FLS EXAM QUESTIONS AND CORRECT
ANSWERS ALREADY PASSED
Which procedure may be performed using local anesthesia alone or with mild sedation?
- Answer-diagnostic laparoscopy
Important features in patient positioning for laparoscopic surgery include: - Answer-
avoidance of position related complications, prevention of DVT, and location of target
organ
The most commonly used anesthetic for laparoscopic procedures is general anesthesia.
all of the following are true EXCEPT - Answer-there are fewer hemodynamic changes
compared to a local anesthetic (true answers are it allows for complete neuromuscular
relaxation, it provides good control of ventilation, an tit allows for more flexibility of
patient positioning)
What is the most common site for initial trocar insertion? - Answer-umbilicus
When checking placement of Veress needle, which of the following is the most accurate
method to detect proper intraperitoneal placement? - Answer-insufflator display
revealing flow of CO2 and low initial pressure
Umbilical Veress needle insertion and blind tracer insertion is contraindicated in all of
the following EXCEPT? - Answer-previous open cholecystectomy via right subcostal
incision (correct answers include previous left hemicolectomy through midline incision,
previous hysterectomy through midline incision, previous Crohn's disease with
enterocutaneous fistula, and previous umbilical hernia repair
What is the best area for alternate Veress needle insertion relative to a midline vertical
scar? - Answer-Palmer's point
Extra caution must be taken when placing the Veress needle and primary trocar in the
midline such as at the umbilicus due to concerns with injury to what organ? - Answer-
Aorta (and IVC)
When should a check for venous bleeding be performed? - Answer-during final
abdominal inspection, while releasing abdominal pressure, and during trocar removal
Once the operative procedure is finished, the surgeon should check which of the
following areas before exiting the abdomen? - Answer-the operative field, the
, dependent portions of the abdomen away from the field of view at the operative site,
and the abdominal wall a each port site once the port has been removed
What are reasons to close the fascia of tracer sites? - Answer-prevention of hernia
which of the following is most likely due to the pressure effects of pneumoperitoneum? -
Answer-bradycardia
when a patient is experiencing gas embolism, would is the appropriate emergency
position? - Answer-left lateral decubitus, head lowered
development of hypercarbia is influenced by which of the following? - Answer-the body's
buffer system, the patient's pulmonary system, and extraperitoneal insufflation
which of the following is NOT a sign of gas embolism? - Answer-bradycardia (correct
signs are hypotension, tachycardia, mill wheel murmur, and JVD)
significant cardiovascular effects of pneumoperitoneum can be caused by? - Answer-
pressure of the pneumoperitoenum, patient position, and acid-base disturbances from
CO2
pneumoperitoneum affects ventilation in all of the following ways EXCEPT: - Answer-
hypocapnea (correct ways include reduced pulmonary compliance, increased peak
airway pressure, and reduced functional residual capacity)
smaller tissue area, greater current density and faster heating - Answer-e.g. Bovie tip
Cut mode - Answer-- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly; cell water converts to steam and causes cell to explode
Coagulation mode - Answer-- High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis
- Non-contact: relies on sparking to tissue
Capacitive coupling - Answer-Transfer current from active electrode through insulation
to passive electrode- electrode to plastic part another LSC instrument
- if constant contact w/ tissue will not store energy and no injury
Direct coupling - Answer-monopolar instrument in direct contact w/ metal portion of
another instrument
ANSWERS ALREADY PASSED
Which procedure may be performed using local anesthesia alone or with mild sedation?
- Answer-diagnostic laparoscopy
Important features in patient positioning for laparoscopic surgery include: - Answer-
avoidance of position related complications, prevention of DVT, and location of target
organ
The most commonly used anesthetic for laparoscopic procedures is general anesthesia.
all of the following are true EXCEPT - Answer-there are fewer hemodynamic changes
compared to a local anesthetic (true answers are it allows for complete neuromuscular
relaxation, it provides good control of ventilation, an tit allows for more flexibility of
patient positioning)
What is the most common site for initial trocar insertion? - Answer-umbilicus
When checking placement of Veress needle, which of the following is the most accurate
method to detect proper intraperitoneal placement? - Answer-insufflator display
revealing flow of CO2 and low initial pressure
Umbilical Veress needle insertion and blind tracer insertion is contraindicated in all of
the following EXCEPT? - Answer-previous open cholecystectomy via right subcostal
incision (correct answers include previous left hemicolectomy through midline incision,
previous hysterectomy through midline incision, previous Crohn's disease with
enterocutaneous fistula, and previous umbilical hernia repair
What is the best area for alternate Veress needle insertion relative to a midline vertical
scar? - Answer-Palmer's point
Extra caution must be taken when placing the Veress needle and primary trocar in the
midline such as at the umbilicus due to concerns with injury to what organ? - Answer-
Aorta (and IVC)
When should a check for venous bleeding be performed? - Answer-during final
abdominal inspection, while releasing abdominal pressure, and during trocar removal
Once the operative procedure is finished, the surgeon should check which of the
following areas before exiting the abdomen? - Answer-the operative field, the
, dependent portions of the abdomen away from the field of view at the operative site,
and the abdominal wall a each port site once the port has been removed
What are reasons to close the fascia of tracer sites? - Answer-prevention of hernia
which of the following is most likely due to the pressure effects of pneumoperitoneum? -
Answer-bradycardia
when a patient is experiencing gas embolism, would is the appropriate emergency
position? - Answer-left lateral decubitus, head lowered
development of hypercarbia is influenced by which of the following? - Answer-the body's
buffer system, the patient's pulmonary system, and extraperitoneal insufflation
which of the following is NOT a sign of gas embolism? - Answer-bradycardia (correct
signs are hypotension, tachycardia, mill wheel murmur, and JVD)
significant cardiovascular effects of pneumoperitoneum can be caused by? - Answer-
pressure of the pneumoperitoenum, patient position, and acid-base disturbances from
CO2
pneumoperitoneum affects ventilation in all of the following ways EXCEPT: - Answer-
hypocapnea (correct ways include reduced pulmonary compliance, increased peak
airway pressure, and reduced functional residual capacity)
smaller tissue area, greater current density and faster heating - Answer-e.g. Bovie tip
Cut mode - Answer-- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly; cell water converts to steam and causes cell to explode
Coagulation mode - Answer-- High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis
- Non-contact: relies on sparking to tissue
Capacitive coupling - Answer-Transfer current from active electrode through insulation
to passive electrode- electrode to plastic part another LSC instrument
- if constant contact w/ tissue will not store energy and no injury
Direct coupling - Answer-monopolar instrument in direct contact w/ metal portion of
another instrument
