabdominally, lap pads are most often used

Dry

Moistened with saline

Moistened with water

Moistened with glycine solution

Intraabdominally, lap pads are most often used moistened with saline. Saline is a sterile solution of salt in water that closely resembles the body's natural fluids. Moistening the lap pads with saline helps to maintain a moist environment in the abdominal cavity, which is important for preventing tissue dehydration and minimizing the risk of adhesion formation. Additionally, saline is isotonic, meaning it has the same concentration of salt as the body, making it safe to use without causing harm or imbalance.

Explanation

Intraabdominally, lap pads are most often used moistened with saline. Saline is a sterile solution of salt in water that closely resembles the body's natural fluids. Moistening the lap pads with saline helps to maintain a moist environment in the abdominal cavity, which is important for preventing tissue dehydration and minimizing the risk of adhesion formation. Additionally, saline is isotonic, meaning it has the same concentration of salt as the body, making it safe to use without causing harm or imbalance.

21. 737. when handing skin towels to the surgeon, where should the scrubperson stand in relation to the surgeon?

On the opposite side of the table

On the same side of the table

At the foot of the table

Any position is acceptable

The scrubperson should stand on the same side of the table as the surgeon when handing skin towels. This allows for easy and efficient transfer of the towels between the scrubperson and the surgeon. Standing on the same side ensures that the towels can be handed over without any obstruction or difficulty. It also allows for clear communication and coordination between the scrubperson and the surgeon during the procedure.

Explanation

The scrubperson should stand on the same side of the table as the surgeon when handing skin towels. This allows for easy and efficient transfer of the towels between the scrubperson and the surgeon. Standing on the same side ensures that the towels can be handed over without any obstruction or difficulty. It also allows for clear communication and coordination between the scrubperson and the surgeon during the procedure.

22. 741. The procedure to follow if a hair is found on the operative field is to

Notify circulator

Complete an incident report

Remove it with a clamp, cover over area

No action is necessary

If a hair is found on the operative field, the correct procedure is to remove it with a clamp and then cover the area. This is important to maintain a sterile environment during surgery and prevent any potential complications or infections that could arise from the presence of a foreign object. Notifying the circulator and completing an incident report may also be necessary, but the immediate action should be to remove the hair and cover the area.

Explanation

If a hair is found on the operative field, the correct procedure is to remove it with a clamp and then cover the area. This is important to maintain a sterile environment during surgery and prevent any potential complications or infections that could arise from the presence of a foreign object. Notifying the circulator and completing an incident report may also be necessary, but the immediate action should be to remove the hair and cover the area.

23. 758. How is a frozen section sent to the lab?

In formalin

In saline

In water

Dry

A frozen section is sent to the lab in a dry state. This means that it is not preserved or transported in any liquid medium such as formalin, saline, or water. Keeping the section dry helps to prevent any potential damage or artifacts that could occur during transportation or processing. Additionally, a dry section allows for easier handling and preparation for further analysis in the lab.

Explanation

A frozen section is sent to the lab in a dry state. This means that it is not preserved or transported in any liquid medium such as formalin, saline, or water. Keeping the section dry helps to prevent any potential damage or artifacts that could occur during transportation or processing. Additionally, a dry section allows for easier handling and preparation for further analysis in the lab.

24. 769. A Whipple operation is surgically termed a

Pancreatectomy

Pancreatoduodenectomy

Pancreatic cyst marsupialization

Transduodenal sphincterotomy

A Whipple operation, also known as a pancreatoduodenectomy, is a surgical procedure that involves the removal of the head of the pancreas, the duodenum, a portion of the bile duct, and sometimes a portion of the stomach. This procedure is typically performed to treat pancreatic cancer, tumors, or other conditions affecting the pancreas and surrounding organs. The term "pancreatoduodenectomy" accurately describes the surgical removal of the pancreas and duodenum, making it the correct answer.

Explanation

A Whipple operation, also known as a pancreatoduodenectomy, is a surgical procedure that involves the removal of the head of the pancreas, the duodenum, a portion of the bile duct, and sometimes a portion of the stomach. This procedure is typically performed to treat pancreatic cancer, tumors, or other conditions affecting the pancreas and surrounding organs. The term "pancreatoduodenectomy" accurately describes the surgical removal of the pancreas and duodenum, making it the correct answer.

25. 797. An entire tumor / mass removal is termed

Needle biopsy

Staging biopsy

Excisional biopsy

Incisional biopsy

An excisional biopsy is the correct answer because it refers to the complete removal of a tumor or mass from the body. This procedure involves surgically removing the entire tumor or mass along with a margin of normal tissue. By removing the entire tumor, doctors can obtain a more accurate diagnosis and determine the extent of the disease. Other types of biopsies, such as needle biopsy, staging biopsy, and incisional biopsy, may not involve complete removal of the tumor or mass.

Explanation

An excisional biopsy is the correct answer because it refers to the complete removal of a tumor or mass from the body. This procedure involves surgically removing the entire tumor or mass along with a margin of normal tissue. By removing the entire tumor, doctors can obtain a more accurate diagnosis and determine the extent of the disease. Other types of biopsies, such as needle biopsy, staging biopsy, and incisional biopsy, may not involve complete removal of the tumor or mass.

26. 739. Each of the following actions by a scrubperson prevents wounds and punctures, according to CDC guidelines EXCEPT

Use an instrument to remove blades

Recap injection needles

Account for each needle as surgeon finishes with it

Protect sharp blades, edges, and tips

The correct answer is "recap injection needles." According to CDC guidelines, it is important to avoid recapping needles as it increases the risk of needlestick injuries. Recapping should only be done using a one-handed technique or a mechanical device. This helps prevent accidental needlestick injuries and exposure to bloodborne pathogens.

Explanation

The correct answer is "recap injection needles." According to CDC guidelines, it is important to avoid recapping needles as it increases the risk of needlestick injuries. Recapping should only be done using a one-handed technique or a mechanical device. This helps prevent accidental needlestick injuries and exposure to bloodborne pathogens.

27. 745. The correct procedure for sterile dressing application is

Apply dressing after drape removal

Apply dressing before drape removal

Apply raytex sponges in thick layer

Apply dressing in recovery room

The correct procedure for sterile dressing application is to apply the dressing before removing the drape. This is because the drape acts as a barrier to prevent contamination of the wound. By applying the dressing before removing the drape, the wound remains protected from any potential sources of contamination during the dressing change. Applying the dressing after drape removal would expose the wound to possible contamination, increasing the risk of infection.

Explanation

The correct procedure for sterile dressing application is to apply the dressing before removing the drape. This is because the drape acts as a barrier to prevent contamination of the wound. By applying the dressing before removing the drape, the wound remains protected from any potential sources of contamination during the dressing change. Applying the dressing after drape removal would expose the wound to possible contamination, increasing the risk of infection.

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

Amputate the appendiceal base

Retract the appendix

Tie off the appendix

Invert the stump of the appendix

During an appendectomy, a purse-string suture is placed around the appendix stump to invert the stump of the appendix. This is done to prevent any spillage of the contents of the appendix into the abdominal cavity, reducing the risk of infection and complications. Inverting the stump also helps to ensure that the suture line is secure and prevents any potential leakage from the stump. This technique is commonly used during an appendectomy to ensure the safe removal of the appendix.

Explanation

During an appendectomy, a purse-string suture is placed around the appendix stump to invert the stump of the appendix. This is done to prevent any spillage of the contents of the appendix into the abdominal cavity, reducing the risk of infection and complications. Inverting the stump also helps to ensure that the suture line is secure and prevents any potential leakage from the stump. This technique is commonly used during an appendectomy to ensure the safe removal of the appendix.

29. 772. The curved transverse incision used for pelvic surgery is

Midabdominal transverse

Poupart

Pfannenstiel

McVey

The Pfannenstiel incision is a curved transverse incision used for pelvic surgery. It is made just above the pubic symphysis, allowing access to the lower abdomen and pelvis. This incision is commonly used in gynecological procedures such as cesarean sections and hysterectomies. It offers good cosmetic results due to its placement along the bikini line and provides adequate exposure to the pelvic organs. The other options mentioned, midabdominal transverse, poupart, and McVey, are not commonly used incisions for pelvic surgery.

Explanation

The Pfannenstiel incision is a curved transverse incision used for pelvic surgery. It is made just above the pubic symphysis, allowing access to the lower abdomen and pelvis. This incision is commonly used in gynecological procedures such as cesarean sections and hysterectomies. It offers good cosmetic results due to its placement along the bikini line and provides adequate exposure to the pelvic organs. The other options mentioned, midabdominal transverse, poupart, and McVey, are not commonly used incisions for pelvic surgery.

30. 809. Which structure(s) are identified and preserved in thyroid surgery?

Parathyroid glands

Hyoid bone

Thyroglossal duct

Thyroid lobe

During thyroid surgery, the parathyroid glands are identified and preserved. These small glands are located behind the thyroid gland and are responsible for regulating calcium levels in the body. Preserving the parathyroid glands is crucial to prevent complications such as hypoparathyroidism, which can lead to low calcium levels. Therefore, surgeons take extra care to identify and protect these glands during thyroid surgery. The other structures mentioned in the options, such as the hyoid bone, thyroglossal duct, and thyroid lobe, are not specifically identified or preserved during thyroid surgery.

Explanation

During thyroid surgery, the parathyroid glands are identified and preserved. These small glands are located behind the thyroid gland and are responsible for regulating calcium levels in the body. Preserving the parathyroid glands is crucial to prevent complications such as hypoparathyroidism, which can lead to low calcium levels. Therefore, surgeons take extra care to identify and protect these glands during thyroid surgery. The other structures mentioned in the options, such as the hyoid bone, thyroglossal duct, and thyroid lobe, are not specifically identified or preserved during thyroid surgery.

31. 729. A closed-wound suction system works by

Possitive pressure

Negative-pressure vacuum

Air displacement

Constant gravity drainage

A closed-wound suction system works by creating a negative-pressure vacuum. This means that the system creates a low-pressure environment within the wound, which helps to remove excess fluids and promote healing. The negative pressure helps to draw out any fluid or debris from the wound, preventing the buildup of bacteria and promoting the formation of healthy tissue. This method is commonly used in medical settings to aid in wound healing and prevent infection.

Explanation

A closed-wound suction system works by creating a negative-pressure vacuum. This means that the system creates a low-pressure environment within the wound, which helps to remove excess fluids and promote healing. The negative pressure helps to draw out any fluid or debris from the wound, preventing the buildup of bacteria and promoting the formation of healthy tissue. This method is commonly used in medical settings to aid in wound healing and prevent infection.

32. 742. Cancer technique in surgery refers to

The administration of an anticancer drug directly into the cancer site

The discarding of instruments coming in contact with tumor after each use

The use of radiation therapy at the time of surgery

The identification of the lesion

The correct answer is "the discarding of instruments coming in contact with tumor after each use." This refers to a technique in surgery where any instruments that come into contact with the tumor are discarded after each use to prevent the spread of cancer cells. This is done to minimize the risk of cancer recurrence or metastasis. By discarding these instruments, the chances of leaving behind any cancer cells or spreading them to other parts of the body are greatly reduced.

Explanation

The correct answer is "the discarding of instruments coming in contact with tumor after each use." This refers to a technique in surgery where any instruments that come into contact with the tumor are discarded after each use to prevent the spread of cancer cells. This is done to minimize the risk of cancer recurrence or metastasis. By discarding these instruments, the chances of leaving behind any cancer cells or spreading them to other parts of the body are greatly reduced.

33. 756. In an extreme patient emergency, a sponge count

May be omitted

May be done by the scrub alone

Must be done before the case is allowed to begin

Must be done before closure

In an extreme patient emergency, a sponge count may be omitted. This means that in critical situations where immediate medical intervention is required, the healthcare team may not have the time to perform a count of surgical sponges used during the procedure. While it is generally important to keep track of all surgical instruments to prevent any complications, in emergency situations, the priority is to save the patient's life.

Explanation

In an extreme patient emergency, a sponge count may be omitted. This means that in critical situations where immediate medical intervention is required, the healthcare team may not have the time to perform a count of surgical sponges used during the procedure. While it is generally important to keep track of all surgical instruments to prevent any complications, in emergency situations, the priority is to save the patient's life.

34. 757. Cultures obtained during surgery

Are handled as any other specimen

Are passed off the sterile field into a bag or container held by the circulator

Should be kept warm or sent to the lab immediately

Should be handled only by the scrub nurse

During surgery, cultures obtained need to be handled properly to prevent contamination. The correct answer states that these cultures should be passed off the sterile field into a bag or container held by the circulator. This ensures that the cultures are transferred in a sterile manner and are not exposed to any potential sources of contamination. The circulator, who is responsible for managing the sterile field, holds the bag or container to maintain the sterility of the cultures. This procedure helps to maintain the integrity of the cultures for accurate laboratory analysis.

Explanation

During surgery, cultures obtained need to be handled properly to prevent contamination. The correct answer states that these cultures should be passed off the sterile field into a bag or container held by the circulator. This ensures that the cultures are transferred in a sterile manner and are not exposed to any potential sources of contamination. The circulator, who is responsible for managing the sterile field, holds the bag or container to maintain the sterility of the cultures. This procedure helps to maintain the integrity of the cultures for accurate laboratory analysis.

35. 791. Following a hemorrhoidectomy, a

Dry dressing of 4 X 4s is packed in the rectum

Petroleum gauze packing is placed in the anal canal

Stent dressing is applied

Steri-strip dressing is used

After a hemorrhoidectomy, petroleum gauze packing is placed in the anal canal. This is done to provide support and promote healing of the surgical site. The petroleum gauze packing helps to control bleeding, reduce swelling, and prevent infection. It also acts as a barrier to protect the surgical site from external contaminants. By packing the anal canal with petroleum gauze, it ensures that the surgical area remains clean and protected during the healing process.

Explanation

After a hemorrhoidectomy, petroleum gauze packing is placed in the anal canal. This is done to provide support and promote healing of the surgical site. The petroleum gauze packing helps to control bleeding, reduce swelling, and prevent infection. It also acts as a barrier to protect the surgical site from external contaminants. By packing the anal canal with petroleum gauze, it ensures that the surgical area remains clean and protected during the healing process.

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

Temporary colectomy

Temporary colostomy

Abdominoperineal resection

McVey procedure

A temporary colostomy is a procedure where a portion of the colon is diverted to an opening in the abdominal wall, allowing waste to bypass a diseased or injured part of the colon. This diversion gives the affected area time to heal and rest. It is a reversible procedure, meaning that it can be reversed once the colon has healed. This procedure is commonly performed in cases of colon obstruction, diverticulitis, or inflammatory bowel disease.

Explanation

A temporary colostomy is a procedure where a portion of the colon is diverted to an opening in the abdominal wall, allowing waste to bypass a diseased or injured part of the colon. This diversion gives the affected area time to heal and rest. It is a reversible procedure, meaning that it can be reversed once the colon has healed. This procedure is commonly performed in cases of colon obstruction, diverticulitis, or inflammatory bowel disease.

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

Cystocath

Cholangiocath

T-tube

Red rubber catheter

Intraoperative cholangiograms are imaging procedures performed during surgery to visualize the bile ducts. They can be done through open abdominal or laparoscopic procedures. A contrast medium is injected directly into the common bile duct to enhance visibility. The correct answer is "cholangiocath," which refers to a catheter specifically designed for cholangiograms. This catheter allows for the safe and efficient injection of the contrast medium into the bile ducts.

Explanation

Intraoperative cholangiograms are imaging procedures performed during surgery to visualize the bile ducts. They can be done through open abdominal or laparoscopic procedures. A contrast medium is injected directly into the common bile duct to enhance visibility. The correct answer is "cholangiocath," which refers to a catheter specifically designed for cholangiograms. This catheter allows for the safe and efficient injection of the contrast medium into the bile ducts.

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

Chromic 4-0 or 3-0

Silk 4-0 or 3-0

Dacron 3-0 or 2-0

Novafil 3-0 or 2-0

The correct answer is chromic 4-0 or 3-0. Chromic refers to chromic gut sutures, which are absorbable sutures made from the collagen of sheep or cattle intestines. These sutures are commonly used in gastrointestinal closures because they provide good tensile strength and are absorbed by the body over time, eliminating the need for suture removal. The numbers 4-0 and 3-0 refer to the size of the suture, with 4-0 being smaller and 3-0 being larger. The choice of suture size depends on the specific needs of the closure, such as the thickness of the tissue being sutured.

Explanation

The correct answer is chromic 4-0 or 3-0. Chromic refers to chromic gut sutures, which are absorbable sutures made from the collagen of sheep or cattle intestines. These sutures are commonly used in gastrointestinal closures because they provide good tensile strength and are absorbed by the body over time, eliminating the need for suture removal. The numbers 4-0 and 3-0 refer to the size of the suture, with 4-0 being smaller and 3-0 being larger. The choice of suture size depends on the specific needs of the closure, such as the thickness of the tissue being sutured.

39. 721. Why are bumpers or bolsters used on retention sutures?

To prevent the suture from cutting into the skin surface

To facilitate easy removal

To identify the order of suture removal

To prevent unequal tension on the wound edges

Bumpers or bolsters are used on retention sutures to prevent the suture from cutting into the skin surface. By providing a cushioning effect, the bumpers or bolsters distribute the pressure evenly along the suture line, reducing the risk of tissue damage or cutting. This helps to promote proper wound healing and minimize complications such as infection or dehiscence.

Explanation

Bumpers or bolsters are used on retention sutures to prevent the suture from cutting into the skin surface. By providing a cushioning effect, the bumpers or bolsters distribute the pressure evenly along the suture line, reducing the risk of tissue damage or cutting. This helps to promote proper wound healing and minimize complications such as infection or dehiscence.

40. 780. An abdominal wall defect may be reconstructed using

Gore-Tex patch

Heavy interrupted silk

Shouldice repair

Bassini repair

A Gore-Tex patch can be used to reconstruct an abdominal wall defect. Gore-Tex is a synthetic material that is biocompatible and durable, making it suitable for use in surgical repairs. It provides a strong and flexible barrier, helping to reinforce the weakened abdominal wall and prevent herniation. The patch can be sutured in place, providing support and allowing for tissue ingrowth over time. This technique is commonly used in abdominal wall reconstruction surgeries.

Explanation

A Gore-Tex patch can be used to reconstruct an abdominal wall defect. Gore-Tex is a synthetic material that is biocompatible and durable, making it suitable for use in surgical repairs. It provides a strong and flexible barrier, helping to reinforce the weakened abdominal wall and prevent herniation. The patch can be sutured in place, providing support and allowing for tissue ingrowth over time. This technique is commonly used in abdominal wall reconstruction surgeries.

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

Kelly

Kocher

Babcock

Allis

The Babcock instrument is commonly used to grasp the mesoappendix during an appendectomy. It is a non-crushing instrument with smooth jaws and a ratcheted handle that allows for secure grip without damaging the tissue. The Babcock instrument is preferred in this procedure because it provides a gentle and effective way to hold and manipulate the delicate mesoappendix without causing unnecessary trauma or injury.

Explanation

The Babcock instrument is commonly used to grasp the mesoappendix during an appendectomy. It is a non-crushing instrument with smooth jaws and a ratcheted handle that allows for secure grip without damaging the tissue. The Babcock instrument is preferred in this procedure because it provides a gentle and effective way to hold and manipulate the delicate mesoappendix without causing unnecessary trauma or injury.

42. 801. A device that may obviate the need for an abdominoperineal resection because a low anterior anastomosis can be performed is a(n)

End-to-end anastomosis (EEA)

GIA

TA 55

LDS

An end-to-end anastomosis (EEA) is a surgical procedure that connects two ends of a hollow organ or blood vessel. In the context of the question, an EEA can be used to create a low anterior anastomosis, which is a surgical technique used to reconnect the colon or rectum to the anus after removing a portion of the lower bowel. By performing a low anterior anastomosis using an EEA, the need for an abdominoperineal resection, which involves removing the rectum and anus, can be obviated. Therefore, an EEA device may eliminate the need for a more extensive surgical procedure.

Explanation

An end-to-end anastomosis (EEA) is a surgical procedure that connects two ends of a hollow organ or blood vessel. In the context of the question, an EEA can be used to create a low anterior anastomosis, which is a surgical technique used to reconnect the colon or rectum to the anus after removing a portion of the lower bowel. By performing a low anterior anastomosis using an EEA, the need for an abdominoperineal resection, which involves removing the rectum and anus, can be obviated. Therefore, an EEA device may eliminate the need for a more extensive surgical procedure.

43. 733. When a sterile item is hanging or extending over the sterile table edge, the scrub nurse

Must watch closely that no one comes near it

Does not touch the part hanging below table level

Should pull it back onto the table so it does not become contaminated

May use the item

When a sterile item is hanging or extending over the sterile table edge, the scrub nurse must not touch the part hanging below table level. This is to ensure that the sterile field remains uncontaminated. Touching the part hanging below table level could introduce pathogens or contaminants onto the sterile item, compromising its sterility. Therefore, it is important for the scrub nurse to be vigilant and avoid touching the hanging part to maintain the integrity of the sterile field.

Explanation

When a sterile item is hanging or extending over the sterile table edge, the scrub nurse must not touch the part hanging below table level. This is to ensure that the sterile field remains uncontaminated. Touching the part hanging below table level could introduce pathogens or contaminants onto the sterile item, compromising its sterility. Therefore, it is important for the scrub nurse to be vigilant and avoid touching the hanging part to maintain the integrity of the sterile field.

44. 746. When drop technique for an intestinal procedure is utilized

Two Mayo stands are used

Drapes and gloves do not need to be changed

Contaminated instruments are discarded, gloves are changed

A separate setup is used for the closure

When the drop technique is used for an intestinal procedure, contaminated instruments are discarded and gloves are changed. This is done to prevent the spread of infection and maintain a sterile environment. The drop technique involves dropping instruments into a sterile field without directly handling them, reducing the risk of contamination. However, if any instruments come into contact with the patient's body or any non-sterile surfaces, they are considered contaminated and must be discarded. Changing gloves is necessary to ensure that the surgical team does not transfer any contaminants while handling the instruments.

Explanation

When the drop technique is used for an intestinal procedure, contaminated instruments are discarded and gloves are changed. This is done to prevent the spread of infection and maintain a sterile environment. The drop technique involves dropping instruments into a sterile field without directly handling them, reducing the risk of contamination. However, if any instruments come into contact with the patient's body or any non-sterile surfaces, they are considered contaminated and must be discarded. Changing gloves is necessary to ensure that the surgical team does not transfer any contaminants while handling the instruments.

45. 750. An enzyme extract from bovine blood used as a topical hemostatic agent is

Oxytocin

Tannic acid

Thrombin

Collagen

Thrombin is a suitable enzyme extract from bovine blood for use as a topical hemostatic agent. Thrombin plays a crucial role in the blood clotting process by converting fibrinogen into fibrin, which forms a mesh-like structure to stop bleeding. As a result, thrombin promotes blood clot formation and aids in stopping bleeding, making it an effective hemostatic agent. Oxytocin is a hormone involved in childbirth and breastfeeding, tannic acid is a plant-derived compound with astringent properties, and collagen is a protein found in connective tissues.

Explanation

Thrombin is a suitable enzyme extract from bovine blood for use as a topical hemostatic agent. Thrombin plays a crucial role in the blood clotting process by converting fibrinogen into fibrin, which forms a mesh-like structure to stop bleeding. As a result, thrombin promotes blood clot formation and aids in stopping bleeding, making it an effective hemostatic agent. Oxytocin is a hormone involved in childbirth and breastfeeding, tannic acid is a plant-derived compound with astringent properties, and collagen is a protein found in connective tissues.

46. 755. Dark Blood in the operative field may indicate that the patient is

Hyperkalemic

Hypovolemic

Hypotensive

Hypoxic

Dark blood in the operative field may indicate that the patient is hypoxic. Hypoxia refers to a condition where there is a lack of oxygen supply to the tissues. When the blood is not adequately oxygenated, it appears dark in color. Therefore, the presence of dark blood in the operative field suggests that the patient may be experiencing a lack of oxygen, which can be indicative of hypoxia.

Explanation

Dark blood in the operative field may indicate that the patient is hypoxic. Hypoxia refers to a condition where there is a lack of oxygen supply to the tissues. When the blood is not adequately oxygenated, it appears dark in color. Therefore, the presence of dark blood in the operative field suggests that the patient may be experiencing a lack of oxygen, which can be indicative of hypoxia.

47. 786. The intestinal layer in order, from inside to outside, is

Serosa, mucosa, musculature

Mucosa, submucosa, serosa

Serosa, musculature, mucosa

Mucosa, serosa, musculature

The correct answer is mucosa, submucosa, serosa. This is the correct order of the layers of the intestine from inside to outside. The mucosa is the innermost layer, followed by the submucosa, and then the serosa.

Explanation

The correct answer is mucosa, submucosa, serosa. This is the correct order of the layers of the intestine from inside to outside. The mucosa is the innermost layer, followed by the submucosa, and then the serosa.

48. 744. A postoperative complication attributed to glove powder entering a wound is

Granulomata

Infection

Inflammation

Keloid formation

Glove powder entering a wound can lead to the formation of granulomata. Granulomata are small nodules that form as a result of the body's immune response to foreign substances. In this case, the glove powder acts as a foreign substance, causing an inflammatory reaction and the formation of granulomata. This complication can occur after surgery and may require further medical intervention to address the granulomata and prevent infection or further inflammation.

Explanation

Glove powder entering a wound can lead to the formation of granulomata. Granulomata are small nodules that form as a result of the body's immune response to foreign substances. In this case, the glove powder acts as a foreign substance, causing an inflammatory reaction and the formation of granulomata. This complication can occur after surgery and may require further medical intervention to address the granulomata and prevent infection or further inflammation.

49. 767. Sutures placed in a wound to prevent wound evisceration are called

Stent

Fixation

Retention

Traction

Sutures placed in a wound to prevent wound evisceration are called retention sutures. These sutures are used to hold the edges of the wound together and prevent the organs or tissues from protruding through the wound. They provide additional support and help in maintaining the integrity of the wound, reducing the risk of complications such as evisceration.

Explanation

Sutures placed in a wound to prevent wound evisceration are called retention sutures. These sutures are used to hold the edges of the wound together and prevent the organs or tissues from protruding through the wound. They provide additional support and help in maintaining the integrity of the wound, reducing the risk of complications such as evisceration.

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

Lumpectomy

Wedge resection

Modified radical mastectomy

Radical mastectomy

A modified radical mastectomy is a breast procedure that involves the removal of the entire breast and axillary contents while preserving the pectoral muscles. This procedure is commonly performed for the treatment of breast cancer, where the goal is to remove the cancerous tissue while preserving the cosmetic appearance and functionality of the chest. Unlike a radical mastectomy, which involves the removal of the pectoral muscles, a modified radical mastectomy ensures that the muscles remain intact, allowing for better postoperative recovery and preservation of strength and function in the chest area.

Explanation

A modified radical mastectomy is a breast procedure that involves the removal of the entire breast and axillary contents while preserving the pectoral muscles. This procedure is commonly performed for the treatment of breast cancer, where the goal is to remove the cancerous tissue while preserving the cosmetic appearance and functionality of the chest. Unlike a radical mastectomy, which involves the removal of the pectoral muscles, a modified radical mastectomy ensures that the muscles remain intact, allowing for better postoperative recovery and preservation of strength and function in the chest area.

51. 814. After uterus removal in a hysterectomy

Cervical and vaginal instruments are isolated from the instrument set in a discard basin

The cervix is cauterized

New instruments are used on the cervical closure

Cervical instruments are returned to the basket

After uterus removal in a hysterectomy, it is necessary to isolate the cervical and vaginal instruments from the instrument set in a discard basin. This is done to prevent any cross-contamination or infection since the uterus has been removed. The cervix is then cauterized to control bleeding, and new instruments are used for the cervical closure to ensure sterility. Finally, the cervical instruments are returned to the basket, indicating that they have been properly cleaned and sterilized for future use.

Explanation

After uterus removal in a hysterectomy, it is necessary to isolate the cervical and vaginal instruments from the instrument set in a discard basin. This is done to prevent any cross-contamination or infection since the uterus has been removed. The cervix is then cauterized to control bleeding, and new instruments are used for the cervical closure to ensure sterility. Finally, the cervical instruments are returned to the basket, indicating that they have been properly cleaned and sterilized for future use.

52. 752. The desirable position for better visualization in the lower abdomen or pelvis is

Fowler's

Reverse Trendelenburg

Trendelenburg

Kraske

The desirable position for better visualization in the lower abdomen or pelvis is Trendelenburg. This position involves tilting the patient's body with the head lower than the feet. By doing so, gravity helps to displace the abdominal organs away from the pelvis, providing a clearer view during surgical procedures or diagnostic imaging. This position is commonly used in gynecological surgeries, laparoscopic procedures, and certain radiological examinations.

Explanation

The desirable position for better visualization in the lower abdomen or pelvis is Trendelenburg. This position involves tilting the patient's body with the head lower than the feet. By doing so, gravity helps to displace the abdominal organs away from the pelvis, providing a clearer view during surgical procedures or diagnostic imaging. This position is commonly used in gynecological surgeries, laparoscopic procedures, and certain radiological examinations.

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

Right subcostal

Kocher's

Midabdominal transverse

Vertical midline

The vertical midline incision is considered the simplest abdominal incision that provides good exposure to any part of the abdominal cavity. This type of incision is made vertically along the midline of the abdomen, dividing it into equal left and right halves. It allows for easy access to various abdominal organs and structures, making it a versatile choice for surgical procedures.

Explanation

The vertical midline incision is considered the simplest abdominal incision that provides good exposure to any part of the abdominal cavity. This type of incision is made vertically along the midline of the abdomen, dividing it into equal left and right halves. It allows for easy access to various abdominal organs and structures, making it a versatile choice for surgical procedures.

54. 812. A gastroplasty

Reduces stomach size

Corrects gastric junction stenosis

Releases adhesions

Provides avenue for hyperalimentation

A gastroplasty is a surgical procedure that is performed to reduce the size of the stomach. This is done by creating a small pouch in the upper part of the stomach, which limits the amount of food that can be consumed. By reducing the size of the stomach, the procedure helps to promote weight loss in individuals who are struggling with obesity. This explanation is supported by the fact that the other options listed, such as correcting gastric junction stenosis, releasing adhesions, and providing avenue for hyperalimentation, are not associated with a gastroplasty procedure.

Explanation

A gastroplasty is a surgical procedure that is performed to reduce the size of the stomach. This is done by creating a small pouch in the upper part of the stomach, which limits the amount of food that can be consumed. By reducing the size of the stomach, the procedure helps to promote weight loss in individuals who are struggling with obesity. This explanation is supported by the fact that the other options listed, such as correcting gastric junction stenosis, releasing adhesions, and providing avenue for hyperalimentation, are not associated with a gastroplasty procedure.

55. 724. Which procedure would not require a pressure dressing?

Plastic surgery

Knee surgery

Radical mastectomy

Hysterectomy

A hysterectomy is a surgical procedure to remove the uterus, which does not typically require a pressure dressing. Unlike plastic surgery, knee surgery, and radical mastectomy, a hysterectomy involves the removal of internal organs rather than altering or operating on external tissues. Therefore, the absence of external incisions or wounds in a hysterectomy procedure eliminates the need for a pressure dressing to control bleeding or promote healing.

Explanation

A hysterectomy is a surgical procedure to remove the uterus, which does not typically require a pressure dressing. Unlike plastic surgery, knee surgery, and radical mastectomy, a hysterectomy involves the removal of internal organs rather than altering or operating on external tissues. Therefore, the absence of external incisions or wounds in a hysterectomy procedure eliminates the need for a pressure dressing to control bleeding or promote healing.

56. 727. A catheter commonly used in a gastrostomy is a

Mushroom

Rehfus

Cantor

Sengstaken-Blakemore

A catheter commonly used in a gastrostomy is a mushroom.

Explanation

A catheter commonly used in a gastrostomy is a mushroom.

57. 794. In a pilonidal cystectomy, the defect frequently is too large to close and requires use of a(n)

Skin graft

Traction suture

Implant

Packing and pressure dressing

In a pilonidal cystectomy, the defect created after removing the cyst is often too large to be closed directly. Therefore, it requires the use of a packing and pressure dressing. This dressing is placed inside the wound to promote healing and prevent infection. It helps to control bleeding, absorb any excess fluids, and maintain the shape of the wound while it heals from the inside out. The packing and pressure dressing also helps to reduce the risk of recurrence by ensuring proper drainage and promoting granulation tissue formation.

Explanation

In a pilonidal cystectomy, the defect created after removing the cyst is often too large to be closed directly. Therefore, it requires the use of a packing and pressure dressing. This dressing is placed inside the wound to promote healing and prevent infection. It helps to control bleeding, absorb any excess fluids, and maintain the shape of the wound while it heals from the inside out. The packing and pressure dressing also helps to reduce the risk of recurrence by ensuring proper drainage and promoting granulation tissue formation.

58. 803. Blunt dissection of the gallbladder from the sulcus of the liver requires the use of a

Metzenbaum

Kelly

Tampon

Peanut

Blunt dissection of the gallbladder from the sulcus of the liver requires the use of a peanut. The peanut is commonly used in surgical procedures as a dissecting instrument due to its small size and blunt edges. It allows for careful separation and dissection of tissues without causing excessive damage or bleeding. The other options, such as Metzenbaum and Kelly, are surgical scissors and tampon is not a suitable instrument for this purpose. Therefore, the correct instrument for this specific dissection is a peanut.

Explanation

Blunt dissection of the gallbladder from the sulcus of the liver requires the use of a peanut. The peanut is commonly used in surgical procedures as a dissecting instrument due to its small size and blunt edges. It allows for careful separation and dissection of tissues without causing excessive damage or bleeding. The other options, such as Metzenbaum and Kelly, are surgical scissors and tampon is not a suitable instrument for this purpose. Therefore, the correct instrument for this specific dissection is a peanut.

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

A white sponge

A white wall

A glove wrapper

Any of the above

White balancing a video camera in endoscopy requires the scrub person to focus the camera on any of the above options (white sponge, white wall, or a glove wrapper). White balancing is the process of adjusting the camera's settings to accurately represent white colors under different lighting conditions. By focusing on a white object, the camera can calibrate its color settings to ensure accurate color reproduction throughout the video. Therefore, any of the mentioned white objects can be used for white balancing in endoscopy.

Explanation

White balancing a video camera in endoscopy requires the scrub person to focus the camera on any of the above options (white sponge, white wall, or a glove wrapper). White balancing is the process of adjusting the camera's settings to accurately represent white colors under different lighting conditions. By focusing on a white object, the camera can calibrate its color settings to ensure accurate color reproduction throughout the video. Therefore, any of the mentioned white objects can be used for white balancing in endoscopy.

60. 735. In which situation should sterility be questioned?

If a sterilized pack is found in an unsterile workroom

If the surgeon turns away from the sterile field for a brow wipe

If the scrub drapes a nonsterile table, covering the edge nearest the body first

If the lip of a pour bottle is held over the basin as close to the edge as possible

If a sterilized pack is found in an unsterile workroom, it raises concerns about the overall sterility of the environment and the potential for contamination. The presence of a sterilized pack in an unsterile workroom suggests that proper sterilization procedures may not have been followed or that there may be issues with the storage and handling of sterile items. This situation calls for questioning the sterility to ensure patient safety and prevent the risk of infection.

Explanation

If a sterilized pack is found in an unsterile workroom, it raises concerns about the overall sterility of the environment and the potential for contamination. The presence of a sterilized pack in an unsterile workroom suggests that proper sterilization procedures may not have been followed or that there may be issues with the storage and handling of sterile items. This situation calls for questioning the sterility to ensure patient safety and prevent the risk of infection.

61. 782. In a cholecystectomy, which structures are ligated and divided?

Cystic duct and cystic artery

Common bile duct and hepatic duct

Cystic duct and common bile duct

Hepatic duct and cystic artery

In a cholecystectomy, the structures that are ligated and divided are the cystic duct and cystic artery. This procedure involves the removal of the gallbladder, and the cystic duct and cystic artery are the structures that supply and drain the gallbladder. By ligating and dividing these structures, the surgeon can safely remove the gallbladder without causing any complications or damage to surrounding organs.

Explanation

In a cholecystectomy, the structures that are ligated and divided are the cystic duct and cystic artery. This procedure involves the removal of the gallbladder, and the cystic duct and cystic artery are the structures that supply and drain the gallbladder. By ligating and dividing these structures, the surgeon can safely remove the gallbladder without causing any complications or damage to surrounding organs.

62. 748. The Sengstaken-Blakemore tube is used for

Esophageal hemorrhage

Tonsillar hemorrhage

Uterine hemorrhage

Nasal hemorrhage

The Sengstaken-Blakemore tube is a medical device used for the treatment of esophageal hemorrhage. It consists of a gastric balloon and an esophageal balloon, which when inflated, exert pressure on the bleeding vessels to control the hemorrhage. This tube is inserted through the mouth and into the esophagus, and it helps to stop the bleeding and stabilize the patient's condition. It is not used for tonsillar, uterine, or nasal hemorrhage.

Explanation

The Sengstaken-Blakemore tube is a medical device used for the treatment of esophageal hemorrhage. It consists of a gastric balloon and an esophageal balloon, which when inflated, exert pressure on the bleeding vessels to control the hemorrhage. This tube is inserted through the mouth and into the esophagus, and it helps to stop the bleeding and stabilize the patient's condition. It is not used for tonsillar, uterine, or nasal hemorrhage.

63. 770. A left subcostal incision indicates surgery of the

Gallbladder

Pancreas

Spleen

Common bile duct

A left subcostal incision is commonly used for surgeries involving the spleen. The spleen is located in the upper left quadrant of the abdomen, just below the ribcage. This type of incision provides access to the spleen while minimizing damage to surrounding organs. Surgeries involving the gallbladder, pancreas, or common bile duct would typically require different incision sites and approaches.

Explanation

A left subcostal incision is commonly used for surgeries involving the spleen. The spleen is located in the upper left quadrant of the abdomen, just below the ribcage. This type of incision provides access to the spleen while minimizing damage to surrounding organs. Surgeries involving the gallbladder, pancreas, or common bile duct would typically require different incision sites and approaches.

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

TA linear

LDS

EEA

GIA

The correct answer is EEA. EEA stands for End-to-End Anastomosis, which is a surgical technique used to join two tubular structures together after resection. The disposable circular staple mentioned in the question refers to the EEA circular stapler, a medical device specifically designed for this purpose. It creates a secure and leak-proof connection between the tubular structures, promoting faster healing and recovery for the patient.

Explanation

The correct answer is EEA. EEA stands for End-to-End Anastomosis, which is a surgical technique used to join two tubular structures together after resection. The disposable circular staple mentioned in the question refers to the EEA circular stapler, a medical device specifically designed for this purpose. It creates a secure and leak-proof connection between the tubular structures, promoting faster healing and recovery for the patient.

65. 787. A common postoperative patient complaint following a laparoscopic procedure is

Headache

Diarrhea

Gastric upset

Shoulder pain

Following a laparoscopic procedure, shoulder pain is a common postoperative patient complaint. This pain is typically caused by the carbon dioxide gas used during the procedure. The gas can irritate the diaphragm, which shares nerve pathways with the shoulder. As a result, patients may experience referred pain in the shoulder area. This discomfort usually resolves within a few days as the gas is absorbed by the body. Headache, diarrhea, and gastric upset are not typically associated with laparoscopic procedures.

Explanation

Following a laparoscopic procedure, shoulder pain is a common postoperative patient complaint. This pain is typically caused by the carbon dioxide gas used during the procedure. The gas can irritate the diaphragm, which shares nerve pathways with the shoulder. As a result, patients may experience referred pain in the shoulder area. This discomfort usually resolves within a few days as the gas is absorbed by the body. Headache, diarrhea, and gastric upset are not typically associated with laparoscopic procedures.

66. 723. A dissecting sponge that is a small roll of heavy cotton tape is a

Kitner

Peanut

Tonsil

Tape

A dissecting sponge that is a small roll of heavy cotton tape is known as a Kitner.

Explanation

A dissecting sponge that is a small roll of heavy cotton tape is known as a Kitner.

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

Temporary colostomy

Anterior resection

Hemicolectomy

Abdominal perineal resection

An advanced inflammation of the bowel could be conservatively treated with a temporary colostomy. This procedure involves creating an opening in the abdominal wall and bringing a portion of the colon to the surface, allowing waste to bypass the inflamed area and heal. It is considered a conservative treatment because it is reversible and allows the bowel to rest and recover. Other procedures listed, such as anterior resection, hemicolectomy, and abdominal perineal resection, may be more invasive and permanent solutions for more severe cases.

Explanation

An advanced inflammation of the bowel could be conservatively treated with a temporary colostomy. This procedure involves creating an opening in the abdominal wall and bringing a portion of the colon to the surface, allowing waste to bypass the inflamed area and heal. It is considered a conservative treatment because it is reversible and allows the bowel to rest and recover. Other procedures listed, such as anterior resection, hemicolectomy, and abdominal perineal resection, may be more invasive and permanent solutions for more severe cases.

68. 804. Direct visualization of the common bile duct is accomplished with a

Cholangiocath

Cholangiogram

Choledochoscope

Trocar

A choledochoscope is a medical instrument that is used to directly visualize the common bile duct. It is inserted through a small incision or natural body opening and allows the healthcare professional to see the inside of the duct and diagnose any abnormalities or blockages. This procedure is known as a choledochoscopy and is commonly used in the diagnosis and treatment of conditions affecting the bile ducts, such as gallstones or tumors.

Explanation

A choledochoscope is a medical instrument that is used to directly visualize the common bile duct. It is inserted through a small incision or natural body opening and allows the healthcare professional to see the inside of the duct and diagnose any abnormalities or blockages. This procedure is known as a choledochoscopy and is commonly used in the diagnosis and treatment of conditions affecting the bile ducts, such as gallstones or tumors.

69. 807. In laparoscopy, tubal patency is checked by

Irrigating with normal saline

Injecting renografin into the tube

Injecting methylene blue into the cervical canal

Irrigating tube with Lugol's solution

In laparoscopy, tubal patency is checked by injecting methylene blue into the cervical canal. Methylene blue is a dye that is commonly used to evaluate tubal patency in laparoscopy procedures. It is injected into the cervical canal and then observed to see if it spills out of the fallopian tubes. If the dye spills out, it indicates that the tubes are patent (open) and functioning properly. This method allows the surgeon to assess the patency of the fallopian tubes and determine if there are any blockages or abnormalities.

Explanation

In laparoscopy, tubal patency is checked by injecting methylene blue into the cervical canal. Methylene blue is a dye that is commonly used to evaluate tubal patency in laparoscopy procedures. It is injected into the cervical canal and then observed to see if it spills out of the fallopian tubes. If the dye spills out, it indicates that the tubes are patent (open) and functioning properly. This method allows the surgeon to assess the patency of the fallopian tubes and determine if there are any blockages or abnormalities.

70. 754. All of the following are helpful in keeping accurate account of the sponges EXCEPT

Keep sponges separate from linen and instruments

Keep needles separate from sponges

Keep all sponges and tapes in a basin or close together on the field

Keep a mental count of the number of sponges on the field at any given time

Keeping all sponges and tapes in a basin or close together on the field is not helpful in keeping an accurate account of the sponges. This is because when sponges and tapes are kept together, it becomes difficult to differentiate and count them individually. It is important to keep sponges separate from linen and instruments, keep needles separate from sponges, and also maintain a mental count of the number of sponges on the field at any given time to ensure accuracy in accounting for the sponges.

Explanation

Keeping all sponges and tapes in a basin or close together on the field is not helpful in keeping an accurate account of the sponges. This is because when sponges and tapes are kept together, it becomes difficult to differentiate and count them individually. It is important to keep sponges separate from linen and instruments, keep needles separate from sponges, and also maintain a mental count of the number of sponges on the field at any given time to ensure accuracy in accounting for the sponges.

71. 722. A Nissen Fundoplication procedure is done to correct

Repeated attacks of volvulus

Antireflux disease

Bladder prolapse

Gastroesophageal stenosis

A Nissen Fundoplication procedure is done to correct antireflux disease. This procedure involves wrapping the upper part of the stomach around the lower part of the esophagus to strengthen the lower esophageal sphincter and prevent stomach acid from flowing back into the esophagus. This helps to alleviate symptoms such as heartburn, regurgitation, and difficulty swallowing that are associated with antireflux disease.

Explanation

A Nissen Fundoplication procedure is done to correct antireflux disease. This procedure involves wrapping the upper part of the stomach around the lower part of the esophagus to strengthen the lower esophageal sphincter and prevent stomach acid from flowing back into the esophagus. This helps to alleviate symptoms such as heartburn, regurgitation, and difficulty swallowing that are associated with antireflux disease.

72. 747. If the floor or wall becomes contaminated with organic debris during a case, the circulator

Calls housekeeping stat

Decontaminates promptly

Decontaminates after case is complete

Defers for terminal cleaning

If the floor or wall becomes contaminated with organic debris during a case, the circulator decontaminates promptly. This means that as soon as the contamination is noticed, the circulator takes immediate action to clean and remove the debris. This is important to prevent the spread of bacteria or other harmful substances, ensuring a safe and sterile environment for the next procedure.

Explanation

If the floor or wall becomes contaminated with organic debris during a case, the circulator decontaminates promptly. This means that as soon as the contamination is noticed, the circulator takes immediate action to clean and remove the debris. This is important to prevent the spread of bacteria or other harmful substances, ensuring a safe and sterile environment for the next procedure.

73. 765. A hernia occurring in Hesselback's triangle is called

Indirect

Spigelean

Direct

Femoral

A hernia occurring in Hesselback's triangle is called a direct hernia. Hesselbach's triangle is an anatomical region in the lower abdomen, bounded by the inguinal ligament, the rectus abdominis muscle, and the inferior epigastric vessels. A direct hernia occurs when abdominal contents protrude through a weakness in the posterior wall of the inguinal canal, specifically through the floor of Hesselbach's triangle. This type of hernia typically presents as a bulge in the groin area and is more common in older individuals.

Explanation

A hernia occurring in Hesselback's triangle is called a direct hernia. Hesselbach's triangle is an anatomical region in the lower abdomen, bounded by the inguinal ligament, the rectus abdominis muscle, and the inferior epigastric vessels. A direct hernia occurs when abdominal contents protrude through a weakness in the posterior wall of the inguinal canal, specifically through the floor of Hesselbach's triangle. This type of hernia typically presents as a bulge in the groin area and is more common in older individuals.

74. 793. Which gallbladder procedure ALWAYS requires intraoperative x-rays?

Choledochoscopy

Cholelithotripsy

Choledochoduodenostomy

Cholangiogram

A cholangiogram is a procedure that involves injecting a contrast dye into the bile ducts and taking x-ray images to visualize the gallbladder and bile ducts. This procedure is used to diagnose and evaluate conditions such as gallstones, tumors, or blockages in the bile ducts. Since the purpose of a cholangiogram is to obtain x-ray images, it always requires intraoperative x-rays. On the other hand, choledochoscopy, cholelithotripsy, and choledochoduodenostomy are different procedures that do not necessarily involve x-rays.

Explanation

A cholangiogram is a procedure that involves injecting a contrast dye into the bile ducts and taking x-ray images to visualize the gallbladder and bile ducts. This procedure is used to diagnose and evaluate conditions such as gallstones, tumors, or blockages in the bile ducts. Since the purpose of a cholangiogram is to obtain x-ray images, it always requires intraoperative x-rays. On the other hand, choledochoscopy, cholelithotripsy, and choledochoduodenostomy are different procedures that do not necessarily involve x-rays.

75. 815. An irreducible hernia whose abdominal contents have become trapped in the extraabdominal sac is called a(n)

Incarcerated hernia

Sliding hernia

Spigelean hernia

Strangulated hernia

An incarcerated hernia refers to an irreducible hernia where the abdominal contents become trapped in the extraabdominal sac. This means that the hernia cannot be manually reduced or pushed back into the abdominal cavity. It is important to address an incarcerated hernia promptly as it can lead to complications such as bowel obstruction or strangulation, which can compromise blood flow to the trapped tissues and result in tissue death.

Explanation

An incarcerated hernia refers to an irreducible hernia where the abdominal contents become trapped in the extraabdominal sac. This means that the hernia cannot be manually reduced or pushed back into the abdominal cavity. It is important to address an incarcerated hernia promptly as it can lead to complications such as bowel obstruction or strangulation, which can compromise blood flow to the trapped tissues and result in tissue death.

76. 781. Mersilene is a(n)

Wire mesh

Absorbable suture

Nonabsorbable suture

Synthetic mesh

Mersilene is a synthetic mesh. Synthetic meshes are made from artificial materials and are used in various medical procedures, such as hernia repairs and pelvic organ prolapse surgeries. They are designed to provide support and reinforcement to weakened or damaged tissues. Mersilene, specifically, is a brand name for a type of synthetic mesh commonly used in surgical procedures. It is known for its strength, durability, and biocompatibility, making it an effective option for providing long-term support and stability.

Explanation

Mersilene is a synthetic mesh. Synthetic meshes are made from artificial materials and are used in various medical procedures, such as hernia repairs and pelvic organ prolapse surgeries. They are designed to provide support and reinforcement to weakened or damaged tissues. Mersilene, specifically, is a brand name for a type of synthetic mesh commonly used in surgical procedures. It is known for its strength, durability, and biocompatibility, making it an effective option for providing long-term support and stability.

77. 816. Which type of endoscopy camera produces the truest color?

One-chip

Two-chip

Three-chip

Four-chip

A three-chip endoscopy camera produces the truest color because it uses three separate image sensors to capture red, green, and blue light. This allows for accurate color reproduction and enhances the overall image quality. The three-chip technology minimizes color distortion and provides a more realistic representation of the visual field during endoscopic procedures.

Explanation

A three-chip endoscopy camera produces the truest color because it uses three separate image sensors to capture red, green, and blue light. This allows for accurate color reproduction and enhances the overall image quality. The three-chip technology minimizes color distortion and provides a more realistic representation of the visual field during endoscopic procedures.

78. 725. Peanuts and dissecting sponges are generally

Used dry

Moistened with saline

Moistened with water

Moistened with antibiotic solution

Peanuts and dissecting sponges are generally moistened with saline because saline solution is sterile and helps to prevent infection. Additionally, saline solution closely resembles the body's natural fluids, making it less irritating to tissues. Moistening with water may not provide the same level of sterility, and moistening with antibiotic solution may be unnecessary unless there is a specific infection concern.

Explanation

Peanuts and dissecting sponges are generally moistened with saline because saline solution is sterile and helps to prevent infection. Additionally, saline solution closely resembles the body's natural fluids, making it less irritating to tissues. Moistening with water may not provide the same level of sterility, and moistening with antibiotic solution may be unnecessary unless there is a specific infection concern.

79. 783. All of the following statements refer to pilonidal cyst surgery EXCEPT

It is performed with an elliptical incision

The wound frequently heals by granulation

Probes are required on setup

The cyst is removed, but the tract remains

The correct answer is "the cyst is removed, but the tract remains." This means that during pilonidal cyst surgery, the cyst itself is removed, but the tract (or channel) that connects the cyst to the skin is not removed. The other statements are all true: the surgery is performed with an elliptical incision, the wound often heals by granulation, and probes are required during the setup of the surgery.

Explanation

The correct answer is "the cyst is removed, but the tract remains." This means that during pilonidal cyst surgery, the cyst itself is removed, but the tract (or channel) that connects the cyst to the skin is not removed. The other statements are all true: the surgery is performed with an elliptical incision, the wound often heals by granulation, and probes are required during the setup of the surgery.

80. 818. Defogging the video camera is usually the responsibility of the

Circulator

Surgeon

Scrub person

Camera operator

The camera operator is responsible for defogging the video camera. This means that they are in charge of removing any fog or condensation that may have formed on the camera lens, ensuring clear and high-quality footage. The circulator, surgeon, and scrub person have different roles in the operating room and are not directly responsible for defogging the camera.

Explanation

The camera operator is responsible for defogging the video camera. This means that they are in charge of removing any fog or condensation that may have formed on the camera lens, ensuring clear and high-quality footage. The circulator, surgeon, and scrub person have different roles in the operating room and are not directly responsible for defogging the camera.

81. 751. A common complication of extubation is

Hypotension

Tachypnea

Hypoxia

Hypercapnia

Hypoxia refers to a condition where there is a deficiency of oxygen supply to the body tissues. Extubation, the process of removing a breathing tube, can lead to hypoxia as it may cause a decrease in the amount of oxygen reaching the lungs. This can occur due to various reasons such as airway obstruction, inadequate respiratory effort, or respiratory muscle weakness. Hypoxia is a common complication of extubation and can have serious consequences if not promptly addressed.

Explanation

Hypoxia refers to a condition where there is a deficiency of oxygen supply to the body tissues. Extubation, the process of removing a breathing tube, can lead to hypoxia as it may cause a decrease in the amount of oxygen reaching the lungs. This can occur due to various reasons such as airway obstruction, inadequate respiratory effort, or respiratory muscle weakness. Hypoxia is a common complication of extubation and can have serious consequences if not promptly addressed.

82. 771. A lower oblique incision is a(n)

Pfannenstiel

Inguinal

Paramedian

Midabdominal

A lower oblique incision refers to an incision made in the lower part of the abdomen, specifically in the inguinal region. This type of incision is commonly used in surgeries involving the groin area, such as hernia repairs or lymph node removal. The inguinal region is located on either side of the lower abdomen, near the crease between the thigh and the abdomen. By making an incision in this area, surgeons can gain access to the underlying structures with minimal damage to surrounding tissues.

Explanation

A lower oblique incision refers to an incision made in the lower part of the abdomen, specifically in the inguinal region. This type of incision is commonly used in surgeries involving the groin area, such as hernia repairs or lymph node removal. The inguinal region is located on either side of the lower abdomen, near the crease between the thigh and the abdomen. By making an incision in this area, surgeons can gain access to the underlying structures with minimal damage to surrounding tissues.

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

Babcock

Lahey

Green

Jackson

A Lahey instrument is used to elevate the thyroid lobe during surgical excision. This instrument is specifically designed for this purpose and allows surgeons to safely and effectively lift and manipulate the thyroid lobe during the procedure. It is named after the surgeon who developed it, Dr. Lahey.

Explanation

A Lahey instrument is used to elevate the thyroid lobe during surgical excision. This instrument is specifically designed for this purpose and allows surgeons to safely and effectively lift and manipulate the thyroid lobe during the procedure. It is named after the surgeon who developed it, Dr. Lahey.

84. 808. In a thyroidectomy, a loop retractor retracts the

Platysma muscle

Cervical fascia

Thyroid veins

Sternocleidomastoid muscle

In a thyroidectomy, a loop retractor is used to retract the sternocleidomastoid muscle. This muscle is located in the neck and plays a crucial role in head and neck movements. By retracting the sternocleidomastoid muscle, surgeons can gain better access to the thyroid gland, which is the target of the thyroidectomy procedure. This allows them to safely remove the thyroid gland while minimizing damage to surrounding structures. The platysma muscle, cervical fascia, and thyroid veins are not directly involved in the retraction process during a thyroidectomy.

Explanation

In a thyroidectomy, a loop retractor is used to retract the sternocleidomastoid muscle. This muscle is located in the neck and plays a crucial role in head and neck movements. By retracting the sternocleidomastoid muscle, surgeons can gain better access to the thyroid gland, which is the target of the thyroidectomy procedure. This allows them to safely remove the thyroid gland while minimizing damage to surrounding structures. The platysma muscle, cervical fascia, and thyroid veins are not directly involved in the retraction process during a thyroidectomy.

85. 775. What incision is indicated for an esophagogastrectomy?

Left paramedian

Upper vertical midline

Thoracoabdominal

Full midabdominal

A thoracoabdominal incision is indicated for an esophagogastrectomy. This type of incision allows access to both the thoracic and abdominal cavities, which is necessary for the removal of the esophagus and stomach. By using a thoracoabdominal incision, surgeons can effectively reach and remove the affected organs while minimizing the risk of complications. Other incisions, such as left paramedian, upper vertical midline, or full midabdominal, may not provide adequate access or visibility for this procedure.

Explanation

A thoracoabdominal incision is indicated for an esophagogastrectomy. This type of incision allows access to both the thoracic and abdominal cavities, which is necessary for the removal of the esophagus and stomach. By using a thoracoabdominal incision, surgeons can effectively reach and remove the affected organs while minimizing the risk of complications. Other incisions, such as left paramedian, upper vertical midline, or full midabdominal, may not provide adequate access or visibility for this procedure.

86. 792. A benign anal wall "slit" type of lesion requiring excision is a(n)

Hemorrhoid

Anal fistula

Anal fissure

Pilonidal sinus

An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools. It is a common condition that can cause pain and discomfort during bowel movements. Treatment typically involves conservative measures such as increasing fiber intake and using stool softeners. In some cases, if the fissure does not heal on its own, surgical intervention may be necessary to excise the lesion. The other options listed, hemorrhoid, anal fistula, and pilonidal sinus, are different types of anal conditions that would not typically require excision for treatment.

Explanation

An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools. It is a common condition that can cause pain and discomfort during bowel movements. Treatment typically involves conservative measures such as increasing fiber intake and using stool softeners. In some cases, if the fissure does not heal on its own, surgical intervention may be necessary to excise the lesion. The other options listed, hemorrhoid, anal fistula, and pilonidal sinus, are different types of anal conditions that would not typically require excision for treatment.

87. 736. Transduodenal sphincterotomy refers to the incision made into the ________ to relieve stenosis.

Cardiac sphincter

Ileocecal sphincter

Sphincter of Oddi

Phyloric sphincter

Transduodenal sphincterotomy refers to the incision made into the sphincter of Oddi to relieve stenosis. The sphincter of Oddi is a muscular valve that controls the flow of bile and pancreatic juice into the duodenum. Stenosis refers to the narrowing or constriction of a passage, in this case, the sphincter of Oddi. By making an incision into the sphincter, the stenosis can be relieved, allowing for better flow of bile and pancreatic juice into the duodenum.

Explanation

Transduodenal sphincterotomy refers to the incision made into the sphincter of Oddi to relieve stenosis. The sphincter of Oddi is a muscular valve that controls the flow of bile and pancreatic juice into the duodenum. Stenosis refers to the narrowing or constriction of a passage, in this case, the sphincter of Oddi. By making an incision into the sphincter, the stenosis can be relieved, allowing for better flow of bile and pancreatic juice into the duodenum.

88. 764. Gastrointestinal technique is required in all of the following procedures EXCEPT

Cholecystectomy

Low anterior colon resection

Appendectomy

Hemicolectomy

Gastrointestinal technique is not required in cholecystectomy because it is a surgical procedure to remove the gallbladder, which is not a part of the gastrointestinal system. On the other hand, low anterior colon resection, appendectomy, and hemicolectomy all involve the gastrointestinal system and therefore require gastrointestinal technique.

Explanation

Gastrointestinal technique is not required in cholecystectomy because it is a surgical procedure to remove the gallbladder, which is not a part of the gastrointestinal system. On the other hand, low anterior colon resection, appendectomy, and hemicolectomy all involve the gastrointestinal system and therefore require gastrointestinal technique.

89. 796. Vaporization and coagulation of hemorrhoidal tissue can be accomplished with

Cautery, bipolar

Cautery monopolar

CO2 laser

Cryosurgery

The CO2 laser is capable of vaporizing and coagulating hemorrhoidal tissue. This laser uses a carbon dioxide gas mixture to produce a beam of infrared light that can be focused and controlled for precise surgical procedures. The laser energy is absorbed by the water in the tissue, causing it to vaporize and coagulate, resulting in the removal or shrinkage of the hemorrhoids. This method is often preferred due to its precision, minimal bleeding, and reduced postoperative pain compared to other techniques such as cautery or cryosurgery.

Explanation

The CO2 laser is capable of vaporizing and coagulating hemorrhoidal tissue. This laser uses a carbon dioxide gas mixture to produce a beam of infrared light that can be focused and controlled for precise surgical procedures. The laser energy is absorbed by the water in the tissue, causing it to vaporize and coagulate, resulting in the removal or shrinkage of the hemorrhoids. This method is often preferred due to its precision, minimal bleeding, and reduced postoperative pain compared to other techniques such as cautery or cryosurgery.

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

Pyloromyotomy

Pyloroplasty

Billroth I

Billroth II

Pyloroplasty is the surgical procedure that involves enlarging the passage between the prepylorus of the stomach and the duodenum. This procedure is performed to treat conditions such as pyloric stenosis, where the muscle at the lower end of the stomach becomes thickened and obstructs the passage of food into the small intestine. Pyloroplasty involves making an incision in the pylorus and then suturing it in a way that widens the opening, allowing for improved gastric emptying.

Explanation

Pyloroplasty is the surgical procedure that involves enlarging the passage between the prepylorus of the stomach and the duodenum. This procedure is performed to treat conditions such as pyloric stenosis, where the muscle at the lower end of the stomach becomes thickened and obstructs the passage of food into the small intestine. Pyloroplasty involves making an incision in the pylorus and then suturing it in a way that widens the opening, allowing for improved gastric emptying.

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

Direct

Umbilical

Spigelian

Indirect

An indirect hernia is a type of hernia that leaves the abdominal cavity at the internal inguinal ring and passes with the cord structures down the inguinal canal. This type of hernia occurs when the abdominal contents, such as the intestines, protrude through a weakness in the abdominal wall. Unlike a direct hernia, which occurs due to a weakness in the posterior wall of the inguinal canal, an indirect hernia occurs due to a congenital weakness in the abdominal wall.

Explanation

An indirect hernia is a type of hernia that leaves the abdominal cavity at the internal inguinal ring and passes with the cord structures down the inguinal canal. This type of hernia occurs when the abdominal contents, such as the intestines, protrude through a weakness in the abdominal wall. Unlike a direct hernia, which occurs due to a weakness in the posterior wall of the inguinal canal, an indirect hernia occurs due to a congenital weakness in the abdominal wall.

92. 798. A surgical procedure performed to relieve esophageal obstruction caused by cardiospasm is an

Esophagectomy

Esophagogastrectomy

Esophagomyotomy

Esophagogastrostomy

Esophagomyotomy is the correct answer because it involves the surgical removal or cutting of the muscles of the lower esophageal sphincter to relieve the obstruction caused by cardiospasm. This procedure helps to open up the esophagus and allow for the smooth passage of food and liquids into the stomach. Esophagectomy involves the removal of the entire esophagus, esophagogastrectomy is the removal of a portion of the esophagus and stomach, and esophagogastrostomy is the surgical connection between the esophagus and the stomach.

Explanation

Esophagomyotomy is the correct answer because it involves the surgical removal or cutting of the muscles of the lower esophageal sphincter to relieve the obstruction caused by cardiospasm. This procedure helps to open up the esophagus and allow for the smooth passage of food and liquids into the stomach. Esophagectomy involves the removal of the entire esophagus, esophagogastrectomy is the removal of a portion of the esophagus and stomach, and esophagogastrostomy is the surgical connection between the esophagus and the stomach.

93. 749. A specially treated form of surgical gauze that has a hemostatic effect when buried in tissue is

Topical thrombin

Gelfoam

Human fibrin foam

Oxycel

Oxycel is a specially treated form of surgical gauze that has a hemostatic effect when buried in tissue. This means that when Oxycel is applied to a bleeding wound or surgical site, it helps to stop the bleeding by promoting clotting and sealing the blood vessels. It is commonly used in surgical procedures to control bleeding and promote faster healing.

Explanation

Oxycel is a specially treated form of surgical gauze that has a hemostatic effect when buried in tissue. This means that when Oxycel is applied to a bleeding wound or surgical site, it helps to stop the bleeding by promoting clotting and sealing the blood vessels. It is commonly used in surgical procedures to control bleeding and promote faster healing.

94. 774. The breast procedure performed to remove extensive benign disease is a(n)

Axillary node dissection

Simple mastectomy

Radical mastectomy

Modified radical mastectomy

A simple mastectomy is the breast procedure performed to remove extensive benign disease. This procedure involves the removal of the entire breast tissue, including the nipple and areola, but does not involve the removal of the lymph nodes. It is typically done when there is a large area of benign disease in the breast that cannot be effectively treated with other methods. Axillary node dissection, radical mastectomy, and modified radical mastectomy are not appropriate for removing extensive benign disease.

Explanation

A simple mastectomy is the breast procedure performed to remove extensive benign disease. This procedure involves the removal of the entire breast tissue, including the nipple and areola, but does not involve the removal of the lymph nodes. It is typically done when there is a large area of benign disease in the breast that cannot be effectively treated with other methods. Axillary node dissection, radical mastectomy, and modified radical mastectomy are not appropriate for removing extensive benign disease.

95. 738. Irrigating fluid used to flush the organ between harvest and transplantation of a liver is known as

Ringer's Lactate

Physiosol

Collin's

Normal saline

Collin's solution is used as an irrigating fluid to flush the liver between harvest and transplantation. It is a balanced salt solution that contains various electrolytes, such as potassium, sodium, and calcium, which help maintain the organ's physiological environment. Collin's solution also contains glucose, which provides energy to the liver cells during the transplantation process. This solution is commonly used in liver transplantation surgeries to preserve the organ's viability and ensure its successful transplantation.

Explanation

Collin's solution is used as an irrigating fluid to flush the liver between harvest and transplantation. It is a balanced salt solution that contains various electrolytes, such as potassium, sodium, and calcium, which help maintain the organ's physiological environment. Collin's solution also contains glucose, which provides energy to the liver cells during the transplantation process. This solution is commonly used in liver transplantation surgeries to preserve the organ's viability and ensure its successful transplantation.

96. 776. In which incision could retention sutures be used?

Vertical midline

McBurney

Transverse

Thoracoabdominal

Retention sutures are used to hold the edges of a surgical incision together and prevent them from separating. They are typically used in cases where there is a high risk of wound dehiscence or the need for prolonged wound support. The vertical midline incision is a common surgical approach that provides good exposure and access to the abdominal cavity. Therefore, retention sutures could be used in a vertical midline incision to ensure the wound remains closed and heals properly.

Explanation

Retention sutures are used to hold the edges of a surgical incision together and prevent them from separating. They are typically used in cases where there is a high risk of wound dehiscence or the need for prolonged wound support. The vertical midline incision is a common surgical approach that provides good exposure and access to the abdominal cavity. Therefore, retention sutures could be used in a vertical midline incision to ensure the wound remains closed and heals properly.

97. 805. "Scratch" marking is done in surgery of the

Chin

Eye

Breast

Thyroid

"Scratch" marking is done in surgery of the thyroid. This marking technique involves making small superficial scratches on the skin overlying the thyroid gland. These scratches serve as reference points for the surgeon during the procedure, helping them to accurately locate and identify the thyroid gland. This marking technique is particularly useful in cases where the thyroid gland may be difficult to visualize or palpate.

Explanation

"Scratch" marking is done in surgery of the thyroid. This marking technique involves making small superficial scratches on the skin overlying the thyroid gland. These scratches serve as reference points for the surgeon during the procedure, helping them to accurately locate and identify the thyroid gland. This marking technique is particularly useful in cases where the thyroid gland may be difficult to visualize or palpate.

98. 806. Fogarty biliary catheters are used to

Drain the gallbladder

Drain the common bile duct

Instill contrast media

Facilitate stone removal

Fogarty biliary catheters are specifically designed to facilitate stone removal. These catheters have an inflatable balloon at the tip which can be inflated to grip and extract stones from the biliary ducts. By inserting the catheter into the duct and inflating the balloon, the stones can be safely removed without the need for invasive surgery. This makes Fogarty biliary catheters a valuable tool in the management of biliary stones.

Explanation

Fogarty biliary catheters are specifically designed to facilitate stone removal. These catheters have an inflatable balloon at the tip which can be inflated to grip and extract stones from the biliary ducts. By inserting the catheter into the duct and inflating the balloon, the stones can be safely removed without the need for invasive surgery. This makes Fogarty biliary catheters a valuable tool in the management of biliary stones.

99. 789. Portal pressure measurement is indicated in

Liver transplant

Splenectomy

Hepatic resection

Whipple operation

Portal pressure measurement is indicated in hepatic resection because this procedure involves the removal of a portion of the liver. Portal pressure is a measurement of the pressure within the portal vein, which carries blood from the digestive organs to the liver. By measuring portal pressure during hepatic resection, surgeons can assess the blood flow and pressure within the liver, which helps in evaluating the risk of postoperative complications such as bleeding or liver failure. This information is crucial in determining the feasibility and safety of the procedure.

Explanation

Portal pressure measurement is indicated in hepatic resection because this procedure involves the removal of a portion of the liver. Portal pressure is a measurement of the pressure within the portal vein, which carries blood from the digestive organs to the liver. By measuring portal pressure during hepatic resection, surgeons can assess the blood flow and pressure within the liver, which helps in evaluating the risk of postoperative complications such as bleeding or liver failure. This information is crucial in determining the feasibility and safety of the procedure.

100. 811. Which incision would require cutting through Scarpa's fascia?

Subcostal

Inguinal

Pfannenstiel

McBurney

The incision that would require cutting through Scarpa's fascia is the inguinal incision. Scarpa's fascia is a layer of connective tissue located in the lower abdomen, specifically in the inguinal region. It lies superficial to the muscles and deep to the subcutaneous tissue. The inguinal incision is commonly used for procedures involving the groin area, such as hernia repairs. Cutting through Scarpa's fascia allows access to the underlying structures while providing a barrier to prevent infection and promote proper healing.

Explanation

The incision that would require cutting through Scarpa's fascia is the inguinal incision. Scarpa's fascia is a layer of connective tissue located in the lower abdomen, specifically in the inguinal region. It lies superficial to the muscles and deep to the subcutaneous tissue. The inguinal incision is commonly used for procedures involving the groin area, such as hernia repairs. Cutting through Scarpa's fascia allows access to the underlying structures while providing a barrier to prevent infection and promote proper healing.

101. 778. In which hernia does the herniation protrude into the inguinal canal but not the cord?

Incisional

Femoral

Direct

Indirect

Direct hernias occur when abdominal contents protrude through a weakness in the abdominal wall, specifically the inguinal canal. However, in direct hernias, the herniation does not extend into the spermatic cord. This is in contrast to indirect hernias, where the herniation does extend into the cord. Therefore, the correct answer is direct.

Explanation

Direct hernias occur when abdominal contents protrude through a weakness in the abdominal wall, specifically the inguinal canal. However, in direct hernias, the herniation does not extend into the spermatic cord. This is in contrast to indirect hernias, where the herniation does extend into the cord. Therefore, the correct answer is direct.

102. 788. A subphrenic abscess occurs in the

Pancreas

Spleen

Lung

Liver

A subphrenic abscess refers to an accumulation of pus in the space between the diaphragm and the liver. This condition typically occurs as a complication of an infection or inflammation in the abdomen, such as a perforated appendix or a ruptured gastric ulcer. The liver is located in the upper right quadrant of the abdomen, adjacent to the diaphragm, making it susceptible to this type of abscess. The pancreas, spleen, and lung are not anatomically positioned in a way that would lead to a subphrenic abscess.

Explanation

A subphrenic abscess refers to an accumulation of pus in the space between the diaphragm and the liver. This condition typically occurs as a complication of an infection or inflammation in the abdomen, such as a perforated appendix or a ruptured gastric ulcer. The liver is located in the upper right quadrant of the abdomen, adjacent to the diaphragm, making it susceptible to this type of abscess. The pancreas, spleen, and lung are not anatomically positioned in a way that would lead to a subphrenic abscess.

103. 760. The term transduodenal sphincterotomy indicates surgery of the

Hepatic duct

Proximal end of the common bile duct

Distal end of the common bile duct

Pyloric sphincter

Transduodenal sphincterotomy refers to a surgical procedure performed on the distal end of the common bile duct. This procedure involves making an incision in the sphincter of Oddi, which is a muscular valve that controls the flow of bile from the common bile duct into the duodenum. By performing a sphincterotomy, the surgeon can widen the opening of the sphincter and improve the flow of bile, which can be beneficial in cases of bile duct obstruction or gallstone removal. The other options mentioned, such as the hepatic duct, proximal end of the common bile duct, and pyloric sphincter, are not specifically related to transduodenal sphincterotomy.

Explanation

Transduodenal sphincterotomy refers to a surgical procedure performed on the distal end of the common bile duct. This procedure involves making an incision in the sphincter of Oddi, which is a muscular valve that controls the flow of bile from the common bile duct into the duodenum. By performing a sphincterotomy, the surgeon can widen the opening of the sphincter and improve the flow of bile, which can be beneficial in cases of bile duct obstruction or gallstone removal. The other options mentioned, such as the hepatic duct, proximal end of the common bile duct, and pyloric sphincter, are not specifically related to transduodenal sphincterotomy.

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

Percutaneous endoscopic gastrostomy (PEG) procedure

Gastrotomy

Gastrostomy

Gastrojejunostomy

A palliative invasive procedure done to prevent malnutrition or starvation is known as gastrostomy. This procedure involves creating an opening in the stomach through the abdominal wall to provide a way for nutrition to be delivered directly into the stomach. It is commonly used in patients who are unable to eat or swallow properly due to various medical conditions, allowing them to receive the necessary nutrients and fluids. The other options mentioned, percutaneous endoscopic gastrostomy (PEG) procedure, gastrotomy, and gastrojejunostomy, are not specifically focused on preventing malnutrition or starvation.

Explanation

A palliative invasive procedure done to prevent malnutrition or starvation is known as gastrostomy. This procedure involves creating an opening in the stomach through the abdominal wall to provide a way for nutrition to be delivered directly into the stomach. It is commonly used in patients who are unable to eat or swallow properly due to various medical conditions, allowing them to receive the necessary nutrients and fluids. The other options mentioned, percutaneous endoscopic gastrostomy (PEG) procedure, gastrotomy, and gastrojejunostomy, are not specifically focused on preventing malnutrition or starvation.